A 45-year-old patient with predicted severe acute pancreatitis is unable to tolerate oral intake by day 3. According to current evidence, which nutritional strategy is preferred?

• A Total parenteral nutrition via central line
• B Nasogastric tube feeding with polymeric formula ✓
• C Nasoduodenal tube feeding beyond the ligament of Treitz
• D Nil by mouth with intravenous fluids alone until CRP normalises

Explanation

Current ESPEN and IAP/APA guidelines recommend early enteral nutrition via the nasogastric route in predicted severe acute pancreatitis. Nasogastric and nasojejunal feeding have shown equivalent safety and efficacy in randomised trials, making nasogastric feeding the preferred simpler option. Parenteral nutrition is reserved for patients failing enteral tolerance.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.