title: Is early enteral nutrition dangerous in acute non surgical complicated diverticulitis? About 25 patients fed with oral fiber free energetic liquid diet.
abstract: OBJECTIVE
  Complicated Acute Colonic Diverticulitis (ACD) is usually treated by parenteral way thus keeping the bowel at rest. To date there are no clear recommendations regarding the route of nutrition administration. We study the safety of early feeding by oral energetic fiber-free liquid diet in non-surgical complicated ACD patients.
  
  
  METHODS
  From February 2008 to October 2011, 25 patients were admitted with complicated ACD and took part in this prospective study. Surgical and medical assessments were performed at admission. Initial treatment was given with perfusion, intravenous antibiotics and hydric diet. Within 72 hours of admission, antibiotic therapy was switched to oral administration for 5 up to 15 days depending on the progression of the disease. At the same time the patient received oral liquid fiber-free feeding. Solid but fiber-free diet was introduced 24h hours before discharge.
  
  
  RESULTS
  25 cases of ACD were complicated with covered perforation and/or abscess. Mean hospitalisation time was 10A.4 days. 23 cases had good recovery and discharged, while 1 case progressed to colonic stenosis during hospitalisation, requiring a sigmoidectomy with a one-time anastomosis with good recovery. One patient relapsed his abscess during hospitalisation despite CT guided drainage and required sigmoidectomy with transient ileostomy. The mean daily treatment and nutrition cost for the non-surgical 23 patients was 30 euros.
  
  
  CONCLUSIONS
  Early enteral nutrition in complicated ACD is feasible, not harmful, and reduce both, mean hospitalization time and treatment cost. Further studies comparing enteral with parenteral nutrition are necessary to confirm our hypothesis.
authors.affiliation: CHWapi Notre Dame, Tournai, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Van Ooteghem
authors.forename: M
authors.initials: M
authors.lastname: El-Mourad
authors.forename: A
authors.initials: A
authors.lastname: Slimani
authors.forename: W
authors.initials: W
authors.lastname: Margos
authors.forename: A
authors.initials: A
authors.lastname: El Nawar
authors.forename: A
authors.initials: A
authors.lastname: Patris
authors.forename: J F
authors.initials: JF
authors.lastname: Gallez
authors.forename: J
authors.initials: J
authors.lastname: Kirsch
authors.forename: P
authors.initials: P
authors.lastname: Hauters
authors.forename: F
authors.initials: F
authors.lastname: Vallot
authors.forename: A
authors.initials: A
authors.lastname: Nakad
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004043:Dietary Fiber; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000178:diet therapy*; D002149:Energy Intake; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors