Original Research Article
Year: 2019 | Month: September | Volume: 9 | Issue: 9 | Pages: 162-171
Effect of Preoperative Feeding with Brown Rice Supplement on the Clinical Outcome in Gastrointestinal Patients
Pooja Thacker1, Dr. Subhadra Mandalika2, Dr. Nilesh Doctor3
1PhD Scholar of College of Home Science, Nirmala Niketan & Chief Dietician of Bhatia Hospital, Mumbai.
2Associate Professor, College of Home Science, Nirmala Niketan, Affiliated to Mumbai University,
3Consulting Hepatobiliary Surgeon at Bhatia Hospital, Mumbai, India
Corresponding Author: Pooja Thacker
ABSTRACT
Background- Preoperative feeding with nutritious food has been reported to reduce postoperative nausea, vomiting and length of hospital stay in hospitalized patients. The aim of the present study was to investigate the influence of preoperative feeding with brown rice based supplement rich in maltodextrin, gamma butyric acid and B-complex vitamins on the post-operative complications and length of hospital stay in gastrointestinal patients undergoing surgery.
Method- Sixty patients (n=60) who were suggested gastrointestinal surgeries like hepaticojejunostomy, pancreatectomy, Whipple’s and gastrojejunostomy were purposively selected and divided into two groups i.e. Control (n=30) and intervention group (n=30). The control group (n=30)received1200 kcal hospital diet and was NBM for 16 hours prior to surgery and intervention group was provided with 1200 kcal hospital diet along with a CHO supplement made of brown rice (20gms of carbohydrate x 3times) providing 300 Kcal on the previous day of the surgery and was NBM for 8 hours. Preoperative parameters including Nutritional status (MUST), anthropometry, selected biochemical markers (CBC, albumin, electrolytes), dietary nutrient intake (24 hour diet recall), and post surgery parameters including clinical symptoms (nausea and vomiting), biochemical parameters (CBC and electrolyte), nutritional intake and length of stay of all the participants were recorded. Data were statistically analysed using SPSS version 16.0.
Results- As per the screening 23.3% patients was severely malnourished and 61.6%were moderately malnourished. All the patients had significantly low MUAC (p=0.03). Overall, females (55.00 ± 6.84yrs) undergoing surgery were younger than males(61.67 ± 4.27yrs) and had significantly greater length of hospital stay as compared to males by 4 days (p=0.03. The total energy intake prior to surgery was significantly higher (p=0.032) in the intervention group (1750 Kcal) than that of control group (1200 Kcal). There was significant drop in serum potassium status (p=0.012) in control as well as intervention group post surgery. White blood cell count was higher than reference values in both groups post surgery due to inflammation but it was higher in control group(mean=15209cells/cumm) than in the intervention group (mean=14700cells/cumm). The length of hospital stay was lower in the intervention group (mean =9.13days) than the control group (mean =9.93days) (p=0.3) also a significant decline in symptoms of nausea and vomiting was observed post surgery in the intervention group (4/30, p=0.005).
Conclusion - Brown rice supplement improved the post surgery complications and LOS among patients undergoing GI surgeries and hence could be considered as an effective pre surgical feeding strategy.
Key words: Preoperative feeding, Brown rice supplement, Gastrointestinal patient, GI surgery.