Comparative Study of Early Versus Late Enteral Feeding in the Postoperative Period Following Small and Large Bowel...

The timing of enteral feeding in the postoperative period after small and large bowel surgeries significantly influences patient recovery. Traditional nil-by-mouth protocols delay feeding until bowel function returns but may exacerbate malnutrition, delay wound healing, and prolong hospital stays. Emerging evidence suggests early enteral feeding (EEF) offers better outcomes.

This study aims to compare the effects of EEF (within 24 hours of surgery) and delayed enteral feeding on postoperative recovery, complications, and hospital stay in patients undergoing small and large bowel surgeries.

A prospective observational study was conducted at a tertiary rural hospital over two years, including 70 patients undergoing bowel surgeries. Patients were divided into two groups: early feeding (EEF) and late feeding. Outcomes assessed included the duration of ileus, wound infection rates, anastomotic leaks, feeding tolerance, and length of hospital stay. Statistical analysis was performed using chi-square tests and t-tests, with P < 0.05 considered significant.

The mean duration of ileus was significantly shorter in the EEF group (4.23 ± 1.26 days) than in the late feeding group (5.6 ± 1.4 days; P < 0.01). The EEF group also had a shorter hospital stay (5.74 ± 1.44 days vs. 7.11 ± 1.23 days; P < 0.01). Complications, including wound infections (2.9% vs. 11.4%) and anastomotic leaks (0% vs. 8.6%), were lower in the EEF group. Feeding tolerance was comparable between the groups, with 94.3% of patients with EEF tolerating feeding well.

EEF significantly reduces ileus duration, hospital stay, and complications, demonstrating its safety and effectiveness. These findings support incorporating EEF into standard postoperative care protocols to improve outcomes and reduce healthcare costs. Further multicentric studies are recommended to validate these results across diverse settings.