Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery—A randomized clinical study

Eckerwall, Gunilla; Tingstedt, Bobby; Bergenzaun, Per; Andersson, Roland

doi:10.1016/j.clnu.2007.04.007

Cited by 200 publications

(167 citation statements)

References 25 publications

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“…Eckerwall et al [24] employed immediate oral feeding, Abou-Assi et al [23], Oláh et al [26], and McClave et al [25] administered nasojejunal feeding, and Petrov et al [27] and Ma et al [29] used nasogastric feeding. Immediate oral feeding (EN) significantly cut the length of hospital stay without any adverse events [24]. Nasogastric feeding starting within 24 h of hospital admission was not only well tolerated, but also reduced the intensity and duration of abdominal pain, decreased the necessity of opiates, and almost totally eliminated the risk of oral food intolerance [27].…”

Section: Discussionmentioning

confidence: 99%

“…Not surprisingly, analyses of low amounts of data in which the mortality and MOF are close to zero could not reveal any significant difference between the two groups. With regard to mortality, five out of six articles contained proper data [23][24][25][26][27]. Risk differences and CI were calculated in the articles.…”

Section: Mild and Moderate Acute Pancreatitis (Map) Groupmentioning

confidence: 99%

“…Thirty-three articles (21 articles containing patients suffering from SAP as well as 12 articles with MAP patients) were selected. They contained two nonrandomized and 31 randomized controlled clinical trials (Table 2) [16][17][18][19][20][21][22][23][24][25][26][27]29,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. Finally, statistical analyses were performed on data from articles where both EN and NPO groups were presented, the trial was randomized, and the relevant data were available.…”

Section: Inclusions and Exclusionsmentioning

confidence: 99%

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Meta-analysis of early nutrition: the benefits of enteral feeding compared to a nil per os diet not only in severe, but also in mild and moderate acute pancreatitis

2017

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Abstract:The recently published guidelines for acute pancreatitis (AP) suggest that enteral nutrition (EN) should be the primary therapy in patients suffering from severe acute pancreatitis (SAP); however, none of the guidelines have recommendations on mild and moderate AP (MAP). A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The following PICO (problem, intervention, comparison, outcome) was applied: P: nutrition in AP; I: enteral nutrition (EN); C: nil per os diet (NPO); and O: outcome. There were 717 articles found in Embase, 831 in PubMed, and 10 in the Cochrane database. Altogether, seven SAP and six MAP articles were suitable for analyses. In SAP, forest plots were used to illustrate three primary endpoints (mortality, multiorgan failure, and intervention). In MAP, 14 additional secondary endpoints were analyzed (such as CRP (C-reactive protein), WCC (white cell count), complications, etc.). After pooling the data, the Mann-Whitney U test was used to detect significant differences. Funnel plots were created for testing heterogeneity. All of the primary endpoints investigated showed that EN is beneficial vs. NPO in SAP. In MAP, all of the six articles found merit in EN. Analyses of the primary endpoints did not show significant differences between the groups; however, analyzing the 17 endpoints together showed a significant difference in favor of EN vs. NPO. EN is beneficial compared to a nil per os diet not only in severe, but also in mild and moderate AP.

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Section: Discussionmentioning

confidence: 99%

Section: Mild and Moderate Acute Pancreatitis (Map) Groupmentioning

confidence: 99%

Section: Inclusions and Exclusionsmentioning

confidence: 99%

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Meta-analysis of early nutrition: the benefits of enteral feeding compared to a nil per os diet not only in severe, but also in mild and moderate acute pancreatitis

2017

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“…The diet should not necessarily be liquid or semi-liquid, but should be low-fat and low residue. 126,127 In severe cases, artificial feeding is necessary with endoscopic or radiological positioning of naso-jejunal tube (preferred) and enteral nutrition formulas rich in protein and low in fat (with a caloric need of 25 kcal/kg of ideal weight). This approach allows, with respect to the total parenteral nutrition (TPN), to maintain the integrity of the intestinal barrier, to reduce the risk of intestinal atrophy and bacterial/fungal translocation and to reduce the risk of sepsis related to the use of central venous access (CVC) and TPN.…”

Section: Nutritionmentioning

confidence: 99%

The management of the patient with acute pancreatitis: from evidence to clinical practice

Cenci

Restuccia

Gnerre³

et al. 2017

Ital J Med

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Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain and elevation of pancreatic enzymes in the blood. The pathogenesis is complex and partly unknown and the evolution is often unpredictable. Many efforts have been made to define this disease and its complications and to classify different grades of severity in order to formulate prognostic scores that could guide the physician in choosing the optimal therapeutic setting and procedures. The management of the patient with pancreatitis is not always optimal and differs among internist, gastroenterologist or surgeon. We think that a patient with clinical suspicion of acute pancreatitis is admitted to medical or surgical department depending on the availability of beds and not according to evidence-based medicine. The aim of this monograph is to identify the optimal management of patients with acute pancreatitis admitted to hospital.

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“…Pankreasdiäten oder der abgestuften Pankreasschonkost ist nicht nur völlig unbewiesen -sie sind auch bei normal entwickeltem Geschmacksempfinden kaum genießbar. Eine kürzlich publizierte randomisierte Studie schlägt vor, bei leichter Pankreatitis keine Nahrungskarenz anzuordnen [201]. Dies führte zu einer Reduktion der Krankenhausverweildauer und einer schnelleren Rekonvaleszenz.…”

Section: Leitlinie 1187unclassified

S3-Leitlinie Chronische Pankreatitis: Definition, Ätiologie, Diagnostik, konservative, interventionell endoskopische und operative Therapie der chronischen Pankreatitis. Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)

et al. 2012

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Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery—A randomized clinical study

Cited by 200 publications

References 25 publications

Meta-analysis of early nutrition: the benefits of enteral feeding compared to a nil per os diet not only in severe, but also in mild and moderate acute pancreatitis

Meta-analysis of early nutrition: the benefits of enteral feeding compared to a nil per os diet not only in severe, but also in mild and moderate acute pancreatitis

The management of the patient with acute pancreatitis: from evidence to clinical practice

S3-Leitlinie Chronische Pankreatitis: Definition, Ätiologie, Diagnostik, konservative, interventionell endoskopische und operative Therapie der chronischen Pankreatitis. Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)

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