Severe acute pancreatitis: Can fasting help the pancreas to rest?

The article is professionally consulted by Doctor Vo Thi Thuy Trang - Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Da Nang International Hospital.

The pancreas is one of the body glands that is directly involved in the digestion and absorption of food through the secretion of pancreatic enzymes in an inactive form. When pancreatic enzymes are activated, they become active in the lumen of the pancreatic duct, causing acute pancreatitis. What is the relationship between the pancreas and the eating process? Why does acute pancreatitis require complete fasting? Fasting when pancreatitis, how does the patient eat?

Pancreas, also known as sugar cane leaves, has both exocrine and endocrine functions of the body:
Exocrine function: The pancreas secretes digestive enzymes to support the process of decomposition and metabolism. and absorb food; Endocrine function: The pancreas secretes insulin and glucagon to help regulate blood sugar balance. The involvement of the pancreas in the digestion of food by the digestive system is as follows:
When there is a stimulus to eat such as smell, look, taste... the pancreas will begin to secrete pancreatic juice containing enzymes. digested as precursors including trypsinogen, chymotrypsinogen, amylase and lipase. Pancreatic enzymes are secreted into the pancreatic duct and then emptied into the small intestine in the D2 segment of the duodenum. In the duodenum, a series of reactions will occur:
Enterokinase enzymes of the duodenum will catalyze the conversion of trypsinogen into active trypsin; Trypsin cleaves the amino acids of inactive chymotrypsinogen into the active form chymotrypsin; Chymotrypsin further cuts the polypeptides in food into small units to facilitate absorption through the intestinal mucosa. Pancreatic juice contains enzymes that digest lipids, proteins, glucose, ... and also contains alkaline bicarbonate ions to neutralize the acid in food when food passes from the stomach down. Normally, pancreatic enzymes are secreted in an inactive, precursor form, and they are only converted to the active form in the duodenum. But due to some reason such as obstruction, damage causes these enzymes to become active in the lumen of the pancreatic duct and destroy the pancreatic parenchyma, causing acute pancreatitis, even necrosis with sudden, severe epigastric pain.

Why fasting when you have pancreatitis? In patients with acute pancreatitis, when the pancreatic parenchyma is being damaged by pancreatic enzymes, feeding the patient at this time is absolutely not recommended. The stimuli from eating such as smell, look, eat... will stimulate the pancreas to increase the production of pancreatic enzymes. The higher the amount of pancreatic enzymes, the stronger the process of destruction of the pancreatic structural parenchyma taking place in the lumen of the pancreatic duct. This can worsen the condition of the pancreas, accelerate the course of the disease to earlier complications, and even increase the risk of death. Therefore, in the treatment of acute pancreatitis, patients should fast during the first period of therapy so that the pancreas has time to rest and recover from damage. When treating acute pancreatitis in patients with indications for complete fasting, nutrition can be provided through an intravenous line.

When there are signs of acute pancreatitis, you need to see a specialist immediately for advice on examination and timely treatment to limit the occurrence of complications later.
In the case of patients with mild acute pancreatitis, oral medications can be prescribed in combination with hospital monitoring. If symptoms improve and the patient shows no signs of complications, they can be discharged from the hospital to take home medication and visit the doctor at regular intervals.
For severe cases requiring immediate hospitalization for combination therapy with drugs in combination with active resuscitation methods.
Notes during the treatment of acute pancreatitis:
Complete fasting in the early stages of acute pancreatitis treatment. Eat and drink normally again when prescribed by the treating doctor; Stop drinking alcohol, quit smoking because it is one of the leading causes of acute pancreatitis; Establish a scientific and reasonable diet, fortified with vitamins; reduce eating fat, greasy food, sweet food; Add water, at least 2 liters/day; Arrange a reasonable rest and work regime, avoid stress and stress. Acute pancreatitis is a disease directly related to eating and living habits. In order to ensure that the treatment is favorable and has the most optimal effect without leaving complications, patients need to fast completely during the first days of treatment. Follow your doctor's instructions so that you can restore the health and function of the pancreas soon.
With nearly 20 years of working at Da Nang General Hospital in the field of gastrointestinal endoscopy - hepatobiliary disease, every year, Doctor Vo Thi Thuy Trang participates in endoscopy more than 1500 cases including: endoscopic diagnosis of diseases stomach, colon such as: detecting inflammation, ulcers, polyps, cancer, finding HP bacteria, detecting cancer early in the digestive tract...; Endoscopic treatment such as: Hemostasis in gastrointestinal bleeding, esophageal varices ligation in cirrhosis, endoscopic gastrointestinal polypectomy...