Kitchen-based diet versus commercial polymeric formulation in acute pancreatitis: a pilot randomized comparative study

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 with a commercially available polymeric formulation in terms of various outcomes in patients with AP within 14 days after the onset of pain. Methods: Sixty patients (39 male, mean age 36.1 ± 12.7 years) 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), 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 formulation for the early initiation of enteral nutrition in patients with severe or moderately severe acute pancreatitis. Clinical trial registration: Trial registered with the Clinical Trials registry-India (CTRI/2018/01/011188).