Author(s)

Shaffer R. S. Mok, Patricia Henry, Punitha Shivaprasad, Thomas A. Judge

Division of Gastroenterology, Department of Internal Medicine, Cooper Digestive Health Institute, Camden, United States of America.
Division of Internal Medicine, Department of Internal Medicine, Cooper University Hospital, Camden, United States of America.

Background: Supplemental nutrition improves long-term outcomes/mortality in acute pancreatitis, with Enteral Nutrition (EN) superior to Total Parenteral Nutrition (TPN). Differences in EN/TPN based upon etiology or disease severity have never been established. Methods: We performed a randomized retrospective case control on subjects admitted to Cooper University Hospital from 06/2007 to 01/2010 with acute pancreatitis who received supplemental nutrition (n = 161). These subjects were examined for caloric and protein demands. Subjects were matched for demographics, weight, albumin, prealbumin eliminating confounders. Demands among disease etiology/severity subgroups and statistical significance were determined. The incidence of EN v.TPN was determined. Results: Significant differences were found in total caloric demands, namely gallstone (n = 50) and alcohol (n = 36) (p = 0.04). Differences in protein demand were not established between these two groups (p = 0.24). Differences in caloric demand were found in bed-side index for severity in acute pancreatitis (BISAP) of 1, 2 and 3 versus 5. Protein demands were different between BISAP of 0 versus all others. 24% of the sample received EN. Conclu: sion: There are significant differences in total caloric demands for subjects with acute pancreatitis by disease severity and in gallstone versus alcohol-induced pancreatitis. These differences are not variations in the sample populations. Finally, EN is under-utilized despite knowledge of its value.

Nutrition; Pancreatitis; TPN; Enteral; BISAP

Mok, S. , Henry, P. , Shivaprasad, P. and Judge, T. (2012) The difference in enteral nutrition (EN) versus total parenteral nutrition (TPN) in acute pancreatitis by etiology and disease severity. Health, 4, 242-248. doi: 10.4236/health.2012.44039.