Oral refeeding in patients with mild acute pancreatitis: prevalence and risk factors of relapsing abdominal pain.
OBJECTIVE
In acute pancreatitis (AP), oral refeeding may stimulate pancreatic secretion, increasing the inflammation of the glandular tissue causing relapse of abdominal pain or even exacerbation of the disease. This study aimed to assess the prevalence and risk factors of abdominal pain relapse over oral refeeding in patients convalescing with AP as well as the impact of pain recurrence on the hospital stay.


METHODS
Inclusion criteria were AP confirmed by biochemical and/or radiological data in the absence of severe disease or extensive necrosis. The same diet was offered to all patients during oral refeeding. Demographic, clinical, biochemical and radiological data were prospectively recorded and analyzed.


RESULTS
A total of 130 patients were included. During the oral refeeding period, 32 (24.6%) patients had pain relapse, which was more common on days 1 (68.8%) and 2 (28.1%). Pain relapse was related to higher serum levels of lipase on the day before refeeding, higher serum levels of C-reactive protein on the fourth day, and presence of peripancreatic fluid collections (P < 0.01). Pain relapse significantly increased total hospital stay (P < 0.01).


CONCLUSIONS
In patients with mild AP, pain relapse during oral refeeding was relatively high (24.6%), particularly on the first or second day. Their risk appeared be associated with more intense or persistent pancreatic inflammation on the day before refeeding, and presence of peripancreatic fluid collections. Pain relapse increased hospital stay, and likely overall costs on disease treatment.
Chebli
Julio Maria Fonseca
JM
Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora, Minas Gerais, Brazil. chebli@globo.com
Gaburri
Pedro Duarte
PD
De Souza
Aécio Flávio Meirelles
AF
Junior
Elson Vidal Martins
EV
Gaburri
Ana Karla
AK
Felga
Guilherme Eduardo Gonçalves
GE
De Paula
Eliane Aparecida
EA
Forn
Cecília Ganimi
CG
De Almeida
Gerusa Vilela
GV
De Castro Nehme
Flavia
F
D015746:Abdominal Pain / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000368:Aged; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism; D010195:Pancreatitis / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors