After colon or rectal surgery, there is a period when the bowel’s rhythmic forward motion or peristalsis stops. Traditionally, patients are not allowed water or food until the bowel begins moving again, usually when gas is passed or there is a bowel movement. This can be a difficult two or three days for patients, sometimes longer.
Nursing researchers at Flinders University in Australia reviewed studies of early feeding in the medical literature and found that reintroducing food and water before peristalsis resumed was safe, well-tolerated by patients, and beneficial. They found 15 studies in the medical literature between 1995 and 2004 that looked at the benefits and risks of allowing food and water after colon surgery before peristalsis had resumed.
All of the studies concluded that early feeding was safe based on low complication rates. Complications for nearly 1,000 patients averaged 12.5% with no increased risk of leaking at the surgical connection (anastomosis), bowel obstruction, or aspiration pneumonia. Complications in the 15 studies ranged from 0 to 25%.
Studies found that earlier resumption of bowel activity and shorter hospital times can result from a program that combines early feeding with:
- early mobilization — getting out of bed and walking after surgery
- epidural anesthesia
- good patient education
The literature review by nursing student Wai Quin Ng appears in June 2006 issue of The Journal of Clinical Nursing.
A poster of Wai Quin Ng’s study Start Early, Go Home Early is available as a PDF file online.
WHAT THIS MEANS FOR PATIENTS
If you are planning colon surgery, talk to your surgeon about trying water and food earlier in your hospital recovery even before your bowels begin working again. Point out that studies have not found increased risks for leaking at the surgical connection, pneumonia from inhaling food, or bowel obstruction.
Work with the nursing staff to get out of bed and walk as soon as possible.
Discuss the risks and benefits of epidural anesthesia to control pain during the first recovery days.
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