Early Enteral Feeding in Acute Pancreatitis

Background: Timing of enteral feeding in acute pancreatitis was always a matter of controversy. Increasing evidence suggests that early enteral feeding reduces systemic and local complications of pancreatitis and thereby hospital stay. Hence the study has been undertaken to determine the feasibility, advantages and disadvantages of early enteral feeding in mild and moderate acute pancreatitis. Methods: Patients admitted with symptoms and signs suggestive of mild and moderate acute pancreatitis who were started on early enteral feeding (within 48 hours of admission) were included in study. Blood investigation results are used to classify patients accordingly to mild and moderate acute pancreatitis based on Ransons’s score. Patients were followed up and categorized based on development of complications, length of hospital stay.Results: Majority of the patients who were started on early enteral feeding showed significant decrease in complications and hospital stay. Study also suggested that age is a significant risk in development of complications. Gender is not significant in the development of complications.Conclusions: There is significant decrease in rate of systemic complication, local infective and non-infective complications, length of hospital stay among acute pancreatitis patients who were started on early enteral feeding (within 48 hours).

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Early Enteral Feeding in Severe Acute Pancreatitis: Can It Prevent Secondary Pancreatic (Super) Infection?

Digestive Surgery ◽

10.1159/000051964 ◽

2000 ◽

Vol 17 (6) ◽

pp. 571-577 ◽

Cited By ~ 25

Author(s):

Peter Lehocky ◽

Michael G. Sarr

Keyword(s):

Acute Pancreatitis ◽

Severe Acute Pancreatitis ◽

Enteral Feeding ◽

Early Enteral Feeding ◽

Super Infection

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TO COMPARE EARLY ENTERAL FEED WITH EARLY PARENTERAL FEED IN PATIENTS OF ACUTE PANCREATITIS; A PROSPECTIVE RANDOMISED OBSERVATIONAL STUDY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i12.815 ◽

2019 ◽

Vol 3 (12) ◽

Author(s):

Devesh Kumar Tiwari ◽

Rajan B. Somani

Keyword(s):

Acute Pancreatitis ◽

Hospital Stay ◽

Enteral Feeding ◽

Intestinal Barrier ◽

Parenteral Feeding ◽

Intestinal Barrier Function ◽

Duration Of Hospital Stay ◽

Early Enteral Feeding ◽

Randomized Clinical Study ◽

Feeding Group

Acute pancreatitis has been recognised since antiquity but the importance of pancreas and the severity of its inflammatory disorders were realized only in the middle of the 19th century. In accordance with this wide variation in clinical presentation, the treatment of acute pancreatitis requires a multidisciplinary approach. But even today with technical advances in medical and surgical fields acute pancreatitis remains a major cause of morbidity and mortality. Increasing evidence suggests that enteral feeding maintains the intestinal barrier function and prevents or reduces bacterial translocation from the gut. Our aim is to compare the effects of early enteral feeding with early parenteral feeding in acute pancreatitis in terms of occurrence of infective & non infective complications in both types of feeding groups and to assess the average duration of hospital stay and cost in both groups. This prospective randomized clinical study was carried out on patients of 50 diagnosed cases of acute pancreatitis admitted in Sir T Hospital from October 2017 to August 2019. Patients included in study were randomly divided into two group A (Enteral feeding) and group B (Parenteral feeding). After initiation of respective nutrition patients were observed for infective and non infective complication incidence, duration of hospital stay and other morbidities. Enteral feeding decrease the incidence of infective and non pancreatic complications, decreases duration of hospital stay. Patients tolerating soft diet earlier in early enteral feeding group compared to early parenteral feeding group. Cost of treatment is also less in enteral feeding. So in acute pancreatitis early enteral feeding is superior to early parenteral feeding. Keywords: Acute pancreatitis , Enteral , Parenteral, Feeding.

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Effect of early enteral feeding on recovery profile in mild acute pancreatitis

International Surgery Journal ◽

10.18203/2349-2902.isj20202414 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1969

Author(s):

Kailash Chandran ◽

Sam Christy Mammen

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Hospital Stay ◽

Enteral Feeding ◽

The Body ◽

Advantages And Disadvantages ◽

Duration Of Hospital Stay ◽

Early Enteral Feeding ◽

Abdominal Symptoms ◽

Mild Acute Pancreatitis

Background: Acute pancreatitis is a pestilent disease with severity ranging from mild and self-limiting to a rapidly progressive illness leading to multi organ failure. Mild acute pancreatitis is inflammation of the pancreas with minimal remote organ involvement. Since the disturbance in the homeostasis is minimal, the treatment aims at supporting the native reparative processes of the body. One of the main supportive mechanisms is adequate nutritional supplementation. Gut barrier damage in the early phase of acute pancreatitis accounts for the bacterial translocation, initiation of sepsis, infected pancreatic necrosis and SIRS. Aim of the study was to determine the feasibility, advantages and disadvantages of early enteral nutrition in mild acute pancreatitis.Methods: 40 patients taken consecutively from units which start enteral feeds before 48 hours (study group) were compared against 40 patients taken consecutively from units where patients will be kept fasting for 48 hours (control group) to determine whether early enteral feeding is better in determining the recovery in terms of duration of hospital stay, reduction in abdominal symptoms and use of analgesics.Results: There was significant reduction in the duration of hospital stay (p=0.011), intensity and duration of abdominal pain, need for analgesics, and risk of oral food intolerance in the study group.Conclusions: Patients with mild acute pancreatitis can safely be started on early enteral feeds. It reduces gastro intestinal adverse effects, abdominal pain and need for analgesics and improves oral food tolerance causing shorter hospital stay.

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Early versus delayed enteral feeding in acute pancreatitis

International Surgery Journal ◽

10.18203/2349-2902.isj20180808 ◽

2018 ◽

Vol 5 (3) ◽

pp. 942

Author(s):

Manjunath B. D. ◽

Abhishek G.

Keyword(s):

Acute Pancreatitis ◽

Severe Acute Pancreatitis ◽

Enteral Feeding ◽

Necrotizing Pancreatitis ◽

Length Of Hospital Stay ◽

Feeding Tube ◽

Clinical Findings ◽

Early Enteral Feeding ◽

Multiple Organs ◽

Feeding Group

Background: Early enteral feeding through a nasoenteric feeding tube is often used in patients with acute pancreatitis, as compared to previous notion of pancreatic rest. This study aims to compare various outcomes of early and late enteral feeding in severe acute pancreatitis.Methods: This study was a randomized trial conducted at Victoria hospital, Bengaluru between July 2016 and June 2017. Patients with severe acute pancreatitis were randomized into early enteral feeding and late enteral feeding groups in the ratio of 1:1. Early enteral feeding group were started on oral feeds within 24 hours of admission. Late enteral feeding group were started on oral feeds after 72 hours of admission. Patient demographics, clinical findings, investigations, length of hospital stay, complications were assessed and compared.Results: In 124 out of 132 patients were included who met inclusion criteria. The mean age of patients was 28.6 years. There were 120 males (96.7%) and 4 females (3.2%). There were no significant differences in age, sex ratio and comorbidities between the two groups. Early enteral feeds group showed lesser number of gastrointestinal adverse effects after initiation of enteral feeds, lesser number of days taken to develop full tolerance to enteral feeds, lesser number of days of admission, lesser complications like necrotizing pancreatitis, single or multiple organs failure, lesser number of ICU admissions, requiring mechanical ventilation, including lesser mortality when compared to delayed enteral feeds group.Conclusions: Patients with severe acute pancreatitis can safely be started on early enteral feeds within 24 hours of admission.

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