Nutritional Considerations in Pediatric Pancreatitis: A Position Paper from the NASPHAN Pancreas Committee and ESPHAN Cystic Fibrosis/Pancreas Working Group

Maisam Abu-El-Haija; Aliye Uc; Steven Werlin; Alvin Freeman; Miglena Georgieva; Danijela Jojkić-Pavkov; Daina Kalnins; Brigitte Kochavi; Bart Koot; Stephanie Van Biervliet; Jaroslaw Walkowiak; Michael Wilschanski; Veronique Morinville

doi:10.1097/MPG.0000000000002023

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Nutritional Considerations in Pediatric Pancreatitis: A Position Paper from the NASPHAN Pancreas Committee and ESPHAN Cystic Fibrosis/Pancreas Working Group

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Nutritional Considerations in Pediatric Pancreatitis: A Position Paper from the NASPHAN Pancreas Committee and ESPHAN Cystic Fibrosis/Pancreas Working Group

Maisam Abu-El-Haija, Aliye Uc, Steven Werlin, Alvin Freeman, Miglena Georgieva, Danijela Jojkić-Pavkov, Daina Kalnins, Brigitte Kochavi, Bart Koot, Stephanie Van Biervliet, …

Journal of pediatric gastroenterology and nutrition, Vol.67(1), pp.131-143

07/2018

DOI: 10.1097/MPG.0000000000002023

PMID: 29927872

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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.

Details

Title: Subtitle: Nutritional Considerations in Pediatric Pancreatitis: A Position Paper from the NASPHAN Pancreas Committee and ESPHAN Cystic Fibrosis/Pancreas Working Group
Creators: Maisam Abu-El-Haija - Division of Gastroenterology Hepatology and Nutrition, Cincinnati Childrenʼs Hospital Medical Center, Cincinnati, OH
Aliye Uc - Stead Family Childrenʼs Hospital, University of Iowa, Iowa City, IA
Steven Werlin - Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
Alvin Freeman - Division of Gastroenterology, Hepatology and Nutrition, Childrenʼs Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA
Miglena Georgieva - Second Pediatric Clinic, University Hospital St Marina, Varna, Bulgaria
Danijela Jojkić-Pavkov - Department of Gastroenterology, Hepatology and Nutrition, Institute for Child and Youth Health Care of Vojvodina, Medical Faculty, University of Novi Sad, Novi Sad, Serbia
Daina Kalnins - Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada
Brigitte Kochavi - Pediatric Gastroenterology Unit, The Edmond and Lily Safra Childrenʼs Hospital, The Haim Sheba Medical Center, Ramat Gan, Israel
Bart Koot - Department of Pediatric Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands
Stephanie Van Biervliet - Pediatric Gastroenterology and Nutrition, Ghent University Hospital, Ghent, Belgium
Jaroslaw Walkowiak - Department of Pediatric Gastroenterology & Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
Michael Wilschanski - Pediatric Gastroenterology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
Veronique Morinville - Division of Pediatric Gastroenterology and Nutrition, Montreal Childrenʼs Hospital, McGill University Health Centre, Montreal, Quebec, Canada
Resource Type: Journal article
Publication Details: Journal of pediatric gastroenterology and nutrition, Vol.67(1), pp.131-143
DOI: 10.1097/MPG.0000000000002023
PMID: 29927872
NLM abbreviation: J Pediatr Gastroenterol Nutr
ISSN: 0277-2116
eISSN: 1536-4801
Publisher: by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology
Grant note: DOI: 10.13039/100006628, name: Mead Johnson Nutrition, award: NASPGHAN
Language: English
Date published: 07/2018
Academic Unit: Stead Family Department of Pediatrics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
Record Identifier: 9984046813702771

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