Clinical trial: oral feeding with a soft diet compared with clear liquid diet as initial meal in mild acute pancreatitis

BACKGROUND: In mild acute pancreatitis, traditional treatment has been initial fasting and oral refeeding with clear liquids to prevent adverse gastrointestinal events such as pain. The diet is gradually progressed to soft solids and hospital discharge is planned based on patients' tolerance to a solid diet. AIM: To determine the length of hospitalization and tolerance to oral refeeding when initiated on a soft diet as compared to a clear liquid diet. METHODS: One hundred and one patients with mild acute pancreatitis were randomized to receive either a clear liquid diet or soft diet when oral feeding was initiated. Frequency of pain, total and postrefeeding length of hospitalization, and dietary intake were monitored. Hospital discharge was decided by the medical team without input from the study coordinators. RESULTS: A statistically significant decrease in the length of hospitalization (total and postrefeeding) of a median of 2 days was seen in patients receiving a soft diet (P < 0.001). No significant difference in the need for cessation of diet because of pain was observed between the two groups. Patients initiated on a soft diet consumed significantly more calories and fats on study day 1 (P < 0.001). CONCLUSION: Oral refeeding with a soft diet in patients with mild acute pancreatitis can be considered safe and can result in shorter length of hospitalization.