**5. Conclusions**

Nutritional therapy since the onset of AP constitutes a critical component in the management of patients that should be performed and assessed in the first hours of hospital admission. If the patient has mild disease and the on-demand oral diet of low-fat solid foods is tolerated, and not limited to clear liquids or if the enteral nutrition support is well tolerated during SAP, a daily reassessment of tolerance should be performed. The correct time to start enteral support should be performed in the first 24–48 hours after onset of AP. In contrast, early EN may not be better than an on-demand oral diet at 72 h. If it is not tolerated, then the enteral route through a nasogastric or nasojejunal feeding tube should be attempted. The use of a standard polymeric formula is recommended in gastric and jejunal feeding; nonetheless, daily assessment of tolerance should be carried out. PN is considered the last option because of the considerable risks of infection, and other complications. Lastly, various nutritional supplements used during AP have mixed clinical outcomes that should be more elucidated to bring certainty of their use to achieve better clinical outcomes.
