Effect of Early Gastric Tube Feeding on Symptoms of Gastroparesis in Patients with Acute Pancreatitis

Abstract

BACKGROUND. Gastroparesis refers to the motility disturbance occurring in patients with pancreatitis. The Gastroparesis Cardinal Symptom Index (GCSI) Daily Diary has been developed to evaluate daily symptoms of gastroparesis which is based on a patient-reported symptom scale. This study was conducted to investigate whether nasogastric tube feeding (NGT) presents any benefit on symptoms of gastroparesis compared to the conventional regimen in patients with mild to moderate acute pancreatitis (AP). METHODS. A total of 35 consecutive patients with mild to moderate AP were randomized to receive either NGT feeding within 24 h of hospital admission or nil per os (NPO) regimen. Patients completed the GCSI daily diary. The end-point was of the GCSI score as reported by patients. RESULTS. A total of 17 patients were randomized to NGT feeding and 18 to NPO. Demographics were similar between two groups. The total GCSI score decreased to a significant extent in both groups (from 13.3 to 6.1 and from 10.6 to 5.7, respectively; p = 0.001) from baseline to 72 h after randomization and no significant differences were found between the two groups. The GCSI consists of eight sub-scales: nausea, vomiting, bloating, stomach fullness, retching and stomach or belly visibly larger, loss of appetite and feeling excessively full after feeding. The GCSI sub-scale analysis showed that the symptoms of nausea, vomiting, stomach fullness, retching and stomach or belly visibly larger improved during the period of treatment, but no significant differences were found between two groups. The subscales of loss of appetite and feeling excessively full after feeding score were significantly different between NGT and NPO groups. The unimproved symptoms from baseline to 72 h after randomization in both groups were bloating and stomach or belly visibly larger. CONCLUSIONS. The findings of this study indicate that the GCSI score can be use as an assessment instrument for evaluating the severity of gastroparesis in patients with mild to moderate AP. When compared with NPO, NGT presents benefits in terms of loss of appetite and but it also results in feeling excessively full after feeding.