Early Oral Refeeding Wisdom in Patients With Mild Acute Pancreatitis

Abstract

In patients with mild AP, EORF, with the subjective feeling of hunger, is safe, feasible, and reduces LOH.

Factors associated with post-ERCP pancreatitis and the effect of pancreatic duct stenting in a pediatric population

“…Although not specifically studied in children undergoing ERCP, simple decisions such as when to initiate feedings in patients with pancreatitis have been shown to have great influence on length of hospitalizations. 17 These findings suggest that the severity of pediatric PEP may more accurately reflect post-ERCP management as opposed to the magnitude of injury to the pancreas. Complicating matters further is the frequent presence of confounding factors such as management of constipation and functional abdominal pain that often contribute to hospitalization length.…”

Meta-analysis of early nutrition: the benefits of enteral feeding compared to a nil per os diet not only in severe, but also in mild and moderate acute pancreatitis

“…Thirty-three articles (21 articles containing patients suffering from SAP as well as 12 articles with MAP patients) were selected. They contained two nonrandomized and 31 randomized controlled clinical trials (Table 2) [16][17][18][19][20][21][22][23][24][25][26][27]29,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. Finally, statistical analyses were performed on data from articles where both EN and NPO groups were presented, the trial was randomized, and the relevant data were available.…”

“Re. ‘Early oral refeeding based on hunger in moderate and severe acute pancreatitis: A prospective controlled, randomized clinical trial.’ Can we really do without enteral nutrition?” Author's response

“…This involves assessing and improving patient-reported health outcomes by taking into account the patients' own objectives, values, and preferences [3,6,7]. In a previous trial, we found that early oral refeeding (EORF), based on hunger, without remission of symptoms or normalization of biochemical markers, in patients with mild AP was safe and reduced the total hospital length of stay (6.8 AE 2.1 versus10.4 AE 4.1 d; P < 0.01) and post refeeding hospital length (2.30 AE 1.60 versus 3.27 AE 0.61 d; P < 0.01) compared with the traditional oral refeeding group [8]. Subjective feelings of hunger, therefore, may reflect recovery from gastrointestinal dysfunction and indicate that patients are ready to try oral feeding.…”