Early Enteral Feeding After Intestinal Anastomosis

Pre operatively, common parameters observed in both study and control groups were:

• Name
• Age
• Sex
• Date of admission
• Weight
• Indication of surgery
• Pre operative features of sepsis (whether present or not) which included temperature, pulse rate& total leukocyte count.

Post operatively, the patients in the study group were kept nil per orally for the first forty eight hours. The nasogastric tube was removed on the first post operative day invariably.

After forty eight hours of surgery, subjects were started on sips of clear liquids orally; the amount was gradually increased as tolerated by the patient. The diet was stepped up to soft diet and to regular diet. A record was made of abdominal discomfort, pain or distension if experienced by the subject during feeding.

Record was made of the following:

• Site of anastomosis
• Type of anastomosis ( sutured / stapled )
• Time of removal of nasogastric tube
• Time of passage of flatus / stools post operatively
• Time of appearance of bowel sounds
• Features of sepsis which included temperature, pulse rate & total leukocyte count
• Presence of wound infection
• Weight on the fifth day of surgery, at the time of discharge
• Date of discharge
• Length of hospital stay

Patients in the control group were kept on maintenance intravenous fluids containing dextrose and saline. Nasogastric tube was removed and feeds were started orally as decided by the operating surgeon depending on the clinical condition of the patient and presence of bowel activity. Post operative records were made of the same parameters as in the study group.

Inclusion criteria

• All patients undergoing intestinal anastamosis on an elective or emergency basis

Exclusion criteria

• Re laparotomies
• Patients who are immunosuppressed
• Patients with renal failure
• Patients with spinal injuries
• Patients requiring critical care
• Pediatric patients