Clinical Nutrition in Gastrointestinal Disease

Alan Buchman, MD, MSPH

Chapter 21: Nutrition In Chronic Pancreatitis (continued)

William B. Evans, MD; Stephen A. McClave, MD

Chronic pancreatitis produces a prolonged inflammatory state, resulting in a steadily progressive destruction of the pancreatic gland. A multitude of factors, ranging from poor oral intake and hypermetabolism to malassimilation and endocrine dysfunction, predis-pose the patient with chronic pancreatitis to protein energy malnutrition (PEM). (Chapter 20 also discusses PEM.) The success of nutritional therapy is dependent on abstinence from alcohol and control of abdominal pain. Nutritional support varies depending on disease severity, from diet restriction with continued oral intake to…