Nutritional support in chronic pancreatitis: a review

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Abstract
Nutritional deficiency in chronic pancreatitis is a complex, multifactorial problem associated with malabsorption, pain, severe metabolic disturbances, and comorbid conditions. The most common cause of chronic pancreatitis is alcohol consumption. Timely diagnosis based on medical history, physical examination, and laboratory and instrumental findings helps prevent the development of severe protein–energy malnutrition. Before initiating nutritional support, it is essential to identify the individual causes of weight loss. The goal of nutritional support is to correct malnutrition and address the underlying causes of impaired digestion and absorption. It prevents further progression of protein–energy deficiency. Nutritional status should be assessed using clinical evaluation, functional tests, anthropometric measurements, and biochemical parameters. Body mass index alone does not adequately reflect the presence of sarcopenia in patients with obesity and chronic pancreatitis. Prevention and correction of nutritional deficiency require pancreatic enzyme replacement therapy, adequate caloric intake, and sufficient protein and micronutrient supply. If nutritional needs cannot be met through a regular diet, nutritional support should be initiated. Enteral nutrition is the preferred method. Parenteral nutrition is indicated in patients with gastric outlet obstruction, fistula formation, or intolerance to enteral feeding. This approach helps prevent malnutrition and sarcopenia and improves quality of life.

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