Oral refeeding in patients with mild acute pancreatitis: Prevalence and risk factors of relapsing abdominal pain

Authors

  • JULIO MARIA FONSECA CHEBLI,

    Corresponding author
    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • PEDRO DUARTE GABURRI,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • AÉCIO FLÁVIO MEIRELLES DE SOUZA,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • ELSON VIDAL MARTINS JUNIOR,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • ANA KARLA GABURRI,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • GUILHERME EDUARDO GONÇALVES FELGA,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • ELIANE APARECIDA DE PAULA,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • CECÍLIA GANIMI FORN,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • GERUSA VILELA DE ALMEIDA,

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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  • FLAVIA DE CASTRO NEHME

    1. Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital, Juiz de Fora, Minas Gerais, Brazil
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Julio Maria Fonseca Chebli, Rua Maria José Leal, 296, Juiz de Fora, Minas Gerais—Brazil, CEP 36036-247. Email: chebli@globo.com

Abstract

Background and Aim:  In acute pancreatitis (AP), oral refeeding may stimulate pancreatic secretion, increasing the inflammation of the glandular tissue causing relapse of abdominal pain or even exacerbation of the disease. This study aimed to assess the prevalence and risk factors of abdominal pain relapse over oral refeeding in patients convalescing with AP as well as the impact of pain recurrence on the hospital stay.

Methods:  Inclusion criteria were AP confirmed by biochemical and/or radiological data in the absence of severe disease or extensive necrosis. The same diet was offered to all patients during oral refeeding. Demographic, clinical, biochemical and radiological data were prospectively recorded and analyzed.

Results:  A total of 130 patients were included. During the oral refeeding period, 32 (24.6%) patients had pain relapse, which was more common on days 1 (68.8%) and 2 (28.1%). Pain relapse was related to higher serum levels of lipase on the day before refeeding, higher serum levels of C-reactive protein on the fourth day, and presence of peripancreatic fluid collections (< 0.01). Pain relapse significantly increased total hospital stay (< 0.01).

Conclusions:  In patients with mild AP, pain relapse during oral refeeding was relatively high (24.6%), particularly on the first or second day. Their risk appeared be associated with more intense or persistent pancreatic inflammation on the day before refeeding, and presence of peripancreatic fluid collections. Pain relapse increased hospital stay, and likely overall costs on disease treatment.

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