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The Benefits of Early Oral Nutrition in Mild Acute Pancreatitis

Kate M Ellery1, Soma Kumar2, Wallace Crandall1

  • 1Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH.

The Journal of Pediatrics
|October 17, 2017
PubMed

Insights

Early oral nutrition for children with mild acute pancreatitis significantly reduced hospital stays and fasting times. Patient-directed nutrition (PDN) proved safe, showing no increase in complications compared to traditional methods.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Pancreatic Diseases

Background:

  • Acute pancreatitis in children often involves prolonged fasting (nil per os, NPO) and hospitalization.
  • Traditional management relies on treatment team-directed nutrition (TTDN), which may extend NPO status and hospital stay.
  • The safety and efficacy of early patient-directed oral nutrition (PDN) in pediatric mild acute pancreatitis require investigation.

Purpose of the Study:

  • To evaluate if early patient-directed oral nutrition (PDN) in children with mild acute pancreatitis reduces hospitalization length.
  • To assess whether PDN increases the incidence of complications compared to traditional TTDN.
  • To determine the impact of PDN on the duration of nil per os (NPO) status.

Main Methods:

  • Prospective study comparing PDN group (n=30) with a retrospective TTDN group (n=92) of pediatric patients (2-21 years) with mild acute pancreatitis.
  • Patients in the PDN group self-selected oral intake at discretion.
  • Outcomes measured: length of hospitalization, time NPO, and 30-day post-discharge complications.

Main Results:

  • The PDN group experienced significantly shorter median hospital stays (48.5 hours) compared to the TTDN group (93 hours) (P < .0001).
  • Median NPO duration was substantially reduced in the PDN group (14 hours) versus the TTDN group (34 hours) (P < .0001).
  • No complications were observed within 30 days of discharge in the PDN group.

Conclusions:

  • Early patient-directed oral nutrition is well-tolerated in children with mild acute pancreatitis.
  • PDN significantly decreases NPO duration and length of hospitalization.
  • This approach does not appear to increase complications, offering a potentially improved management strategy.
Abstract

Keywords:
amylaselength of staylipaselow-fat diet

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