title: Bleeding and starving: fasting and delayed refeeding after upper gastrointestinal bleeding.
abstract: BACKGROUND
  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.
authors.affiliation: Hospital Garcia de Orta, Serviço de Gastrenterologia, Grupo de Estudo de Nutrição Entérica - GENE, Pragal, Almada, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Fonseca
authors.affiliation: Hospital Garcia de Orta, Serviço de Gastrenterologia, Grupo de Estudo de Nutrição Entérica - GENE, Pragal, Almada, Portugal.
authors.forename: Tânia
authors.initials: T
authors.lastname: Meira
authors.affiliation: Hospital Garcia de Orta, Serviço de Gastrenterologia, Grupo de Estudo de Nutrição Entérica - GENE, Pragal, Almada, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Nunes
authors.affiliation: Hospital Garcia de Orta, Serviço de Gastrenterologia, Grupo de Estudo de Nutrição Entérica - GENE, Pragal, Almada, Portugal.
authors.forename: Carla Adriana
authors.initials: CA
authors.lastname: Santos
mesh_terms: D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005215:Fasting; D005248:Feeding Methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D041742:Upper Gastrointestinal Tract