Maisam Abu-El-Haija1, Aliye Uc2, Steven L Werlin3, Alvin Jay Freeman4, Miglena Georgieva5, Danijela Jojkić-Pavkov6, Daina Kalnins7, Brigitte Kochavi8, Bart G P Koot9, Stephanie Van Biervliet10, Jaroslaw Walkowiak11, Michael Wilschanski12, Veronique D Morinville13. 1. Division of Gastroenterology Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 2. Stead Family Children's Hospital, University of Iowa, Iowa City, IA. 3. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI. 4. Division of Gastroenterology, Hepatology and Nutrition, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA. 5. Second Pediatric Clinic, University Hospital St Marina, Varna, Bulgaria. 6. Department of Gastroenterology, Hepatology and Nutrition, Institute for Child and Youth Health Care of Vojvodina, Medical Faculty, University of Novi Sad, Novi Sad, Serbia. 7. Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada. 8. Pediatric Gastroenterology Unit, The Edmond and Lily Safra Children's Hospital, The Haim Sheba Medical Center, Ramat Gan, Israel. 9. Department of Pediatric Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands. 10. Pediatric Gastroenterology and Nutrition, Ghent University Hospital, Ghent, Belgium. 11. Department of Pediatric Gastroenterology & Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland. 12. Pediatric Gastroenterology, Hadassah Hebrew University Medical Center, Jerusalem, Israel. 13. Division of Pediatric Gastroenterology and Nutrition, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Abstract
OBJECTIVES: Wide variations exist in how physicians manage the nutritional aspects of children affected by acute pancreatitis (AP), acute recurrent pancreatitis (ARP), and chronic (CP) pancreatitis. Better consensus for optimal management is needed. METHODS: This consensus statement on nutrition in pediatric pancreatic diseases was developed through a joint ESPGHAN-NASPGHAN working group that performed an evidence-based search of the literature on nutrition in AP, ARP, and CP with a focus on pediatrics. The literature was summarized, quality of evidence reviewed, and expert recommendations developed. The authorship met to discuss the evidence and statements. Voting on recommendations occurred over 2 rounds based on feedback. A consensus of at least 75% was required to approve a recommendation. Areas requiring further research were identified. RESULTS AND DISCUSSION: The literature on nutrition in pediatric pancreatitis is limited. Children with mild AP benefit from starting an early nutritional regimen in the course of the attack. Early nutrition should be attempted in severe AP when possible; enteral nutrition is preferred over parenteral nutrition. Children with ARP are likely to tolerate and benefit from a regular diet. Children with CP need ongoing assessment for growth and nutritional deficiencies, exocrine and endocrine insufficiencies. CONCLUSIONS: This document presents the first authoritative recommendations on nutritional considerations in pediatric pancreatitis. Future research should address the gaps in knowledge particularly relating to optimal nutrition for AP in children, role of diet or dietary supplements on recurrent attacks of pancreatitis and pain episodes, monitoring practices to detect early growth and nutritional deficiencies in CP and identifying risk factors that predispose children to these deficiencies.
OBJECTIVES: Wide variations exist in how physicians manage the nutritional aspects of children affected by acute pancreatitis (AP), acute recurrent pancreatitis (ARP), and chronic (CP) pancreatitis. Better consensus for optimal management is needed. METHODS: This consensus statement on nutrition in pediatric pancreatic diseases was developed through a joint ESPGHAN-NASPGHAN working group that performed an evidence-based search of the literature on nutrition in AP, ARP, and CP with a focus on pediatrics. The literature was summarized, quality of evidence reviewed, and expert recommendations developed. The authorship met to discuss the evidence and statements. Voting on recommendations occurred over 2 rounds based on feedback. A consensus of at least 75% was required to approve a recommendation. Areas requiring further research were identified. RESULTS AND DISCUSSION: The literature on nutrition in pediatric pancreatitis is limited. Children with mild AP benefit from starting an early nutritional regimen in the course of the attack. Early nutrition should be attempted in severe AP when possible; enteral nutrition is preferred over parenteral nutrition. Children with ARP are likely to tolerate and benefit from a regular diet. Children with CP need ongoing assessment for growth and nutritional deficiencies, exocrine and endocrine insufficiencies. CONCLUSIONS: This document presents the first authoritative recommendations on nutritional considerations in pediatric pancreatitis. Future research should address the gaps in knowledge particularly relating to optimal nutrition for AP in children, role of diet or dietary supplements on recurrent attacks of pancreatitis and pain episodes, monitoring practices to detect early growth and nutritional deficiencies in CP and identifying risk factors that predispose children to these deficiencies.
Authors: V Tangpricha; A Kelly; A Stephenson; K Maguiness; J Enders; K A Robinson; B C Marshall; D Borowitz Journal: J Clin Endocrinol Metab Date: 2012-03-07 Impact factor: 5.958
Authors: André M Cantin; Terry B White; Carroll E Cross; Henry Jay Forman; Ronald J Sokol; Drucy Borowitz Journal: Free Radic Biol Med Date: 2006-09-29 Impact factor: 7.376
Authors: M Castiñeira-Alvariño; B Lindkvist; M Luaces-Regueira; J Iglesias-García; J Lariño-Noia; L Nieto-García; J E Domínguez-Muñoz Journal: Clin Nutr Date: 2013-02-08 Impact factor: 7.324
Authors: Amit S Grover; Alvin J Freeman; Maisam Abu-El-Haija; John F Eisses; Timothy B Gardner; Quin Y Liu; Mark E Lowe; Jaimie D Nathan; Tonya M Palermo; Vikesh K Singh; Andrew T Trout; Aliye Uc; Sohail Z Husain; Veronique D Morinville Journal: J Pediatr Gastroenterol Nutr Date: 2019-02 Impact factor: 2.839
Authors: Jan Stanisław Bukowski; Łukasz Dembiński; Marcin Dziekiewicz; Aleksandra Banaszkiewicz Journal: Nutrients Date: 2022-08-22 Impact factor: 6.706
Authors: Jutta Keller; Heinz F Hammer; Paul R Afolabi; Marc Benninga; Osvaldo Borrelli; Enrique Dominguez-Munoz; Dan Dumitrascu; Oliver Goetze; Stephan L Haas; Bruno Hauser; Daniel Pohl; Silvia Salvatore; Marc Sonyi; Nikhil Thapar; Kristin Verbeke; Mark R Fox Journal: United European Gastroenterol J Date: 2021-06-14 Impact factor: 4.623