Pancreatitis

Question 1

What are the functions of the pancreas?

Answer 1

The pancreas has two main functions: an exocrine function that helps in digestion and an endocrine function that regulates blood sugar.

Question 2

What are the different disorders of the pancreas?

Answer 2

Acute/Chronic Pancreatitis - Necrotising pancreatitis

Pancreatic Cancer- Whipples Surgery as treatment

Pancreatic Pseudocyst

Cystic Fibrosis

Pancreatic exocrine insufficiency (PEI)

Diabetes

Question 3

What is resected in a whipples procedure?

Answer 3

During this procedure, surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct, the gallbladder and associated lymph nodes

Question 4

What are the clinical symptoms of Pancreatitis?

Answer 4

• Steatorrhoea
• Poor appetite
• Early satiety
• Nausea/vomiting
• Irregular Blood glucose levels

Question 5

What is Steatorrhoea?

Answer 5

It is “Fatty” Diarrhoea
• Signs:
• Floating
• Oily
• Particularly offensive
• Pale or yellow

Question 6

What is Dumping Syndrome?

Answer 6

Rapid passage of food from stomach to duodenum.

Is characterised as;

Bloating
Sweating
Fast heart rate
Dizziness

Question 7

What are the energy requirement of patients with Pancreatitis?

Answer 7

Energy:
• 100-125 kJ/kg BW if well nourished
• 125-145 kJ/kg BW if malnourished or post operatively

Question 8

What are the protein requirement of patients with Pancreatitis?

Answer 8

Protein:
• 1.0-1.2 g/kg BW if well nourished
• 1.2-1.5 g/kg BW if malnourished or post operatively

Question 9

What forms of Enteral Nutrition would be used on these patients?

Answer 9

• Post operatively: Jejunal
• Pancreatitis: Gastric
• Polymeric formula
• May need to consider PERT

Question 10

What would be a Example PESS Statement?

Answer 10

(1): Severe malnutrition (SGA – C) related to some loss of appetite and likely fat malabsorption as evidenced by 20% body weight lost over a period of 3/12

(2): Predicted suboptimal intake related to whipples
procedure as evidenced by requiring alternative nutrition post operatively for gut rest.

Question 11

What would be a Intervention Plan?

Answer 11

Diet: High protein high energy

ONS: MT&AT

Mid-Meals Trolley

Request commencement of PERT:
▪ 50000 IU at meal times
▪ 25000 IU at mid meals