Role of Fibre in Nutritional Management of Pancreatic Diseases

Overview

Journal Nutrients

Date 2019 Sep 22

PMID 31540004

Citations 6

Authors

Emanuela Ribichini

Serena Stigliano

Sara Rossi

Piera Zaccari

Maria Carlotta Sacchi

Giovanni Bruno

Danilo Badiali

Carola Severi

Affiliations

Soon will be listed here.

Abstract

The role of fibre intake in the management of patients with pancreatic disease is still controversial. In acute pancreatitis, a prebiotic enriched diet is associated with low rates of pancreatic necrosis infection, hospital stay, systemic inflammatory response syndrome and multiorgan failure. This protective effect seems to be connected with the ability of fibre to stabilise the disturbed intestinal barrier homeostasis and to reduce the infection rate. On the other hand, in patients with exocrine pancreatic insufficiency, a high content fibre diet is associated with an increased wet fecal weight and fecal fat excretion because of the fibre inhibition of pancreatic enzymes. The mechanism by which dietary fibre reduces the pancreatic enzyme activity is still not clear. It seems likely that pancreatic enzymes are absorbed on the fibre surface or entrapped in pectin, a gel-like substance, and are likely inactivated by anti-nutrient compounds present in some foods. The aim of the present review is to highlight the current knowledge on the role of fibre in the nutritional management of patients with pancreatic disorders.

Citing Articles

An Improved Assessment Method to Estimate (Poly)phenol Intake in Adults with Chronic Pancreatitis.

Siprelle K, Kennedy A, Hill E, Hinton A, Shi N, Madril P Dig Dis Sci. 2024; 69(8):2996-3007.

PMID: 38850506 PMC: 11341752. DOI: 10.1007/s10620-024-08417-6.

Dietary Fibre for the Prevention of Post-Pancreatitis Diabetes Mellitus: A Review of the Literature and Future Research Directions.

Li X, Petrov M Nutrients. 2024; 16(3).

PMID: 38337719 PMC: 10857198. DOI: 10.3390/nu16030435.

Association between Dietary Habits and Pancreatitis among Individuals of European Ancestry: A Two-Sample Mendelian Randomization Study.

Mao X, Huang C, Wang Y, Mao S, Li Z, Zou W Nutrients. 2023; 15(5).

PMID: 36904153 PMC: 10004739. DOI: 10.3390/nu15051153.

The Effect of Oat Hay, Alfalfa Hay, and Their Combined Diets on the Morphology and Function of the Pancreas in Preweaning Yak Calves.

Jiao Y, Zhou Y, Liu S, Yang D, Li J, Sun L Animals (Basel). 2023; 13(2).

PMID: 36670833 PMC: 9855006. DOI: 10.3390/ani13020293.

Early Enteral Nutrition in Paediatric Acute Pancreatitis-A Review of Published Studies.

Bukowski J, Dembinski L, Dziekiewicz M, Banaszkiewicz A Nutrients. 2022; 14(16).

PMID: 36014947 PMC: 9416066. DOI: 10.3390/nu14163441.

References

Olah A, Belagyi T, Poto L, Romics Jr L, Bengmark S . Synbiotic control of inflammation and infection in severe acute pancreatitis: a prospective, randomized, double blind study. Hepatogastroenterology. 2007; 54(74):590-4. View

Ewald N, Kaufmann C, Raspe A, Kloer H, Bretzel R, Hardt P . Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev. 2011; 28(4):338-42. DOI: 10.1002/dmrr.2260. View

Meier R, Ockenga J, Pertkiewicz M, Pap A, Milinic N, MacFie J . ESPEN Guidelines on Enteral Nutrition: Pancreas. Clin Nutr. 2006; 25(2):275-84. DOI: 10.1016/j.clnu.2006.01.019. View

Knop F . Incretin hormones and beta cell function in chronic pancreatitis. Dan Med Bull. 2010; 57(7):B4163. View

Dutta S, Bustin M, Russell R, Costa B . Deficiency of fat-soluble vitamins in treated patients with pancreatic insufficiency. Ann Intern Med. 1982; 97(4):549-52. DOI: 10.7326/0003-4819-97-4-549. View

Eckerwall G, Tingstedt B, Bergenzaun P, Andersson R . Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery--a randomized clinical study. Clin Nutr. 2007; 26(6):758-63. DOI: 10.1016/j.clnu.2007.04.007. View

Ewald N, Hardt P . Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J Gastroenterol. 2013; 19(42):7276-81. PMC: 3831209. DOI: 10.3748/wjg.v19.i42.7276. View

Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S . Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015; 34(3):335-40. DOI: 10.1016/j.clnu.2015.03.001. View

Conforti F, Perri V, Menichini F, Marrelli M, Uzunov D, Statti G . Wild Mediterranean dietary plants as inhibitors of pancreatic lipase. Phytother Res. 2011; 26(4):600-4. DOI: 10.1002/ptr.3603. View

10.

Bassi C, Delle Fave G, Capurso I, Vantini I, Magarini F, Albarello L . Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010; 42 Suppl 6:S381-406. DOI: 10.1016/S1590-8658(10)60682-2. View

11.

Abu-El-Haija M, Hornung L, Denson L, Husami A, Lin T, Matlock K . Prevalence of abnormal glucose metabolism in pediatric acute, acute recurrent and chronic pancreatitis. PLoS One. 2018; 13(10):e0204979. PMC: 6209152. DOI: 10.1371/journal.pone.0204979. View

12.

Dhingra D, Michael M, Rajput H, Patil R . Dietary fibre in foods: a review. J Food Sci Technol. 2013; 49(3):255-66. PMC: 3614039. DOI: 10.1007/s13197-011-0365-5. View

13.

Jafari T, Feizi A, Askari G, Fallah A . Parenteral immunonutrition in patients with acute pancreatitis: a systematic review and meta-analysis. Clin Nutr. 2014; 34(1):35-43. DOI: 10.1016/j.clnu.2014.05.008. View

14.

Drasar B, Jenkins D, Cummings J . The influence of a diet rich in wheat fibre on the human faecal flora. J Med Microbiol. 1976; 9(4):423-31. DOI: 10.1099/00222615-9-4-423. View

15.

Moore W, Holdeman L . Human fecal flora: the normal flora of 20 Japanese-Hawaiians. Appl Microbiol. 1974; 27(5):961-79. PMC: 380185. DOI: 10.1128/am.27.5.961-979.1974. View

16.

Pezzilli R, Zerbi A, Campra D, Capurso G, Golfieri R, Arcidiacono P . Consensus guidelines on severe acute pancreatitis. Dig Liver Dis. 2015; 47(7):532-43. DOI: 10.1016/j.dld.2015.03.022. View

17.

Dominguez-Munoz J . Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007; 9(2):116-22. DOI: 10.1007/s11894-007-0005-4. View

18.

Hart P, Bellin M, Andersen D, Bradley D, Cruz-Monserrate Z, Forsmark C . Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol. 2017; 1(3):226-237. PMC: 5495015. DOI: 10.1016/S2468-1253(16)30106-6. View

19.

Whitcomb D, Frulloni L, Garg P, Greer J, Schneider A, Yadav D . Chronic pancreatitis: An international draft consensus proposal for a new mechanistic definition. Pancreatology. 2016; 16(2):218-24. PMC: 6042966. DOI: 10.1016/j.pan.2016.02.001. View

20.

Prizment A, Jensen E, Hopper A, Virnig B, Anderson K . Risk factors for pancreatitis in older women: the Iowa Women's Health Study. Ann Epidemiol. 2015; 25(7):544-8. PMC: 4457556. DOI: 10.1016/j.annepidem.2014.12.010. View