Clinical Nutrition in Gastrointestinal Disease

Alan Buchman, MD, MSPH

Chapter 22: Nutritional Support In Acute Pancreatitis (continued)

Stephen J.D. O'Keefe, MD, MSc, FRCP

It is essential to understand how acute pancreatitis occurs before attempts at nutritional support are conducted. Compelling evidence now exists that the root cause of acute pancreatitis is premature activation of trypsinogen within the acinar cell of the pancreas.1 Normally, proteolytic enzymes, such as trypsinogen, are stored within the acinar cells in an inactive form as zymogens. Following stimulation of the pancreas by the consumption of food, the trypsinogen is released from the cell and travels via the duct system into the intestine (Figure 22-1). Only once within the lumen is the…