Factors associated with intolerance after refeeding in mild acute pancreatitis.
OBJECTIVE
This study aimed to describe the mode of refeeding, frequency of intolerance, and related factors in mild acute pancreatitis (AP).


METHODS
We included all cases of mild AP between January 2007 and December 2009 in an observational, descriptive, and retrospective study. We analyzed demographic and etiological data, admission variables, treatment, refeeding mode, intolerance frequency, and treatment. Intolerance-related variables were determined using a Cox regression.


RESULTS
Two-hundred thirty-two patients were included (median age, 74.3 years, bedside index for severity in AP score, 1). Oral diet was reintroduced at 3 days (range, 0-11 days) in 90.9% of cases with a liquid diet. Intolerance to refeeding appeared in 28 patients (12.1%) at a median time of 1 day (range, 0-14 days). Oral diet was reduced or suspended in 71.4%; analgesic and antiemetic drugs were required in 64% and 35.7% of patients, respectively. The variables independently associated with intolerance to refeeding were choledocholithiasis (hazard ratio [HR], 12.35; 95% confidence interval [CI], 2.98-51.19; P = 0.001), fasting time (HR, 1.33; 95% CI, 1.09-1.63; P = 0.005), refeeding with complete diet (HR, 4.93; 95% CI, 1.66-14.66; P = 0.04), length of symptoms before admission (HR, 1.004; 95% CI, 1.001-1.006; P = 0.012), and metamizole dose (HR, 1.11; 95% CI, 1.02-1.21; P = 0.014).


CONCLUSIONS
Intolerance to refeeding is an infrequent event. We have identified several factors independently associated with intolerance.
Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
María
M
Francisco
Fátima
F
Valentín
Joaquín
J
Cubiella
Maria Teresa
MT
Alves
María Jesús
MJ
García
Teresa
T
Fernández
Javier
J
Fernández-Seara
D015746:Abdominal Pain / Q000178:diet therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D004177:Dipyrone / Q000627:therapeutic use; D005215:Fasting; D005248:Feeding Methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000178:diet therapy* / Q000188:drug therapy; D055677:Refeeding Syndrome / Q000178:diet therapy* / Q000188:drug therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013662:Tea; D016896:Treatment Outcome; D055815:Young Adult
D000700:Analgesics; D000932:Antiemetics; D013662:Tea; D004177:Dipyrone