Which of the following is a demonstrated benefit of EN over PN in severe acute pancreatitis?

• A. Decreased hospital LOS
• B. Reduced multiple organ failure
• C. Significant reduction in infectious morbidity
• D. Reduced need for surgical intervention

Answer: (C)

Entering feeding through the GI tract helps maintain the gut’s barrier and immune function, which is especially important in severe acute pancreatitis. When the gut is fed enterally, the mucosal lining stays more intact, gut-associated lymphoid tissue remains active, and the risk of bacterial translocation into the bloodstream or peritoneal cavity decreases. Parenteral nutrition, on the other hand, bypasses the gut and relies on a central venous catheter; it can contribute to gut atrophy, increased bacterial translocation, and catheter-related infections. Because of these factors, enteral nutrition consistently lowers infectious complications compared with parenteral nutrition in this setting, even if its effects on hospital length of stay, organ failure, or the need for surgery are less uniform across studies.