Patients with mild acute pancreatitis who received early initiation of a full solid diet vs a stepwise diet had a shorter total length of hospital stay, according to study results published in Pancreatology.
For the meta-analysis, researchers sourced data from PubMed, Embase, and Cochrane Library, from inception through August 2, 2021, on randomized controlled trials that analyzed types of oral diet initiation and length of hospital stay among patients with mild acute pancreatitis. Of 2482 trials identified, researchers included 7 in the review. The 7 studies comprised 613 patients, 305 of which were randomly assigned to a full solid diet and 308 of which were assigned to sequential advancement. The primary outcome was total length of hospital stay.
A significant reduction in total length of hospital stay was observed for patients who received a full solid diet vs a stepwise diet (standardized mean difference, -0.52; 95% CI, -0.69 to -0.36; I2=81.7%). No significant differences were observed between groups with diet tolerance (odds ratio [OR], 1.69; 0.55-5.22; I2=54.6%) and post-refeeding abdominal pain (OR, 0.85; 0.43-1.67; I2=29.6%).
Study limitations include the small number of trials included in the meta-analysis, only analyzing patients with mild pancreatitis, and significant heterogeneity in total length of hospital stay.
“We found that solid diet effectively reduces total length of hospital stay, does not increase risk of post-refeeding abdominal pain, and is well tolerated,” the study authors wrote. “This effect was consistent for very early initiation (<24 h or immediately upon ignition of bowel sounds) and possibly even more pronounced. While more studies are needed, initiation of solid diet as early as possible should be considered when managing patients with mild pancreatitis.”
Chowdhury AR, Chang P, Zhou S, et al. Optimal initial diet in mild acute pancreatitis: a comprehensive meta-analysis of randomized control trials. Pancreatology. Published online August 11, 2022. doi:10.1016/j.pan.2022.07.016