Nutritional support in chronic pancreatitis. Literature review.

Malnutrition in chronic pancreatitis is a complex and multifactorial problem and is accompanied by malabsorption, pain syndrome, severe metabolic disorders and concomitant diseases. The most common cause of chronic pancreatitis is alcohol abuse. Timely diagnostics based on anamnesis, physical, laboratory and instrumental examination data helps to avoid the development of severe protein-energy malnutrition. Before starting nutritional support, it is necessary to identify individual causes of weight loss. The goal of nutritional support is to treat malnutrition and correct the cause of impaired absorption and digestion. This helps to prevent further development of protein-energy malnutrition. The patient's nutritional status should be assessed taking into account the clinical picture, results of functional tests, anthropometric and biochemical parameters. Isolated use of body mass index does not reflect the presence of sarcopenia in patients with obesity and chronic pancreatitis. To prevent and correct malnutrition, it is necessary to conduct enzyme replacement therapy, ensure sufficient caloric intake of the diet, adequate protein and micronutrient intake. If the usual diet is inadequate in providing nutrients, nutritional support must be prescribed. Enteral nutrition is considered the preferred method. Parenteral nutrition is indicated for patients with gastric outlet obstruction, fistula formation, and in cases of enteral nutrition intolerance. This approach helps prevent the development of nutritional deficiency, sarcopenia, and improve the quality of life of patients.