Ms.Jeshma Santhosh, I M.Sc Foods and Nutrition
Introduction
The pancreas is a flat, elongated organ situated behind the stomach. Its primary functions are aiding in food digestion and controlling blood sugar levels in the body. Pancreatitis refers to the swelling and irritation of the pancreas, which is caused by immune system activity and can lead to discomfort, inflammation, and disruptions in the organ’s functioning. Pancreatitis, a condition where the pancreas becomes inflamed, is typically not the result of infections, but is instead often brought on by factors such as gallstones and excessive alcohol intake.
Types:
Acute pancreatitis – appears suddenly and generally last a short time.
Symptoms:
- Pain in the upper belly.
- Pain in the upper belly that radiates to the back.
- Tenderness when touching the belly.
- Fever.
- Rapid pulse.
- Upset stomach.
- Vomiting.
Causes:
- Blockage in the bile duct caused by gallstones.
- Heavy alcohol use.
- Certain medicines.
- High triglyceride levels in the blood.
- High calcium levels in the blood.
- Pancreas cancer.
- Injuries from trauma or surgery.
Chronic pancreatitis – it is a long-term condition. The damage to the pancreas may worse over time.
Symptoms:
- Pain in the upper belly.
- Belly pain that feels worse after eating.
- Losing weight without trying.
- Oily, smelly stools.
Causes:
- Damage from repeated acute pancreatitis.
- Heavy alcohol use.
- Inherited genes linked to pancreatitis.
- High triglyceride levels in the blood.
- High calcium levels in the blood
Risk factors:
Some factors that can elevate the chances of developing pancreatitis are excessive alcohol consumption, smoking, obesity, diabetes, and a family history of the disease. Studies have shown that consuming four or five drinks daily can raise the risk of pancreatitis, while smokers are three times more likely to develop chronic pancreatitis compared to non-smokers. Being obese, having diabetes, or having a family history of pancreatitis can also increase the risk.
Complications
Pancreatitis can cause serious complications, including:
- Kidney failure
- Breathing problems
- Infection
- Pseudocyst
- Malnutrition
- Diabetes
- Pancreatic cancer
Principles of diet
- Low calorie
- High protein
- Low carbohydrate
- Low fat
- High fluid
Nutritional Management :
ACUTE PANCREATITIS
- Withhold oral and enteral feeding
- Support with IV fluids
- If oral nutrition cannot be initiated in 5 to 7 days, nutrition support can be started
- For less severe cases of prolonged acute pancreatitis, tube feeding can be initiated using a defined formula diet.
For severe acute pancreatitis parenteral nutrition should be initiated.
- If triglycerides are <400 mg/ dL before parenteral nutrition initiation, 3 in 1 solution is used and triglyceride levels are moniotored.
- If triglycerides are elevated more than 400 mg/dL, dextrose-based solution is used. Serum glucose is monitored frequently and treat as needed with insulin.
Once oral nutrition is started, following can be provided
- Easily digestible foods
- Low fat diet
- 6 small meals
- Adequate protein intake
- Increased calories
CHRONIC PANCREATITIS
- Provide oral diet as in acute phase
- Tube feeding can be used when oral diet is inadequate
- Supplement pancreatic enzymes
- Supplement fat soluble vitamins and vitamin B12
Dietary Guidelines
- Include foods rich in B vitamins and iron such as whole grains, dark leafy greens (spinach and kale).
- Restrict refined foods such as sugar and refined wheat flour products.
- Include anti-oxidant rich foods such as blueberries, cherries and tomatoes.
- Reduce the consumption of red meats and include more lean meat or depend on pulses for protein.
- Avoid trans-fat foods especially found in bakery products.
- Use of cooking oil such as coconut oil and olive oil.
- Restrict alcohol, coffee, tobacco and other stimulants.
- The food must be bland, soft and well cooked.
- Increased fluid intake of 6 to 8 glasses of purified water per day.
- Moderate exercise for 30 minutes per day and 5 days a week is recommended.
Nutri Geode @ RVSCAS F&N 