ISPUB.COM The Internet Journal of Gastroenterology Volume 7 Number 1 1 of 7 Early enteral nutrition following gastrointestinal anastomosis S Marwah, R Godara, R Goyal, N Marwah, R Karwasra Citation S Marwah, R Godara, R Goyal, N Marwah, R Karwasra. Early enteral nutrition following gastrointestinal anastomosis. The Internet Journal of Gastroenterology. 2007 Volume 7 Number 1. Abstract Objective :- to compare feasibility, safety and efficacy of early Vs delayed oral feeding after elective intestinal anastomosis. Methods :- A –three –year comparative single –centre study in which 25 patients who had early feeding within 6 hrs after surgery were compared with 25 patients who had late feeding after appearance of bowel sounds and flatus passage. Patients were matched for age, sex, indication of surgery and nutritional status. Analysis was done using student's t-test regarding timing of appearance of bowel sounds, passage of flatus and stool, wound sepsis, anastomotic leaks and duration of hospital stay etc. Results :- Mean time for appearance of bowel sounds was 1.08 ± 0.27 days in study group compared to 2.12 ± 0.6 days in control group (p<0.05). The mean time for passage of flatus in study and control group was 1.32 ± 0.55 Vs 2.76 ± 0.87 days (p<0.05) and passage of stool 2.28 ± 0.89 Vs 3.92 ± 0.90 days (p<0.05). Post operative serum proteins level of study group were significantly higher in comparison to control group (p<0.05). Three patients (12%) in control and two patients(8%) in study group had anastomosis leak. The mean hospital stay was 5.8 ± 3.09 days in study group and 10.56 ± 7.01 days in control group (p<0.05). Conclusion :- Early oral feeding after elective gastro-intestinal anastomosis is well tolerated, helps in early resolution of ileus, decreased wound infection and short hospital stay. INTRODUCTION Routines in surgery have evolved as a way of eliminating as many variables as possible in effecting safe outcomes. One such routine practiced for last 50 years has been postoperative nasogastric decompression.However, many prospective randomized trials performed in recent years evaluating the effects of nasogastric intubation have suggested that it may be unnecessary, itself delaying passage of flatus and bowel movements as well as lengthening the duration of hospital stay 1 . There has been genuine and great apprehension regarding increased chances of anastomotic leaks in non intubated patients. However various studies have shown that the incidence of anastomotic leak is equal in both the intubated and non-intubated patients. In a systematic review and meta-analysis of controlled trials on early enteral feeding versus “nil by mouth” after gastrointestinal surgery, eleven studies with 837 patients it was concluded that there was no clear advantage of keeping patients nil by mouth after elective gastrointestinal resection and early feeding may be of benefit. Since surgical patients are subjected to postoperative stress and hypercatabolic state, these patients require some form of nutritional support in the form of enteral or total parenteral nutrition (TPN).Although there is strong evidence that “nil by mouth” is not justified, the data are still conflicting over the role of early enteral nutrition compared with the traditional methods of postoperative feeding including total parenteral nutritional support. 2 AIMS & OBJECTIVES To compare the feasibility, safety and efficacy of early versus delayed oral feeding after elective intestinal anastomosis. MATERIAL & METHODS The present prospective and randomized trial included 50 patients undergoing elective intestinal anastomosis . Patients were divided into two groups of 25 patients each.