In severe acute pancreatitis, the use of enteral nutrition via nasojejunal feeding tube rather than parenteral nutrition is associated with

• A. EN is contraindicated in severe acute pancreatitis
• B. EN has no effect on infectious complications
• C. PN reduces infectious complications
• D. EN is well tolerated and reduces infectious complications

Answer: (D)

Enteral feeding supports the gut and immune defenses, which in severe acute pancreatitis translates into fewer infectious complications when nutrition is delivered enterally rather than parenterally. Using a nasojejunal tube keeps the feed away from the pancreas, helps minimize pancreatic stimulation and reflux, and preserves gut mucosal integrity. This reduces bacterial translocation and the risk of infection, translating to better tolerance and fewer infectious complications compared with parenteral nutrition, which bypasses the gut and carries higher infection risks from central lines and gut barrier disruption. So, the statement that enteral nutrition is well tolerated and reduces infectious complications best captures the clinical advantage.