A 55-year-old patient with severe acute pancreatitis is unable to tolerate oral intake. The ICU team wishes to provide enteral nutrition. According to current evidence, what is the preferred route of feeding?

• A Total parenteral nutrition via central line
• B Oral feeding with clear liquids only
• C Nasojejunal tube feeding
• D Nasogastric tube feeding ✓

Explanation

Current evidence and guidelines (IAP/APA, ACG) support nasogastric enteral feeding as safe and effective in severe acute pancreatitis, with no significant advantage of nasojejunal feeding. Enteral nutrition maintains gut barrier integrity, reduces bacterial translocation, and decreases infectious complications compared to TPN. Gastric feeding is preferred when tolerated; nasojejunal is reserved for patients with gastric outlet obstruction or intolerance to gastric feeds. TPN is reserved for patients who cannot tolerate enteral nutrition.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

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Written and medically reviewed by the StethoPrep medical team.