The Purpose of Fasting in Acute Pancreatitis Treatment

Acute pancreatitis is a condition characterized by the abnormal activation and secretion of pancreatic enzymes, leading to a cascade of organ damage. During this condition, eating or drinking can stimulate the pancreas to produce and activate more enzymes, worsening the situation. Therefore, fasting and fluid restriction are crucial components of treatment, aimed at minimizing pancreatic stimulation and reducing the burden on both the pancreas and other affected organs.

The primary approach in managing acute pancreatitis involves withholding food and fluids, often accompanied by additional therapeutic strategies such as gastrointestinal decompression, medication therapy, antibiotic use, and intravenous nutritional support.

Gastrointestinal decompression becomes necessary in severe cases where fasting alone is insufficient. Patients may develop paralytic ileus, a type of bowel obstruction, which requires gastric tube placement and decompression to relieve pressure and prevent further complications.

Medication therapy typically includes two key drug categories. The first is somatostatin or its analogs, which directly inhibit the secretion and activation of pancreatic enzymes, helping to control the progression of the disease. The second category is proton pump inhibitors (PPIs), which protect the gastric lining and reduce gastric acid production, thereby lessening the impact of pancreatitis on the digestive system.

Antibiotic therapy is considered when there is a biliary origin to the pancreatitis, such as pancreatitis caused by bile duct stones. In these cases, antibiotics are administered to manage infection and prevent septic complications.

Lastly, intravenous nutrition is essential to maintain proper hydration, electrolyte balance, and nutrient intake during the fasting period. This supportive care ensures that patients receive the necessary calories and micronutrients while allowing the pancreas to rest and recover.