© 2014 American Society for Parenteral and Enteral Nutrition

ncp.sagepub.com hosted at online.sagepub.com Invited Review Pancreatic stimulation and therefore digestion is a tightly con-trolled and hormonally mediated process. Food in the stomach entering into the small intestine is the most potent stimulator for these digestive reactions to occur.1 Most notably, the hormone secretin acts on the pancreas for bicarbonate release, and cholecys-tokinin (CCK) acts on the gallbladder and the pancreas to stimulate the release of bile and pancreatic secretions.2 Furthermore, the parasympathetic system is involved with acetylcholine, stimulat-ing peristalsis and pancreatic secretion.3 Pancreatic juices flow out of the main pancreatic duct, which merges with the common bile duct, delivering bile from the liver and gallbladder. The contents o