• Chebli Julio Maria Fonseca JM Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora, Minas Gerais, , Pedro Duarte Gaburri, Aécio Flávio Meirelles De Souza, Elson Vidal Martins Junior, Ana Karla Gaburri, Guilherme Eduardo Gonçalves Felga, Eliane Aparecida De Paula, Cecília Ganimi Forn, Gerusa Vilela De Almeida, and Flavia De Castro Nehme.
• Division of Gastroenterology, Department of Internal Medicine, University Hospital of the Federal University of Juiz de Fora, Minas Gerais, Brazil. chebli@globo.com
• J. Gastroenterol. Hepatol. 2005 Sep 1; 20 (9): 1385-9.

Background And AimIn 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.MethodsInclusion 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.ResultsA 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 (P < 0.01). Pain relapse significantly increased total hospital stay (P < 0.01).ConclusionsIn 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.Copyright 2005 Blackwell Publishing Asia Pty Ltd.

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