Kitchen-based diet versus commercial polymeric formulations in acute pancreatitis: A pilot randomized comparative study

Abstract

Abstract Introduction: Nutrition plays an important role in management of acute pancreatitis (AP) and decreases its severity and infectious complications. Various formulations of enteral nutrition (EN) are available and are costly. For developing countries, cost and availability is a major issue and kitchen-based diet should be explored in patients with AP. Aim: Comparison of kitchen-based diet to commercially available polymeric formulations in terms of various outcomes in patients with AP. Methods: Sixty patients (39 male, mean age 36.1 ± 12.7 years, BMI 24.15 ± 3.31 kg/m2) of moderately severe and severe AP of any etiology were randomized (30 in each group) to either kitchen-based diet or commercial polymeric formulation group. Outcome measures were refeeding pain, tolerability, infectious complications, mortality, total hospital/intensive care unit stay; and change in serum C-reactive protein (CRP), transferrin and pre albumin. Results: There was no significant difference in baseline demographic and biochemical parameters in both groups. No difference was observed in refeeding pain (7.1% vs 8%, p = 0.99), tolerability (28.6% vs 12%, p = 0.17), infectious complications (57.14% vs 36%, p = 0.12), mortality (31.7% vs 20%, p = 0.69), new onset organ failure (10.7% vs 12%, p = 0.99), hospital stay (19.5 vs 23.5 days, p = 0.86), CRP (74.4 vs 59 mg/L, p = 0.97), transferrin levels (23.6 vs 25.6 mg/dL, p = 0.75) and pre albumin (9.45 vs 13.09 mg/dL, p = 0.68) in both groups. Conclusion: Kitchen-based diet is comparable to commercial polymeric formulations for the early initiation of enteral nutrition in patients with severe or moderately severe acute pancreatitis. Trial registered with the Clinical Trials registry-India (CTRI/2018/01/011188).