Clear Liquid Diet vs Soft Diet as the Initial Meal in Patients With Mild Acute Pancreatitis: A Randomized Interventional Trial

• Published in: Nutrition in clinical practice 2013-06, Vol.28 (3), p.365-370
• Main Authors: Rajkumar, Nagarajan, Karthikeyan, Vilvapathy Senguttuvan, Ali, Sheik Manwar, Sistla, Sarath Chandra, Kate, Vikram
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Amylases - blood; Diet; Female; Hospitalization; Humans; Length of Stay; Male; Meals; Nursing; Pancreatitis - diet therapy; Pancreatitis - prevention & control; Recurrence; Treatment Outcome; Young Adult
• ISSN: 0884-5336; 1941-2452
• DOI: 10.1177/0884533612466112

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.