Bleeding and starving: fasting and delayed refeeding after upper gastrointestinal bleeding

Fonseca, Jorge; Meira, Tânia; Nunes, Ana; Santos, Carla Adriana

http://hdl.handle.net/10400.26/8821

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Authors

Fonseca, Jorge

Meira, Tânia

Nunes, Ana

Santos, Carla Adriana

Abstract(s)

"Context - Early refeeding after nonvariceal upper gastrointestinal bleeding is safe and reduces hospital stay/costs. Objective - The aim of this study was obtaining objective data on refeeding after nonvariceal upper gastrointestinal bleeding. Methods - From 1 year span records of nonvariceal upper gastrointestinal bleeding patients that underwent urgent endoscopy: clinical features; rockall score; endoscopic data, including severity of lesions and therapy; feeding related records of seven days: liquid diet prescription, first liquid intake, soft/solid diet prescription, first soft/solid intake. Results - From 133 patients (84 men) Rockall classification was possible in 126: 76 score ≥5, 50 score <5. One persistent bleeding, eight rebled, two underwent surgery, 13 died. Ulcer was the major bleeding cause, 63 patients underwent endoscopic therapy. There was 142/532 possible refeeding records, no record 37% patients. Only 16% were fed during the first day and half were only fed on third day or later. Rockall <5 patients started oral diet sooner than Rockall ≥5. Patients that underwent endoscopic therapy were refed earlier than those without endotherapy. Conclusions - Most feeding records are missing. Data reveals delayed refeeding, especially in patients with low-risk lesions who should have been fed immediately. Nonvariceal upper gastrointestinal bleeding patients must be refed earlier, according to guidelines."

Description

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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http://creativecommons.org/licenses/by-nc/3.0//deed.en