医学
营养不良
卡路里
微量营养素
胰腺炎
医学营养疗法
人体测量学
观察研究
糖尿病
内科学
重症监护医学
内分泌学
病理
作者
Rupjyoti Talukdar,Misbah Unnisa
出处
期刊:Current Opinion in Gastroenterology
[Ovid Technologies (Wolters Kluwer)]
日期:2022-09-01
卷期号:38 (5): 495-500
被引量:1
标识
DOI:10.1097/mog.0000000000000866
摘要
This review aims to discuss recent developments in the nutritional management in chronic pancreatitis.Nutritional assessment should be comprehensive and include dietary history, anthropometry, and biochemical nutritional parameters. Micronutrients should be evaluated at least yearly and dual-energy X-ray absorptiometry (DEXA) at every 2-yearly intervals. Studies on pancreatic enzyme replacement therapy (PERT) have primarily evaluated coefficient of fat excretion (CFA), coefficient of nitrogen excretion (CNA), and stool weight. Two RCTs, in which patients were treated with PERT for 7 days in a blinded manner and subsequently extended for 6-12 months in an open-label manner, showed improvement in nutritional parameters. However, two subsequent RCTs failed to show any benefit, and the most recent observational study demonstrated persistence of malnutrition even after PERT. The reason for the latter findings were nonadherence to PERT and poor oral intake of calories. Therefore, it is essential to educate the patients on adherence, counsel on taking high-protein, high-calorie diet, and supplement nutrients in those with inadequate oral intake. Other associated manifestations, such as diabetes and related complications, and anxiety/depression could also contribute to malnutrition directly or indirectly, and should, therefore, be adequately managed.Nutritional assessment should be performed meticulously. Nutritional therapy should not be restricted to only PERT and nutritional supplementation, but should also include dietary counselling and disease related education.
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