A controlled trial of early versus delayed feeding following ligation in the control of acute esophageal variceal bleeding.
BACKGROUND
The impact of feeding after endoscopic treatment of gastroesophageal varices has rarely been thoroughly investigated. We conducted a controlled study to evaluate whether delayed feeding causes a reduced incidence of rebleeding on patients receiving emergency endoscopic therapy for bleeding gastroesophageal varices.


METHODS
Cirrhotic patients presenting with acute esophageal variceal bleeding were provided critical treatment through emergency endoscopic variceal ligation. After bleeding from the varices had been arrested, the eligible participants were randomized to two groups. The early-feeding group and the delayed-feeding group were asked to fast for 4 hours and 48 hours, respectively, after endoscopic therapy. The primary end points were initial hemostasis, very early rebleeding, and ulcer-bleeding rates.


RESULTS
There were 36 patients enrolled in the early-feeding group and 34 patients in the delayed-feeding group. Both groups were comparable in baseline data. Initial hemostasis was achieved in 100% in both groups, and very early rebleeding was not encountered in either group. The incidence of adverse events was similar between both groups. The mean hospitalization days were 6.0 ± 2.4 days (range: 2-17 days) in the early-feeding group, and 7.5 ± 3.1 days (range: 3-22 days) in the delayed-feeding group (p < 0.05).


CONCLUSIONS
Early feeding with liquid diet after a successful endoscopic therapy of bleeding varices did not have any impact on hemostasis.
Department of Medical Research, Division of Gastroenterology, E-Da Hospital, School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan, ROC. Electronic address: ghlo@kimo.com.
Gin-Ho
GH
Lo
Department of Medical Research, Division of Gastroenterology, E-Da Hospital, School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan, ROC.
Chih-Wen
CW
Lin
Department of Medical Research, Division of Gastroenterology, E-Da Hospital, School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan, ROC.
Yao-Chun
YC
Hsu
D000208:Acute Disease; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005248:Feeding Methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D013997:Time Factors
banding ligation; early feeding; variceal bleeding