[When should patients with bleeding peptic ulcer resume oral intake? A randomized controlled study]

Area of Science:

• Gastroenterology
• Endoscopy
• Clinical Medicine

Background:

• Patients with bleeding peptic ulcers are commonly kept nil by mouth.
• The impact of early feeding on bleeding recurrence and patient outcomes is not well-established.

Purpose of the Study:

• To evaluate the effect of early feeding on bleeding peptic ulcer recurrence.
• To assess the impact of early feeding on the overall outcome of patients with severe bleeding peptic ulcers.

Main Methods:

• A prospective controlled study involving 26 patients with active bleeding peptic ulcers treated with emergency endoscopic injection.
• Patients were randomized into two groups: early feeding (Group A) and fasting (Group B).
• Group A received milk on day 1, progressing to a normal diet by day 3, while Group B was kept nil by mouth until day 3.

Main Results:

• No significant differences were observed in bleeding ulcer recurrence rates or transfusion requirements between the early feeding and fasting groups.
• Patients in the early feeding group (Group A) had a significantly shorter hospital stay (6.8 days) compared to the fasting group (Group B, 9.9 days).
• Baseline characteristics, including hemoglobin levels and ulcer localization, were comparable between the groups.

Conclusions:

• Fasting offers no apparent advantage for patients with active bleeding peptic ulcers treated with endoscopic sclerotherapy.
• Early feeding is safe and does not worsen outcomes in patients with active bleeding peptic ulcers.
• Early feeding can lead to a reduced hospital stay for patients with bleeding peptic ulcers.