ABSTRACT
Introduction: Acute pancreatitis is a potentially lethal disease with wide variation in severity ranging from mild and self-limiting to a rapidly progressive illness leading to multiorgan failure. In accordance with this wide variation in clinical presentation, the treatment of acute pancreatitis requires a multidisciplinary approach. Mild acute pancreatitis causes disturbance in the homeostatic mechanism of the body is minimal; the treatment is aimed at supporting the native reparative processes of the body. One of the main supportive mechanisms is adequate and safe nutritional supplementation. Objectives: To assess the occurrence of infective and non-infective complications in cases of acute pancreatitis on early enteral nutrition. Materials & Methods: This is a prospective study conducted on patients who were admitted to SSIMS AND RC Davangere with symptoms suggestive of acute pancreatitis from July 2019 to July 2021. Patients with a clinical picture consistent with the diagnosis of acute pancreatitis, along with more than a 3-fold elevation of serum amylase and elevated serum lipase were considered to have acute pancreatitis. After initial diagnosis and assessment, patients were duly informed regarding the study and consent was obtained. A 16-gauge nasogastric Ryle’s tube was inserted for all patients included in the study. The feeding patterns were initiated depending upon the severity of acute pancreatitis. Feeding was started after calculating the nutrition requirement. In the early feeding group, patients were given a protein powder to achieve a target nutrition in a stepwise manner. The tolerance to feeds, infective and non-infective complications and the time taken to start on an oral diet were noted and analysed. Results: The incidence of infective complications in our study was found to be 2% with none of the infections involving the pancreas itself. The incidence of non-infective complications in our study was found to be 30% with 13% involving the pancreas proper. Conclusions: The use of early enteral feeding does not influence the incidence of infective and non-infective complications in mild and moderate acute pancreatitis. Early enteral feeding delivers nutrition, in a simpler and more cost-effective. Nasogastric and oral feeding reduces the morbidity of the patient by accelerating the return to normal activities.