Both acute and chronic pancreatitis are frequent diseases of the pancreas, which, despite being of benign nature, are related to a significant risk of malnutrition and may require nutritional support. Acute necrotizing pancreatitis is encountered in 20% of patients with acute pancreatitis, is associated with increased morbidity and mortality, and may require artificial nutrition by enteral or parenteral route, as well as additional endoscopic, radiological or surgical interventions. Chronic pancreatitis represents a chronic inflammation of the pancreatic gland with development of fibrosis. Abdominal pain leading to decreased oral intake, as well as exocrine and endocrine failure are frequent complications of the disease. All of the above represent risk factors related to malnutrition. Therefore, patients with chronic pancreatitis should be considered at risk, screened and supplemented accordingly. Moreover, osteoporosis and increased facture risk should be acknowledged in patients with chronic pancreatitis, and preventive measures should be considered.

Keywords: Acute pancreatitis, Chronic pancreatitis, Pancreatic diseases, Nutrition, Nutritional support, Medical Nutrition

Digestiva (Spanish Society of Digestive Endoscopy) and the Sociedad Espanola de Anatomía Patológica (Spanish Society of Pathology), aims to establish recommendations for the screeningof gastric cancer (GC) in low incidence populations, such as the Spanish. To establish the quality of the evidence and the levels of recommendation, we used the methodology based on theGRADE system (Grading of Recommendations Assessment, Development and Evaluation). We obtained a consensus among experts using a Delphi method. The document evaluates screening in the general population, individuals with relatives with GC and subjects with GC precursor lesions (GCPL). The goal of the interventions should be to reduce GC-related mortality. We recommend the use of the OLGIM classification and to determine the intestinal metaplasia(IM) subtype in the evaluation of GCPL. We do not recommend establishing endoscopic massscreening for GC or H. pylori. However, the document strongly recommends treating H. pylori if the infection is detected, and investigation and treatment in individuals with a family history of GC or with GCPL. Meanwhile, we recommend against the use of serological tests to detect GCPL. Endoscopic screening is suggested only in individuals that meet familial GC criteria. As for individuals with GCPL, endoscopic surveillance is only suggested in extensive IM associated with additional risk factors (incomplete IM and/or a family history of GC), after resection of dysplastic lesions or in patients with dysplasia without visible lesion after a high-quality gastroscopy with chromoendoscopy.

Keywords: Helicobacter pylori; Mass screening; Chronic gastritis; Intestinal metaplasia; Dysplasia; Familial gastric cancer