A comparative study on early versus conventional feeding in patients under going small bowel anastomosis

Babu Venkatesh Sundar; Muthu Sankaralingam; Ria Tulsian

doi:10.18203/2349-2902.isj20263341

Authors

Babu Venkatesh Sundar Department of General Surgery, Government Theni Medical College, Theni, Tamil Nadu, India
Muthu Sankaralingam Department of General Surgery, Government Theni Medical College, Theni, Tamil Nadu, India
Ria Tulsian Department of General Surgery, Government Theni Medical College, Theni, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20263341

Keywords:

Early enteral feeding, Small bowel anastomosis, Early bowel recovery, ERAS, Reduced hospitalisation

Abstract

Background: Postoperative nutritional management plays a critical role in surgical recovery, particularly following gastrointestinal procedures such as small bowel anastomosis. Traditional practice delays enteral nutrition until bowel sounds or flatus return; however, recent evidence suggests that early enteral feeding (EEN) may improve outcomes without increasing complications. Aim was to compare patient compliance, tolerance, and clinical outcomes between early enteral feeding and conventional feeding methods in patients undergoing elective small bowel anastomosis.

Methods: This prospective comparative study was conducted at a tertiary care center over a two-year period. A total of 100 patients undergoing elective small bowel anastomosis were randomly divided into two groups: Group A (Early feeding, n=50): Initiated enteral feeding via nasogastric tube on postoperative day (POD) 2. Group B (Conventional feeding, n=50): Began oral feeding after return of bowel sounds, typically POD 5-7. Parameters assessed included vomiting, abdominal distension, return of bowel function, nasogastric tube removal, infection, anastomotic leak, length of hospital stay, and patient compliance. Data were analyzed using standard statistical tests; a p<0.05 was considered significant.

Results: Early return of bowel function: Flatus passed significantly earlier in group A (mean 2.4±0.6 days) vs. group B (3.6±0.7 days), p<0.001. Shorter hospital stay: Group A had a significantly shorter stay (6.1±1.3 days) than group B (9.4±1.6 days), p<0.001. Lower abdominal distension: Group A (10%) vs Group B (26%), p=0.04. Similar complication rates: anastomotic leak was rare and not significantly different (2% vs. 4%, p=0.56). High compliance: 92% in Group A tolerated early feeding; 100% in Group B adhered to conventional feeding.

Conclusions: Early enteral feeding following small bowel anastomosis is better tolerated and enhances postoperative recovery of the patients, faster bowel function recovery and reduced hospital stay without increasing the risk of complications. Following Early enteral feeding in routine practice is aligned with Enhanced Recovery After Surgery protocol (ERAS).

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