A Prospective, Randomized Trial of Clear Liquids Versus Low-Fat Solid Diet as the Initial Meal in Mild Acute Pancreatitis
Open accessAbstract
Background & aims Patients recovering from mild acute pancreatitis typically receive a clear liquid diet (CLD) when ready to initiate oral nutrition. Patient discharge then depends on their successful advancement to solid food. We hypothesized that initiating oral nutrition with a low-fat solid diet (LFSD) after mild pancreatitis would be well tolerated and would result in a shorter length of hospitalization (LOH). Methods Patients with mild pancreatitis were randomized to a CLD or LFSD when they were ready to resume oral nutrition. Decisions about diet advancement and hospital discharge were at the discretion of the medical team, without input from study team members. Patients were monitored daily for recurrence of pain, need to stop feeding, post-refeeding LOH (primary end point), and for 28 days post-refeeding to capture re-admission rates. Results We randomized 121 patients: 66 to CLD and 55 to LFSD. The number of patients requiring cessation of feeding because of pain or nausea was similar in both groups (6% for CLD, 11% for LFSD; P = .51). The median LOH after refeeding was identical in both groups (1-day interquartile range, 1-2; P = .77). Patients in the LFSD arm consumed significantly more calories and grams of fat than those in the CLD arm during their first meal and on study day 1. There was no difference in the 28-day re-admission rates between the 2 arms. Conclusions Initiating oral nutrition after mild acute pancreatitis with an LFSD appeared safe and provided m…
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An RCT including 151 patients showed that oral refeeding with a soft diet in patients with mild acute pancreatitis is safe and results in a shorter length of hospital stay.
“oral refeeding with a soft diet in patients with mild”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [198]
Starting early feeding with clear liquids, soft diet, low-fat diet, or solid food was shown to be safe in different RCTs.
“Starting early feeding with clear liquids, soft diet, low-fat diet,”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [198]
Cites
Moher, D., Schulz, K. F., & Altman, D. G. (2001) · The Lancet · doi:10.1016/s0140-6736(00)04337-3 · Cited by 5,373 · see citing works
Moher, D., Schulz, K. F., & Altman, D. G. (2001) · BMC Medical Research Methodology · doi:10.1186/1471-2288-1-2 · Cited by 2,755 · see citing works
Practice guidelines in acute pancreatitis
Banks, P. A., Freeman, M. L., & the Practice Parameters Committee of the American College of Gastroenterology (2006) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2006.00856.x · Cited by 2,050 · see citing works
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McClave, S. A., Taylor, B. E., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C., McCarthy, M. S., Davanos, E., Rice, T. W., Cresci, G. A., et al. (2016) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607115621863 · Cited by 3,982 · see citing works
American College of Gastroenterology guideline: management of acute pancreatitis
Tenner, S., Baillie, J., DeWitt, J., & Vege, S. S. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.218 · Cited by 2,327 · see citing works
Taylor, B. E., McClave, S. A., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C., McCarthy, M. S., Davanos, E., Rice, T. W., Cresci, G. A., et al. (2016) · Critical Care Medicine · doi:10.1097/ccm.0000000000001525 · Cited by 1,476 · see citing works
ESPEN guideline on hospital nutrition
Thibault, R., Abbasoglu, O., Ioannou, E., Meija, L., Ottens-Oussoren, K., Pichard, C., Rothenberg, E., Rubin, D., Siljamäki-Ojansuu, U., Vaillant, M.-F., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.09.039 · Cited by 259 · see citing works
- Authors
- Jacobson, B. C., Vander Vliet, M. B., Hughes, M. D., Maurer, R., McManus, K., & Banks, P. A.
- Affiliations
- Boston University (US)
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2007-08
- Volume
- 5
- Issue
- 8
- Pages
- 946-951
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC2034288
- OpenAlex
- W2028844827
- Cited by
- 151
- References
- 3
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 1 · 2023: 9 · 2022: 7 · 2021: 5 · 2020: 9 · 2019: 3 · 2018: 9 · 2017: 8 · 2016: 8 · 2015: 13 · 2014: 10 · 2013: 12 · 2012: 13
- FWCI
- 9.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K08DK070706)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- mild acute pancreatitis, clear liquid diet, oral nutrition, refeeding, length of hospital stay, hospital discharge, hospital readmission, energy intake
- MeSH terms
- Cholangiopancreatography, Endoscopic Retrograde, Dietary Fats, Female, Follow-Up Studies, Humans, Length of Stay, Male, Middle Aged, Prospective Studies, Severity of Illness Index, Tomography, X-Ray Computed, Treatment Outcome, Nutritional Support, Diet, Fat-Restricted, Pancreatitis, Acute Necrotizing
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