title: A full solid diet as the initial meal in mild acute pancreatitis is safe and result in a shorter length of hospitalization: results from a prospective, randomized, controlled, double-blind clinical trial.
abstract: OBJECTIVE
  To compare the safety and length of hospitalization (LOH) between a full solid diet as the initial meal for refeeding after mild acute pancreatitis (AP) as compared with 2 other diets.
  
  
  BACKGROUND
  In mild AP, the need for fat restriction during refeeding has not been studied. It was hypothesized that the reintroduction of oral feeding with a full solid diet after mild AP was safe and might result in a shorter LOH.
  
  
  METHODS
  Subjects with mild AP were randomized to receive 1 of 3 diets (clear liquid, soft, or full solid) as the initial meal during oral refeeding. Diet progression and hospital discharge were decided by the physicians that were not members of trial team. During hospital stay, patients were monitored for relapse of pain (primary endpoint), dietary intake, LOH (secondary endpoint), and 7 days postdischarge to record pain relapse rates.
  
  
  RESULTS
  A total of 210 patients were included, 70 in each arm. On a per-protocol basis, there was no difference in pain relapse rates during refeeding between the 3 diet arms (P=0.80). Subjects initiated on a full solid diet consumed significantly more calories and fats on trial days 1 and 2 (P<0.001). A shorter LOH (median of -1.5 d) was observed among patients receiving a full solid diet without abdominal pain relapse (P=0.000).
  
  
  CONCLUSIONS
  Oral refeeding with a full solid diet in mild AP was well tolerated and resulted in a shorter LOH in patients without abdominal pain relapse.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Universitary Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Minas Gerais, Brazil.
authors.forename: José Maria Mendes
authors.initials: JM
authors.lastname: Moraes
authors.forename: Guilherme Eduardo Gonçalves
authors.initials: GE
authors.lastname: Felga
authors.forename: Liliana Andrade
authors.initials: LA
authors.lastname: Chebli
authors.forename: Márcio Bousada
authors.initials: MB
authors.lastname: Franco
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Gomes
authors.forename: Pedro Duarte
authors.initials: PD
authors.lastname: Gaburri
authors.forename: Alexandre
authors.initials: A
authors.lastname: Zanini
authors.forename: Julio Maria Fonseca
authors.initials: JM
authors.lastname: Chebli
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004041:Dietary Fats / Q000008:administration & dosage*; D004311:Double-Blind Method; D002149:Energy Intake; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000178:diet therapy* / Q000503:physiopathology; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D004041:Dietary Fats