What does TPN stand for?
In the beginning, total parenteral nutrition (TPN) was introduced, allowing ‘‘pancreatic rest’’ and ‘‘gut rest’’. But no advantages of total parenteral nutrition on the total hospital stay or incidences of complications of pancreatitis were detected. Besides, intestinal atrophy was noticed, making the condition even worse. However, enteral nutrition (EN) was found to be better at maintaining the gut barrier by helping to modify the lactulose/mannitol ratio, lower the plasma endotoxin level and maintain the normal makeup and distribution of intestinal microbial, and lower the bacterial Translocation. In clinical practice, enteral nutrition has provided a safer route. Early nutritional support may aid recovery, one of the goals of this therapy is to avoid stimulation of the pancreas, to give it a rest. Parenteral nutrition (PN), rather than enteral nutrition (EN), used to be the standard treatment of care because it was considered important for ‘pancreas rest.’ The rationale was to prevent stimulating increased pancreatic secretion of proteolytic enzymes and thereby exacerbating the severity of pancreatitis. The reliance on parenteral nutrition has decreased in response to an increased awareness of attendant problems, such as catheter-related sepsis, the high cost of treatment, electrolyte and metabolic disturbances, atrophy and gut barrier failure with the promotion of bacterial translocation, systemic sepsis, and multiple organ failure.