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Acute pancreatitis — UKMLA MCQ

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HardEmergency medicine & Acute presentationsAcute pancreatitisUKMLAMRCEM SBAMRCP Part 1

A patient with predicted severe acute pancreatitis cannot tolerate oral food after 48 hours, but the gut is functioning and there is no obstruction. Which nutritional approach is preferred?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Early enteral nutrition through oral or tube feeding

The best answer is “Early enteral nutrition through oral or tube feeding”. Enteral nutrition preserves gut-barrier function and is preferred when oral intake is not possible but the gastrointestinal tract works. It reduces infectious complications compared with routine parenteral nutrition and does not need to wait for enzyme normalisation or radiological resolution. Oral feeding can resume as tolerated, often earlier than historical pancreatic-rest practice. Parenteral nutrition is reserved for situations in which enteral feeding is contraindicated or fails, rather than used automatically in severe disease.

Reference: NICE NG104: Pancreatitis: https://www.nice.org.uk/guidance/ng104/chapter/Recommendations