Effect of early versus delayed feeding following emergency endoscopic therapy for acute esophageal variceal bleeding on short-term outcomes

Abstract

Background/aim It is generally assumed that systematic fasting is obligatory in the context of acute variceal bleeding owing to the fear of increasing the risk of rebleeding if patients instituted feeding early after endoscopy. However, this assumption is generally built on experts’ beliefs instead of being based on large clinical trials. Such lack of clinical trials was the reason why we conducted this controlled study. Patients and methods Patients were selected from those with acute esophageal variceal bleeding admitted at the Hematemesis Unit at Mansoura Emergency Hospital. The study involved 90 patients who divided into two equal groups: group I included 45 patients as the early-feeding group and group II included 45 patients as the late-feeding group. Results There was no statistically significant difference regarding treatment complications distribution between the studied groups. The successful hemostatic rate was 100% in both groups. Neither rebleeding incidents nor deaths were encountered in the first 5 days in either group. Conclusion Early feeding with a liquid diet after successful endoscopic therapy of bleeding esophageal varices did not enhance rebleeding or increase mortality in the first 5 days following endoscopic intervention.

Keywords

• early feeding
• esophageal varices
• rebleeding