Dr. Akhilesh Kumar Kasyap
Grande International Hospital Dhapasi, Kathmandu, Nepal.
Background : To date, usually, the initial treatment of AP consists of nil per os (NPO) regimen and administration of analgesic and abundant intravenous fluids . It is assumed that the benefit without food intake that pancreatic stimulation be enteral feeding may aggravate pancreatic inflammation. However, the validity of such assumptions is pretty much debatable. On the other hand, various studies have revealed that enteral feeding significantly reduced the risk of infection, lowers the need of surgical intervention, and reduces the length of hospital stay. Results from the meta analysis show that mortality rate is significantly reduced when patients of acute pancreatitis are fed enterally. More importantly, the timing of the start of the start of nutrition, within 48 hours of hospital admission a factor that relate in the reduction of the mortality in patients with severe AP.
General objective : To determine the tolerance and efficacy of early NGT versus NPO in patients with mild to moderate acute pancreatitis
Methods : Prospective randomized Trial: The prospective randomized control trial is designed in patients with diagnosed mild to moderate pancreatitis. The patients satisfying the inclusion criteria were subjected to early nasogastric tube feeding and were compared with nil per oral group.
Results : In the present study, we investigated an alternative approach to reinitiating feeding that was based on hunger, without the remission of abdominal pain or normalization of pancreatic amylase and lipase. Our results demonstrated that early oral refeeding based on this approach significantly decreased the duration of hospitalization. We found mean difference between the groups was 1.65 (P=0.04).
Conclusion : Based on the finding illustrated above it implies that EEF could be appropriate strategy for the management of mild to moderate acute pancreatits in term of reduction of hospital stay and intensity of pain score.