Comparison of Early vs Late Resumption of Enteral Feeding after Small Bowel Anastomosis

Introduction: Small bowel anastomosis is commonly performed in general surgical practice. Traditionally, Patients are kept nil by mouth for 48 to 72 hours in the belief that it will help in the healing of the anastomosis. However, recently, there is increasing evidence that early initiation of enteral feeding is both safe and beneficial. Our study aimed to compare early and traditional practices of enteral feeding after small bowel anastomosis. Materials and Methods: This study was a single-blinded, randomised controlled trial. The sample size was calculated to be 204, 102 in each group. Participants were randomly allocated to the early enteral feeding group (Group A) or the late group (Group B). In the Early group, enteral feeding was commenced after full recovery from anaesthesia, usually within 24 hours of surgery. In the late group, feeding was started after 24 - 48 hours, usually after the return of bowel function. Results: Our study demonstrated a statistically significant difference in terms of time to passage of stool or flatus and mean hospital stay between early and delayed initiation of enteral feeding. The incidence of postoperative vomiting and anastomotic leak had no statistically significant difference. Conclusion: Early initiation of enteral feeding after small bowel anastomosis is safe and is associated with quicker return of bowel function and shorter hospital stay as compared to delayed initiation of enteral feeding.