An effective remedy for acute pancreatitis has so far not been found despite substantial efforts, and supportive care remains the prime treatment for it.
With this in mind, the review assessed recent advances in different nutritional interventions, as well as a number of supplements.
Patients administered glutamine tended to require shorter hospitalisation and reduced duration of total parenteral nutrition, as did patients given prebiotic fibre supplementation. The latter also saw a reduction in overall acute pancreatitis complications.
Probiotic supplementation, on the other hand, had contradictory effects on patients. Multispecies probiotic supplementation “did not reduce the risk of infectious complications and was associated with an increased risk of mortality”.
However, early enteral nutrition with Bifidobacterium reduced pro-inflammatory cytokines, improved gastrointestinal function, minimised complications, and led to a shorter hospital stay even for patients with severe acute pancreatitis.
Therefore, the review hypothesised that supplementation with single specific probiotic strains could benefit patients, but “should be further evaluated by validated clinical trials”.
The review also found that consumption of both lean and fatty fish “may be associated with decreased risk of non-gallstone-related” acute pancreatitis.
Additionally, supplementation containing soybean oil or fish oil decreased pro-inflammatory cytokines in patients.
"Although polyunsaturated fatty acids remain potential beneficial supplements...further larger trials are needed for formulations and confirmatory beneficial clinical effects," the review added.
The researchers also pointed to a study in China where high-dose vitamin C supplementation demonstrated therapeutic efficacy on the disease by promoting anti-oxidising capability in patients, blocking lipid peroxidation and improving cellular immune function.
However, they added that the effects of multiple vitamin therapy were inconclusive and said it should be carefully evaluated for dosing and timing.
The review concluded that due to the various clinical manifestations of acute pancreatitis, “precision medicine, although not much applied in the condition, remains a temping approach to optimise clinical outcomes on classified individuals based on susceptibility to the condition and its systemic complications.
"Various nutritional supplement(s) [are] a subject of interest for future evaluation and may lead to promising outcomes."
Source: Frontiers in Immunology
“Recent Advances on Nutrition in Treatment of Acute Pancreatitis”
Authors: Li-Long Pan, et al.
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