Abstract
Background: At the time of discharge, acceptability of oral feeds is one of the major criteria, so initiating early feeds gives patient the advantage of early feed acceptability and shorter hospital stay.
Objective: To assess the effect of early clear liquid diet vs. early low residue diet in terms of feasibility and outcome in patients with colorectal anastomosis and to study the outcome of early initiation of low residue diet on acceptability, complications and length of hospital stay.
Methods: It was a comparative, non-randomized study done. Total 30 patients undergoing colorectal anastomosis, for various indications were allotted into two groups. One group was given clear liquid as initial feed and the other group was given Low residue diet. Patients were studied for post-operative vomiting, abdominal distension, NG tube decompression required post-operatively, number of days on intravenous anti emetics, anastomotic leak and wound dehiscence.
Results: Early initiation of feeding in patients undergoing elective colorectal surgery resulted in early return of bowel functions, early feed acceptability and shorter hospital stay.
References
- Pearl ML, Valea FA, Fischer M, Mahler L, Chalas E. A randomized controlled trial of early postoperative feeding in gynaecologic oncology patients undergoing intra-abdominal surgery. Obstet Gynecol. 1998:92:94-7.10/1016/S0029-7844(98)00114-8.
- Bufo AJ, Feldman S. Daniels GA, Liberman RC, Early postoperative feeding. Dis Colon Rectum. 1994:37:1260-5.10.1007/BF02257793.
- Silk DBA, Gow NM. Post-operative starvation after gastrointestinal surgery. British Medical Journal. 2001:323:761-2.10.1136/bmj.323.7316.761
- Casto CJ, Krammer J, Drake J, Postoperative feeding: a clinical review. Obstetrical and Gynecological Survey. 2000:55:571-3.10.1097/00006254-2000090000-00022.
- Oritz H, Armendariz P, Yarnoz C. Is early postoperative feeding feasible in elective colon and rectal surgery. International Journal Of Colorectal Disease. 1996:11:119-21.10.1007/s003840050032.
- Grimble RF. Basics in clinical nutrition: Main cytokines and their effect during injury and sepsis. e-SPEN.2008;3:289-292
- Hancock S, Cresci G, Martindale R. The clear liquid diet: when it is appropriate? Curr Gastroenterol Rep. 2002;4:324-331.
- Boeckxstaens GE, de Jonge WJ. Neuroimmune mechanisms in post-operative ileus. Gut.2009;58:1300-1311.
- Toumadre JP, Barclay M, Fraser R et al. small intestinal motor patterns in critically ill patients after major abdominal surgery. Am J Gastroenterol. 2001;96:2418-2426
- Kasparek MS, Mueller MH, Glatzle J et al. Post operative colonic motility increases after early food intake in patients undergoing colorectal surgery. Surgery. 2004;136:1019-1027.
- Kamath PS, Philips SF. Initiation of motility in canine ileum by short chain fatty acids and inhibition by pharmacological agents. Gut. 1988;29: 941-948.
- Rao SS, Kavelock R, Beaty J et al. effects of fat and carbohydrate meal on colonic motor response. Gut 2000;46:205-211.
Corresponding Author
Saxena A
Department of Surgery, NSCB Medical College and Hospital, Jablapur, India