Early Feeding or Enteral Nutrition in Patients with Cirrhosis After Bleeding from Esophageal Varices? (A Randomized Controlled Study)

The aim of this randomized controlled study wasto assess the nutritional and clinical effects of earlyenteral nutrition (EN) in cirrhotic patients withbleeding from esophageal varices. From August 1994 through August 1995, all patients admitted foracute variceal bleeding underwent emergencysclerotherapy or banding ligation and continuousinfusion of octreotide and were randomized in twogroups. In group A, patients received from day 1 discontinuouspolymeric EN (1665 kcal/day, through nasogastric tube)and in group B, patients were nil by mouth. On day 4,all patients received oral diet. Nutritional status, liver function, and rebleeding were evaluatedon days 4, 7, and 35. Twenty-two patients (17 men, 5women, mean age 56 years) were included. On day 0,patients in group A (N = 12) and group B (N = 10) werecomparable. On day 4, nitrogen balance was 0.7 ± 2.5g/day in group A and –11.2 ± 6.7 g/day ingroup B (P = 0.01, Mann-Whitney test). On days 4, 7, and35, no significant differences between the two groupswere observed for nutritional status and liver function. Four(33%) group A patients rebled compared with one (10%)group B patient (NS). Hospital stay (14.5 ± 4.1days vs 12.9 ± 5.3 days) and mortality (3 vs 2patients), were comparable between the two groups. Inconclusion, our study failed to demonstrate anyfavorable effect of short-term EN on nutritional statusand liver function in cirrhotic patients hospitalizedfor variceal bleeding.