A prospective comparative study on early versus traditional late enteral feeding after loop ileostomy reversal

Ankit Yadav; Brij B. Banga; Harish Sharma

doi:10.18203/2349-2902.isj20260132

Authors

Ankit Yadav Department of General Surgery, Aadhar Health Institute, Hisar, Haryana, India
Brij B. Banga Department of General Surgery, Aadhar Health Institute, Hisar, Haryana, India
Harish Sharma Department of General Surgery, Aadhar Health Institute, Hisar, Haryana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20260132

Keywords:

Loop ileostomy reversal, Delayed feeding, Early enteral feeding, Postoperative ileus, ERAS, Hospital stay

Abstract

Background: Loop ileostomy reversal, though a routine procedure, is often associated with postoperative morbidity and delayed recovery. Traditional delayed feeding protocols prolong ileus and hospital stay. This study aimed to evaluate the safety and efficacy of early enteral feeding compared to conventional delayed feeding following loop ileostomy reversal.

Methods: A prospective, randomized controlled trial was conducted on 40 patients undergoing loop ileostomy reversal, equally divided into early and late enteral feeding groups (n=20 each). The early group received oral fluids 4 hours postoperatively, while the late group resumed oral intake after the return of bowel activity. Parameters assessed included time to bowel recovery, duration of hospitalization, postoperative complications, and cost-effectiveness. Statistical analysis was performed using the Chi-square and independent t-tests, with p<0.05 considered significant.

Results: Baseline demographic and biochemical characteristics were comparable between groups. Early enteral feeding significantly reduced recovery time—clear liquids (6 hours versus 54 hours), stool passage (18 hours versus 67 hours)—and shortened hospital stay (43±5 hours versus 94±9 hours; p<0.001). No increase in postoperative complications such as nausea, vomiting, distension, or anastomotic leakage was observed. All patients tolerated feeds within 24 hours, with complete wound healing by day 14.

Conclusions: Early enteral feeding after loop ileostomy reversal is safe, well tolerated, and accelerates gastrointestinal recovery, thereby reducing hospital stay and healthcare costs. Its integration into enhanced recovery protocols can substantially improve postoperative outcomes and surgical efficiency.

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