Pancreatitis refers to the inflammation of the pancreas and is
characterized by oedema, cellular exudates and fat necrosis. The disease can
range from mild and self-limiting to severe condition which results in auto
digestion, necrosis and haemorrhage of pancreatic tissue.
Acute pancreatitis results from
auto digestion of tissue and toxic effects of digestion products.
The causes of acute pancreatitis are biliary tract disease, such as
gallstones, alcohol abuse, trauma and hyperlipidemia (rarely).
The symptoms of this condition are continuous or intermittent pain of
varying intensity in the upper abdominal region that radiates to the back and
the symptoms worsen with ingestion of food, swollen and tender abdomen, nausea
and vomiting, steatorrhoea and malabsorption, sweating, fever, mild jaundice
and rapid pulse.
Some complications of this condition include low blood pressure, heart
failure, kidney failure, diabetes, ascitis and cysts in pancreas.
Parenteral nutrition and
metabolic support becomes essential in order to minimize mortality. The goals
of nutritional management in acute
pancreatitis are to provide rest to the pancreas and maintaining fluid balance,
maintaining nil-by-mouth till the pain and fever subsides, providing support to
the patient by early enteral nutrition with the formulation of nutrient in
predigested forms and supplementation with low fat intake, resorting to clear
fluid diet when starting oral feeds and maintaining a total fat intake of 30
g/day which maybe gradually increased as per the patient’s tolerance.
Decreased calcium levels are
observed during acute pancreatitis due to hypoalbuminemia and soap formation of
calcium with fatty acids created by fat necrosis.
Post by Faiz Lahori
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