Chronic Pancreatitis

Chronic pancreatitis results following the repeated attacks of acute pancreatitis and the effects of digestive enzymes on pancreas or may be associated with chronic inflammation of the biliary tract.

The causes of this condition are neglect of acute pancreatitis, alcohol abuse, excessive iron in the blood and other unknown factors.

The common symptoms of chronic pancreatitis are pain, malabsorption, weight loss, malnutrition and steatorrhoea.

The goals of nutritional management of this condition are to provide rest to pancreas, prevention of diabetes, enteral supplementation, diet control and special feeding.

Pancreatic enzyme supplementation is important in long term patient management and it helps to control and reduce malabsorption.

The dietary guidelines include:

Nutrients	Note
Calories	35 Kcal/kg IBW is ascertained keeping in mind the moderate stressful state.
Fats	Low fat diet. 40-60 g/day. Parenteral administration of fat-soluble vitamin is necessary.
Calcium and Vitamin B12	To prevent deficiency

Important guidelines for managing chronic pancreatitis:

• Avoid alcohol
• Avoid meal with a high fat content. Use MCTs in severe steatorrhoea.
• Give adequate energy and protein intake.
• Monitor blood glucose levels regularly.
• Give vitamin and mineral supplementation (fat soluble vitamins, folic acid and calcium).
• Pancreatic enzyme supplementation should be taken adjusted to quantity of food and fat content of meals.

Post by Faiz Lahori