There is a renewed awareness of the detrimental impact of undernutrition on organ function and clinical outcome. There is also evidence that in some clinical circumstances nutritional support will reverse nutritional depletion and improve recovery.1Nutritional recovery may not be achieved in the metabolically stressed patient.2 The effects of nutritional depletion occur early,3 and subsequent recovery may be prolonged in the severely depleted patient.4 Thus, there is emphasis on early nutritional intervention to prevent or retard the development of malnutrition in patients who are unable to eat or absorb an adequate oral diet. The British Society of Gastroenterology guidelines suggest that such patients should not be deprived of nutrition for more than seven days, and that nutritional support should be considered earlier in patients who are already malnourished or who are metabolically stressed.5 The conventional management of patients with acute pancreatitis includes parenteral nutrition, which is instituted early in the course of the illness, partly because of the frequently associated ileus, and partly for fear of the consequences of stimulating pancreatic function by …