Fasting Before and After Surgery

Nil per oral (NPO) or Nil by mouth (NBM) is an order in which patients are not allowed to take liquids or solids through the mouth.

When is this order given?

• Before and after
• Pre-procedure e.g. colonoscopy, USG Whole abdomen, CT abdomen Why do I have to stop eating and drinking before my surgery?

Sometimes during anaesthesia and surgery, the stomach contents travel the wrong way up the food pipe and enter the lungs through the wind pipe. This is called “pulmonary aspiration”. It is a very dangerous condition and can be a risk to life.

So, to prevent this complication, anaesthesiologists and surgeons tell their patients to fast before surgery and anesthesia.

When do I stop eating and drinking?

• Solid food like biscuits, poha, bread, roti etc. minimum 6 hours before the procedure. Milk is a solid food in this circumstance.
• Fried and heavy foods like parathas, puris: minimum 8 hours before the procedure because they take longer to digest and leave the stomach.
• Clear liquids like water, coconut water, apple juice, ORS: minimum 2 hours before the procedure.

Can I take some medications instead of fasting for so long?

While some medicines are available to decrease the risk of aspiration, no medicine completely prevents it. So, it is always better for the patient to be fasting per the above-mentioned times.

Am I at high risk for aspiration?

In some patients the risk for aspiration can be higher than the general population. These are

• Emergency surgery e.g. emergencies following trauma, when there no time to wait for the stomach to empty itself of food.
• Pregnant ladies
• Morbid Obesity
• H/o gastric motility disorders- symptomatic oeophageal reflux disease/ heartburn, diabetic gastropathy, hiatal hernia etc.

 

When can I start eating and drinking again?

Generally, we restart drinking clear liquids and simple foods 4-6 hours after surgery allowing for the sedative effects of anaesthetics to have worn off.

But this time can vary depending upon the procedure or surgery that you have undergone.

Your nurse will keep track of the orders and will re-start your food and drin k according to them.