Published online Jan 14, 2021. doi: 10.3748/wjg.v27.i2.224
Peer-review started: November 5, 2020
First decision: November 25, 2020
Revised: November 29, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: January 14, 2021
Acute pancreatitis is one of the most common causes of acute abdominal pain, resulting in a huge clinical and financial burden worldwide. Most patients (80%) with acute pancreatitis present with mild disease, which is characterized by a short hospital stay, no or few complications, and rapid resumption of oral feeding. Allowing for the very low mortality rate (about 0.79%) of mild acute pancreatitis, shortening the length of hospital stay (LOS), and reducing medical financial expenditure have become the research priority.
Probiotics play an important role in a variety of microecologic interventions. The effects of probiotics in mild acute pancreatitis have not been studied. Considering the potential benefits of probiotics in the treatment of gastrointestinal disease, we hypothesized that probiotics may accelerate the recovery of intestinal function and shorten the LOS in patients with mild pancreatitis. Thus, we conducted a randomized, double-blind, placebo-controlled trial to evaluate the effect of the administration of probiotics in patients with mild pancreatitis.
This study was designed to investigate the value of probiotics in reducing the LOS in patients with mild acute pancreatitis.
We conducted a double-blind randomized clinical trial to evaluate the effects of probiotics administered to patients with mild acute pancreatitis at a tertiary medical center. The patients were given probiotics capsules (a mixed preparation of Bacillus subtilis and Enterococcus faecium) or placebo. The primary study endpoint was the LOS. The secondary endpoints included time to abdominal pain relief, recurrent abdominal pain, and time to successful oral feeding.
A total of 128 patients were included, with 64 patients in each arm. The severity of illness and the etiological distribution of disease were similar in the two groups. There was a significant reduction in the LOS in the probiotics treatment group vs the placebo group (5.36 ± 0.15 vs 6.02 ± 0.17 d, P < 0.05). The probiotics group was associated with a shorter time to abdominal pain relief and time to successful oral feeding (P < 0.01 for both) than the placebo group. No statistical difference was found in recurrent abdominal pain between the two groups.
The study results showed that the administration of probiotics capsule is associated with a shorter duration of hospitalization in patients with mild acute pancreatitis.
Probiotics supplementation appears to be safe and effective in reducing the length of hospitalization for patients with mild acute pancreatitis in this double-blinded randomized clinical trial. However, the sample size is small and the follow-up time is short in this study. In future studies, a randomized study with a larger sample using different types and doses of probiotics can be conducted to further clarify the role of probiotics in acute pancreatitis and other uninvestigated gastrointestinal diseases.