Scholarly Article
EARLY VERSUS DELAYED ENTERAL FEEDING IN ACUTE PANCREATITIS: A PROSPECTIVE OBSERVATIONAL STUDY
Dr Raju N, Dr Loganayaki D, Dr Sugumar S
2026-09-30 · International Journal of Clinical and Biomedical Research · Sumathi Publications
Abstract
Background: Acute pancreatitis produces a systemic inflammatory response that increases metabolic demands and may impair intestinal mucosal integrity. Early enteral feeding has been proposed to preserve gut barrier function and accelerate recovery, but its optimal timing among clinically stable patients remains uncertain in routine practice. Objective: To compare the clinical outcomes and post-feeding biochemical profiles of early versus delayed enteral feeding in patients with acute pancreatitis. Methods: This prospective observational study was conducted over 12 months in the Department of General Surgery at a tertiary care teaching hospital in Tamil Nadu. One hundred eligible patients with acute pancreatitis were enrolled by non-probability consecutive sampling. Fifty commenced enteral feeding within 24 hours of admission and 50 commenced feeding after 48 hours, according to decisions made by the treating surgical team. The groups were compared for refeeding pain, ICU admission and duration of hospitalization. Blood urea, serum creatinine, serum amylase and serum lipase were assessed at admission and after feeding initiation. Categorical variables were compared using the Pearson chi-square or Fisher exact test, biochemical variables using the independent-samples Student t-test, and hospital stay using the Mann-Whitney U test. Results: The groups were comparable in age, sex, aetiology and recorded disease- severity scores. Refeeding pain was less frequent in the early-feeding group than in the delayed-feeding group (16.0% versus 46.0%; p = 0.001). None of the early-fed patients required ICU care, compared with 48.0% of delayed-fed patients (p < 0.001). Median hospital stay was 3 days (IQR: 2-3) in the early-feeding group and 4 days (IQR: 4-5) in the delayed- feeding group (p < 0.001). Biochemical parameters did not differ significantly between the groups at admission or after feeding initiation. Conclusion: Early enteral feeding within 24 hours was well tolerated and was associated with less refeeding pain, lower ICU use and shorter hospitalization without biochemical deterioration in this selected cohort of patients with acute pancreatitis. Because feeding timing was not randomized, the findings are susceptible to confounding by indication and require confirmation in randomized studies.
Keywords
Acute pancreatitis, delayed enteral feeding, early enteral feeding, hospital stay, refeeding pain
Citation Details
International Journal of Clinical and Biomedical Research, Vol. 11, No. 3, pp. 427-435