La pancréatite aigüe

There are two types of pancreatitis: acute pancreatitis and chronic pancreatitis. According to the Canadian Digestive Health Foundation (FCSD) pancreatitis is a digestive disorder that affects one million Canadians. Of these, more than 300,000 are affected by chronic pancreatitis and over 600,000 are affected by acute pancreatitis. Let's learn more about the most common form of pancreatitis in Canada, acute pancreatitis.

Definition of acute pancreatitis

Acute pancreatitis is a gastrointestinal disorder characterized by sudden inflammation of the pancreas, an organ in the upper abdomen that produces digestive juices and insulin. The process that causes this disease to develop is the self-digestion of the pancreas by its own enzymes.

Causes of acute pancreatitis

The main causes of acute pancreatitis, responsible for over 70% of cases, are gallstones, about 40% of cases, and alcohol consumption, about 30% of cases. Other causes include, among others, genetic predisposition, the use of certain drugs and pancreatic cancer.

Classification of acute pancreatitis

Acute pancreatitis can be classified as mild, moderately severe, or severe depending on its severity.

Symptoms of acute pancreatitis

The main symptom of acute pancreatitis is severe pain in the upper abdomen. Individuals may also experience nausea, vomiting, sweating, abdominal distension, hypotension, difficulty in breathing, and increased heart rate. In severe acute pancreatitis, damage to other organs (eg, lungs, kidneys) and infection of the pancreas can also occur.

Diagnosis of acute pancreatitis

The diagnosis of acute pancreatitis is made by blood tests and imaging tests, such as computed tomography (CT) or ultrasound.

Treatment of acute pancreatitis

Treatment for acute pancreatitis requires hospitalization and usually includes intravenous fluids, pain medications, and nutritional support. Antiemetic drugs can also be given for nausea and vomiting. Finally, in some more severe cases, administration of antibiotics and surgery may also be necessary.

Nutritional approach for acute pancreatitis

The three main goals of nutritional intervention are to maintain or improve nutritional status, reduce symptoms, and decrease stimulation of the pancreas in order to put it to rest and minimize destruction.

Dietary recommendations for acute pancreatitis

  1. At first, no oral feeding.
  2. Then, in mild cases, oral feeding is started gradually as soon as it can be tolerated. The gradual recovery generally begins with a liquid or semi-liquid diet, before progressing to a solid diet, divided into several small daily meals according to the tolerance of each individual. When resuming food, a low fat diet is generally recommended for a few weeks to months or until there is no longer any sign of inflammation. Finally, it is also advisable to avoid all alcohol consumption.
  3. In more severe cases, enteral feeding (whichconsists of the delivery of a nutrient mixture directly into the digestive tract via a probe)is generally used. If enteral feeding is not possible, parenteral (whichconsists of the intravenous infusion of a nutrient mixture)is used. Then, when it can be tolerated, oral feeding is resumed gradually as in mild cases.

References

 

Article written by:

Marie-Noël Marsan, Nutritionist

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