Early and/or immediately full caloric diet versus standard refeeding in mild acute pancreatitis: A randomized open-label trial
Open accessAbstract
Unlabelled Refeeding after acute pancreatitis (AP) is traditionally started in a successively increasing manner when abdominal pain is absent and pancreatic enzymes are decreasing. We aimed to evaluate length of hospital stay (LOHS) and refeeding tolerance for early refeeding and/or immediately full caloric intake in patients recovering from AP. Methods In this randomized, open-label trial, patients with AP were randomized into four different refeeding protocols. Group 1 and 2 received a stepwise increasing diet during three days while 3 and 4 received an immediately full caloric, low fat diet. Group 2 and 4 started refeeding early (once bowel sounds returned) and 1 and 3 started at standard time (bowel sounds present, no abdominal pain, no fever, leucocytes and pancreatic enzymes decreasing). Main outcomes measurements were LOHS and tolerance (ability to ingest >50% of meals without severe pain, nausea or AP relapse). Results Eighty patients were evaluated and 72 randomized (median age 60 years, range 24-85, 33 male). LOHS was significantly reduced after early refeeding (median 5 versus 7 days (p = 0.001)) but not in patients receiving immediately full caloric diet, compared to standard management (6 versus 6 days (p = 0.12)). There was no difference in refeeding tolerance comparing immediately full caloric diet versus stepwise increasing diet (31/35 (89%) versus 33/37 (89%) patients tolerating the treatment, p = 1.00) or early versus standard time for refeeding (33/37 (89%)…
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The refeeding regimen may also be gradually progressed from a clear liquid diet to a low-fat solid diet.
“The refeeding regimen may also be gradually progressed from a clear liquid diet”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [201]
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 [201]
Cites
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
Eckerwall, G. E., Tingstedt, B. B. Å., Bergenzaun, P. E., & Andersson, R. G. (2007) · Clinical Nutrition · doi:10.1016/j.clnu.2007.04.007 · Cited by 227 · see citing works
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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
- Lariño-Noia, J., Lindkvist, B., Iglesias-García, J., Seijo-Ríos, S., Iglesias-Canle, J., & Domínguez-Muñoz, J. E.
- Affiliations
- Complejo Hospitalario Universitario de Santiago (ES)
- University of Gothenburg (SE)
- Corresponding author
- Lariño-Noia, J.
- Venue
- Pancreatology
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 14
- Issue
- 3
- Pages
- 167-173
- ISSN
- 1424-3903 (ISSN-L)
- OpenAlex
- W2149807595
- Cited by
- 85
- References
- 2
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 9 · 2023: 6 · 2022: 12 · 2021: 8 · 2020: 10 · 2019: 5 · 2018: 10 · 2017: 3 · 2016: 2 · 2015: 4 · 2012: 1
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Pancreatology (publishedVersion)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- 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
- acute pancreatitis, refeeding, length of hospital stay, bowel sounds, mild acute pancreatitis
- MeSH terms
- Acute Disease, Adult, Aged, Aged, 80 and over, Energy Intake, Enteral Nutrition, Female, Humans, Length of Stay, Male, Middle Aged, Pancreatitis, Prospective Studies, Severity of Illness Index, Treatment Outcome, Diet, Fat-Restricted
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