Realimentação oral em pacientes com pancreatite aguda: a composição química e calórica da dieta influencia na recorrência da dor abdominal?

Abstract

In acute pancreatitis (AP) the need for fat restriction during refeeding has not been studied. The thesis is that to start oral refeeding with a full solid diet after mild AP would be safe and might result in a shorter length of hospitalization. The objective of this study was to explore the safety and length of hospital stay when a full solid diet is used as the initial meal after a mild AP comparing to two other diets: liquid and pasty. Patients with mild AP were randomized to receive one of three diets: clear liquid, pasty or full solid as the initial meal during oral refeeding. Diet progression and hospital discharge were determined by non-members of the trial team. Patients were monitored daily for abdominal pain recurrence (primary endpoint), diet tolerance, length of hospitalization (secondary endpoint) and during seven days after discharge to record the pain recurrence rates. A total of 210 patients was evaluated, 70 in each type of diet. Based on the protocol, there was no difference in pain recurrence rates during refeeding between the three diet types: 20% for liquid diet, 17% for pasty and 21% for full solid (P=0.80). The patients who received a full solid diet without abdominal pain recurrence had a shorter length of hospitalization (median of -1.5 days) when compared with those who received the liquid or pasty diets (P=0.000). Oral refeeding with a full solid diet after mild AP was well tolerated and resulted in a shorter length of hospitalization in patients without abdominal pain recurrence.