IMMEDIATE ORAL REFEEDING COMPARED TO HUNGER BASED REFEED-ING AND CONVENTIONAL ORAL REFEEDING IN PATIENTS WITH MILD AND MODERATE ACUTE PANCREATITIS - A MULTI-ARM RANDOMIZED CON-TROLLED TRIAL drsureshkumar08@gmail.com

 

IMMEDIATE ORAL REFEEDING COMPARED TO HUNGER BASED REFEED-ING AND CONVENTIONAL ORAL REFEEDING IN PATIENTS WITH MILD AND MODERATE ACUTE PANCREATITIS - A MULTI-ARM RANDOMIZED CON-TROLLED TRIAL

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India

Oral or Poster

This study aimed to evaluate the effect of immediate oral refeeding (IOF) compared to hunger based oral refeeding (HBORF) and conventional refeeding (CRF) in patients with mild and moderate acute pancreatitis (AP)

In this prospective multi-arm randomised control trail, AP patients were randomized into one of the three feeding groups. Regardless of symptoms, those in IOF group were started on low fat solid diet as soon as they were admitted in hospital. Those on HBORF, liquid diet was started when patient felt hunger and gradually increased to semisolids and solids. Patients in CRF were started on liquid diet when clinical and laboratory parameters were normalised and gradually escalated to semisolids and solids. LOH, ICU admission, readmissions, pain relapse, need for interventions were assessed.

A total of 186 patients with mild or moderate AP were randomized into IOF, CRF and HBORF. The median LOH in CRF, IORF and HBORF groups were 3 (IDR 4.25), 2 (IQR 4.25) and 2 (IQR 3). The LOH was significantly low with IORF compared to CRF (p- 0.016). There was no significant difference between IORF- HBORF and CRF – HBORF. Sub group analysis among mild and moderate AP patients revealed no significant difference in LOH among three groups. There was no significant difference in pain relapse, complications, interventions, ICU admission and readmissions.

In mild and moderate AP, IORF reduces LOH compared to CRF. There is no significant difference between IORF, CRF and HBORF in terms of ICU admission, readmissions, pain relapse and need for interventions.