Ernährungstherapie bei akuter und chronischer Pankreatitis – Update 2021

Pankreatitis ist ein häufiges Krankheitsbild. Mithilfe einer enteralen bzw. parenteralen Ernährung kann der Krankheitsverlauf positiv beeinflusst werden. Dieser Beitrag zeigt, welchen großen Stellenwert die individualisierte Ernährungsberatung hat, um eine adäquate Nahrungszufuhr sicherzustellen.

Abstract

In the western world acute pancreatitis is a frequent clinical entity. About 80 % of patients with acute pancreatitis develop an oedematous pancreatitis, whereas 20 % develop a severe and/or necrotizing pancreatitis: the later one, a potential life-threatening disease. In this case an enteral nutrition has been proven to improve the course of the disease. Usually, a gastric enteral nutrition via a nasogastric tube is possible; only in a minority a jejunal feeding is necessary due to a high gastric residual volume. If enteral feeding is not feasible within 5–7 days, parenteral nutrition has to be considered. In a mild pancreatitis oral feeding should be started according to clinical symptoms.

Chronic pancreatitis is characterized by reduced caloric intake and a high risk for malnutrition. Next to adequate pain management and pancreatic enzyme supplementation an individualized nutritional counselling should be provided with the aim to maintain caloric intake. In addition, a pancreoprivic diabetes can occur. Artificial feeding is uncommon.

Schlüsselwörter

Ernährung - akute Pankreatitis - chronische Pankreatitis - Ernährungsstatus - nekrotisierende Pankreatitistherapie

Keywords

nutrition - acute pancreatitis - chronic pancreatitis - nutritional status, - acute necrotizing/therapy

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