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Clear liquid diet vs soft diet as the initial meal in patients with mild acute pancreatitis: a randomized
Nagarajan Rajkumar1, Vilvapathy Senguttuvan Karthikeyan, Sheik Manwar Ali
1Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Background:
Patients recovering from mild acute pancreatitis are usually started on a liquid diet and advanced to a solid diet. Evidence suggests a soft diet as the initial meal is tolerated well by such patients. However, the results are controversial.
Objectives:
To assess the safety of starting an early soft diet compared with a liquid diet in patients with mild acute pancreatitis as the initial meal.
Methods:
We randomized 60 patients with mild acute pancreatitis into 2 groups to receive either a clear liquid diet (CLD) or a soft diet (SD) as the initial meal, and parameters such as tolerance to diet, recurrence of pain, length of hospitalization (LOH), need to stop feeding, post-refeeding length of hospitalization (PRLOH), and postdischarge readmission rate within 30 days were analyzed.
Results:
The demographic and baseline parameters (amylase, total leucocyte count, Balthazar score) in the 2 groups were comparable. Patients in both groups tolerated the diet well except 1 patient in the SD group, who developed vomiting and diarrhea, not severe enough to stop feeding. LOH and PRLOH were significantly lower in the SD group (4.23 ± 2.08 and 1.96 ± 1.63 days, P < .0001) compared with the CLD group (6.91 ± 2.43 and 4.10 ± 1.64 days, P < .0001). PRLOH in the SD group was 2.14 days less when compared with the CLD group.
Conclusion:
In patients with mild acute pancreatitis, a soft diet as the initial meal is well tolerated and leads to a shorter total length of hospitalization.
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