title: Optimal timing of oral refeeding in mild acute pancreatitis: results of an open randomized multicenter trial.
abstract: OBJECTIVE
  The aim of this study was to compare 2 protocols regarding the initiation of oral nutrition in patients with mild acute pancreatitis.
  
  
  METHODS
  We randomized 143 patients to the Lipase directed (LIP) (n = 74) and the self selected PAT (n = 69) group. In the (PAT) group, the patients restarted eating through self-selection. In the LIP group, serum lipase had to normalize before eating.
  
  
  RESULTS
  The mean time between admission and oral nutrition was 2 days (interquartile range [IQR], 1-3) in the PAT group and 3 days (IQR, 2-4) in the LIP group (P < 0.005). Before and after the first meal, the mean Δ visual analogue scale (VAS) was +3.14 mm (±11.5 mm) in the PAT group and +2.85 mm (±16.4) in the LIP group (P = 0.597). The length of hospital stay was 7 days (median; IQR, 5-10.5) in the PAT group and 8 days (median; IQR, 5.75-12) in the LIP group (P = 0.315).
  
  
  CONCLUSIONS
  We were not able to demonstrate a difference in postprandial abdominal pain or in the length of hospital stay. Patients with self-selected eating, however, were able to restart eating 1 day earlier, and this difference was found to be significant. Our data suggest that normalization of serum lipase is not obligatory for enteral nutrition in mild acute pancreatitis.
authors.affiliation: Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten, Leipzig. teich@igvs.de
authors.forename: Niels
authors.initials: N
authors.lastname: Teich
authors.forename: Ali
authors.initials: A
authors.lastname: Aghdassi
authors.forename: Julia
authors.initials: J
authors.lastname: Fischer
authors.forename: Bastian
authors.initials: B
authors.lastname: Walz
authors.forename: Karel
authors.initials: K
authors.lastname: Caca
authors.forename: Thomas
authors.initials: T
authors.lastname: Wallochny
authors.forename: Andreas
authors.initials: A
authors.lastname: von Aretin
authors.forename: Georg
authors.initials: G
authors.lastname: von Boyen
authors.forename: Siri
authors.initials: S
authors.lastname: Göpel
authors.forename: Johann
authors.initials: J
authors.lastname: Ockenga
authors.forename: Andreas
authors.initials: A
authors.lastname: Leodolter
authors.forename: Jessica
authors.initials: J
authors.lastname: Rüddel
authors.forename: Eckhard
authors.initials: E
authors.lastname: Weber
authors.forename: Julia
authors.initials: J
authors.lastname: Mayerle
authors.forename: Markus M
authors.initials: MM
authors.lastname: Lerch
authors.forename: Joachim
authors.initials: J
authors.lastname: Mössner
authors.forename: Ingolf
authors.initials: I
authors.lastname: Schiefke
mesh_terms: D000208:Acute Disease; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010195:Pancreatitis / Q000201:enzymology / Q000628:therapy*; D012907:Smoking; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein; D008049:Lipase