A myth that early feeding causes bowel anastomotic leakage: is it true?

Abstract

Background: Traditionally it’s believed that long fasting after intestinal surgery protect anastomosis site. However delayed feeding causes mental stress on patients, any beneficial effect of delayed feeding is yet to be proved. Early feeding should be promoted as longer fasting cause mucosal atrophy of the intestine and fasting patients requires TPN that has its own problems and complications along with additional costs. Methods: The aim of study is to evaluate the outcomes of early feeding in bowel anastomosis in terms of intestinal anastmotic leakage, post operative ileus and hospital stay. We included 100 patients of age group 20-50 yrs who underwent ileostomy closure and they were randomized blindly into two groups - early vs. late feeding group. Results: The mean time of first oral normal feed in early feeding group was 2.29± 0.37 as compared to delayed feeding group which was 6.44± 0.43 days (p value significant <0.0001). The first defecation was significantly earlier in the study group as compared to late feeding group (study group mean 4.04± 0.21 vs. control group mean 7.9± 0.22, p value <0.0001) and hospital stay is significantly shorter in study group (early group mean 4± 0.21 vs. delayed feeding group 8.08 ± 0.23, p value <0.0001) as compared to late feeding group. There was no mortality and anastomotic leakage in both groups. Conclusions: Early feeding does not cause any major complication i.e. anastomotic leakage and promotes overall patients feeling of wellbeing and decrease hospital stay and costs.