{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:05:57Z","timestamp":1784264757901,"version":"3.55.0"},"reference-count":113,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pancreatitis (CP) often leaves patients with debilitating abdominal pain, postprandial symptom exacerbation, and progressive malnutrition. While traditional management focuses on analgesics and enzyme replacement, strategies aimed to reduce pancreatic secretory stimulation may offer an adjunct to standard approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We explore the physiologic rationale and the existing clinical evidence for jejunal feeding and elemental diets to attenuate pancreatic secretion and improve the symptom burden of CP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We summarize pancreatic exocrine regulation, emphasizing how nutrient composition and intestinal delivery site shape feedback pathways and pancreatic secretion. We review the physiologic and observational studies of mid-to-distal jejunal tube feeding and elemental diets in animal models, healthy individuals, and patients with CP pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Studies suggest that jejunal feeding can reduce pancreatic stimulation and may be associated with significant reductions in abdominal pain and analgesic utilization, with improvements in nutritional status. Furthermore, elemental diets, composed of free amino acids, medium-chain triglycerides, and simple carbohydrates, may complement this effect by facilitating efficient nutrient absorption while keeping the pancreas relatively quiescent. However, evidence remains limited by heterogeneity and predominantly nonrandomized study designs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Jejunal feeding and elemental diets represent potential adjunctive strategies for selected CP patients with pain-predominant phenotypes and postprandial symptom exacerbation. Prospective trials are needed to define patient selection, optimal formula, delivery location, durability of benefit, and standardized outcomes regarding patient-reported pain impact, nutritional markers, and treatment-related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2026.1828606","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:23:57Z","timestamp":1784262237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic application of feeding strategies in chronic pancreatitis: the potential for jejunal feeding and elemental diet to modulate pancreatic secretion to alleviate painful symptoms"],"prefix":"10.3389","volume":"17","author":[{"given":"Mei","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Scripps Clinic\/Scripps Green Hospital","place":["La Jolla, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niwen","family":"Kong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Stanford University","place":["Stanford, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baraa","family":"Abdelghne","sequence":"additional","affiliation":[{"name":"School of Humanities and Sciences, Stanford University","place":["Stanford, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Evans","family":"Phillips","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, Nutrition, University of Pittsburgh School of Medicine","place":["Pittsburgh, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohail Z.","family":"Husain","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University School of Medicine","place":["Stanford, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Pandol","sequence":"additional","affiliation":[{"name":"Karsh Division of Gastroenterology, Departments of Medicine, Cedars-Sinai Medical Center","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Jiang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Stanford University","place":["Stanford, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1136\/gut.20.1.37","article-title":"Inhibition of secretin stimulated pancreatic secretion by pancreatic polypeptide","volume":"20","author":"Adrian","year":"1979","journal-title":"Gut"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007884.pub3","article-title":"Endoscopic or surgical intervention for painful obstructive chronic pancreatitis","volume":"2015","author":"Ahmed Ali","year":"2015","journal-title":"Cochrane Database Systematic Rev."},{"key":"B3","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1097\/MPA.0000000000000585","article-title":"Proglucagon-derived peptides do not significantly affect acute exocrine pancreas in rats","volume":"45","author":"Akalestou","year":"2016","journal-title":"Pancreas"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1364110","article-title":"Pancreatitis with use of new diabetic medications: A real-world data study using the post-marketing FDA adverse event reporting system (FAERS) database","volume":"15","author":"Alenzi","year":"2024","journal-title":"Front. 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