Pancreatitis is an acute inflammation of the pancreas in which pancreatic enzymes digest the pancreatic and surrounding tissues. This causes damage to the pancreas, surrounding fat and adjacent structures, which results in inflammation. Nausea and vomiting occur with a pancreatic attack.
Considerations
Pancreatitis can be acute or chronic. Acute pancreatitis usually results from a gallstone causing an obstruction; it occurs suddenly. Chronic pancreatitis is most commonly caused from alcohol abuse and occurs over a period of time.
Symptoms
According to "Sheehy's Emergency Nursing Principles and Practice," a clinical hallmark found in 90 percent of patients with pancreatitis is abdominal pain, originating in the epigastric area and radiating to the back. Pain seems to be worse when lying down and improves with sitting. In addition to pain, nausea and vomiting, patients may have a slight fever and increased heart rate. Blood tests will indicate elevated amylase and lipase levels during pancreatic attacks.
Acute Pancreatitis Attack
In acute cases of pancreatitis, the patient is admitted to the hospital and not allowed to eat anything by mouth to avoid stimulating the pancreas. Fluids are administered intravenously. Pain is controlled with intravenous medication and antibiotics are administered to help prevent infections. Once the pain is controlled for 24 hours, the patient is allowed to have a clear liquid diet. Over the next 2 to 3 days, the patient is allowed a soft diet and can progress to a regular diet if tolerated without a recurrence of pain. In severe cases, patients may require nutritional support with a feeding tube until the pain is controlled.
Chronic Pancreatitis
Patients with chronic pancreatitis have dull, abdominal pain that is intermittent and aggravated by food. Dietary recommendations for patients with chronic pancreatitis include a total abstinence from alcohol and an increase of protein and calories from fat and carbohydrates. During episodes of pain, patients are instructed to maintain a clear liquid diet for 24 to 48 hours. Some patients require pancreatic enzyme supplements with meals to improve protein absorption.
Food Specifics
High carbohydrate and low fat foods should be included as part of a regular diet for those with pancreatitis. Types of foods that are high in carbohydrates include all types of beans, breads and muffins, cereals and crackers. Potatoes, sweet potatoes and rice are good sources of carbohydrates. In the fruit category, apples and bananas, strawberries, raspberries and grapefruit are recommended. Limiting high fat foods such as red meat, can help decrease problems associated with pancreatitis (Reference 4). Patients with pancreatitis are encouraged to eat several small meals throughout the day instead of three large meals. Foods that should be avoided in pancreatitis include all alcoholic beverages, coffee and soda, and all processed deli meats. Onions, spinach and cabbage, in addition to canned foods are not included in pancreatic diets.
Nutritional Goals and Complications
According to "Nutrition and Diet Therapy," the goal of nutritional support is to meet the elevated metabolic demands as much as possible without stimulating pancreatic secretion. Complications of pancreatitis can include necrosis, or death of segments of the pancreas, and abscess formation.
References
- "Sheehy's Emergency Nursing Principles and Practice"; Mosby Elsevier; 2010
- "Nutrition and Diet Therapy"; F.A. Davis; 2011
- "Current Diagnosis and Treatment Emergency Medicine"; McGraw Hill; 2008
- Health and Nutrition Tips: Pancreatitis Diet
