A Full Solid Diet as the Initial Meal in Mild Acute Pancreatitis is Safe and Result in a Shorter Length of Hospitalization

Results From a Prospective, Randomized, Controlled, Double-blind Clinical Trial

Abstract

Goals 

To compare the safety and length of hospitalization (LOH) between a full solid diet as the initial meal for refeeding after mild acute pancreatitis (AP) as compared with 2 other diets.

Background 

In mild AP, the need for fat restriction during refeeding has not been studied. It was hypothesized that the reintroduction of oral feeding with a full solid diet after mild AP was safe and might result in a shorter LOH.

Study 

Subjects with mild AP were randomized to receive 1 of 3 diets (clear liquid, soft, or full solid) as the initial meal during oral refeeding. Diet progression and hospital discharge were decided by the physicians that were not members of trial team. During hospital stay, patients were monitored for relapse of pain (primary endpoint), dietary intake, LOH (secondary endpoint), and 7 days postdischarge to record pain relapse rates.

Results 

A total of 210 patients were included, 70 in each arm. On a per-protocol basis, there was no difference in pain relapse rates during refeeding between the 3 diet arms (P=0.80). Subjects initiated on a full solid diet consumed significantly more calories and fats on trial days 1 and 2 (P<0.001). A shorter LOH (median of –1.5 d) was observed among patients receiving a full solid diet without abdominal pain relapse (P=0.000).

Conclusions 

Oral refeeding with a full solid diet in mild AP was well tolerated and resulted in a shorter LOH in patients without abdominal pain relapse.