Effect of Nasogastric Tube Feeding vs Nil per Os on Dysmotility in Acute Pancreatitis: Results of a Randomized Controlled Trial.
BACKGROUND
Evidence from animal studies suggests that gastrointestinal motility is impaired in acute pancreatitis. Enteral nutrition, and more specifically nasogastric tube feeding, has emerged as a key treatment modality in patients with acute pancreatitis, but its effect on motility has not been investigated in this setting. The aim was to validate the Gastroparesis Cardinal Symptom Index (GCSI) in patients with acute pancreatitis and determine the effect of nasogastric tube feeding on GCSI.


METHODS
The study design was a randomized controlled trial. Patients were allocated to nasogastric tube feeding or nil per os within 24 hours of hospital admission. GCSI data from before randomization to 72 hours after randomization were analyzed. The test-retest reliability analysis was used to calculate Cronbach's α.


RESULTS
Seventeen patients were randomized to nasogastric tube feeding and 18 to nil per os. Overall, the total GCSI score significantly decreased over the study (F = 8.537; P = .001) but was not significantly different between the 2 study groups during hospitalization (F = 1.159; P = .322). However, patients on nasogastric tube feeding did show improved appetite compared with nil per os (F = 3.526; P = .036). The GCSI was found to be a reliable tool in the setting of acute pancreatitis (Cronbach's α = 0.852).


CONCLUSIONS
Nasogastric tube feeding does not appear to affect dysmotility symptoms in acute pancreatitis as measured by the GCSI, although appetite improved. Use of the simple, noninvasive, and inexpensive GCSI tool to evaluate motility is recommended in future clinical trials in pancreatology.
Department of Surgery, University of Auckland, Auckland, New Zealand.
Jiemin
J
Ma
Department of Surgery, University of Auckland, Auckland, New Zealand.
Sayali A
SA
Pendharkar
Department of Surgery, University of Auckland, Auckland, New Zealand.
Gregory
G
O'Grady
Department of Surgery, University of Auckland, Auckland, New Zealand.
John A
JA
Windsor
Department of Surgery, University of Auckland, Auckland, New Zealand max.petrov@gmail.com.
Maxim S
MS
Petrov
D000328:Adult; D001066:Appetite; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005769:Gastrointestinal Motility; D018589:Gastroparesis / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000503:physiopathology* / Q000628:therapy; D015203:Reproducibility of Results; D012720:Severity of Illness Index
dysmotility; enteral nutrition; gastrointestinal motility; pancreatitis; stomach