Application Of Enteral Nutrition Prevention And Treatment Of Acute Pancreatitis And Intestinal Barrier Dysfunction

Compared to mild acute pancreastitis, severe acute pancreastitis has a severestate of illnesses and long time-course, due to the secondary infection andexcessive release of inflamematory cytokines, the case fatality is about 20percent.Gut is not only a digestive organ, but also an immune organ; the gut barrierfunction can prevent the invasion of the normal flora. Traditionally, in orderto avoid the stimulating of exocrine pancreas, fasting is performed inpancreastitis, although parenteral nutrition could provide enough energy andnitrogen source, there are complications of catheter-related infections, veinthrombi, and so on. Long-term parenteral nutrition could lead to the attenuateof intestinal peristalsis, lack of nutrition, gut barrier functional disturbance,bacterial and endotoxin translocation, stimulate the releasing of inflammatorycytokines, and finally aggravate the state of pancreastitis.Compared to parenteral nutrition, enteral nutrition could reduce thecomplication rate of infection and cost, shorten hospital length of stay. Despitethe nutritional support, enteral nutrition does not stimulate the exocrinepancreas, moreover, it can increase the blood flow to gut, decrease the intestinalpermeability and bacterial translocation, modulate the mediators of inflammationand cytokines, attenuate the level of endotoxin, recover the gut mechanicalbarrier, modulate systemic inflamematory response syndrome or multiple organdysfunction syndrome.In addition, the traditional Chinese medicine has advantage in augmentingintestinal peristalsis and protecting the gut barrier function.