Factors associated with early postoperative feeding: An observational study in a colorectal surgery population

Charlotte Atkinson, Vaneesha C Monk, Andy R Ness, Stephen J Lewis, Robert J Longman, Steve J Thomas, Sam D Leary, Will Hollingworth, Chris M Penfold

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
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BACKGROUND AND AIMS: Early post-operative feeding is recommended within enhanced recovery after surgery programmes. This study aimed to describe post-operative feeding patterns and associated factors among patients following colorectal surgery, using a post-hoc analysis of observational data from a previous RCT on chewing gum after surgery.

METHODS: Data from 301 participants (59% male, median age 67 years) were included. Amounts of meals consumed on post-operative days (POD) 1-5 were recorded as: none, a quarter, half, three-quarters, all. 'Early' consumers were those who ate ≥a quarter of a meal on POD1. 'Early' tolerance was the consumption of at least half of three meals on POD1 or 2 without vomiting. Exploration of selected peri-operative factors with early feeding and tolerance were assessed using logistic regression.

RESULTS: 222 people (73.8%) consumed solid food early, and 109 people (36.2%) tolerated solid food early. Several factors were associated with postoperative feeding: provision of pre-operative bowel preparation was associated with delayed consumption [odds ratio (OR) 0.34, 95% confidence interval (CI) 0.14-0.83] and tolerance (OR 0.35, 95% CI 0.16-0.81) of food; and laparoscopic/laparoscopic assisted (vs. open/converted to open surgery) was associated with early tolerance of food (OR 1.99, 95% CI 1.17-3.39).

CONCLUSIONS: While three-quarters of the study population ate solid food early, only one-third tolerated solid food early. Findings suggest that bowel preparation and surgery type are factors warranting further investigation in future studies to improve uptake of early post-operative feeding.

Original languageEnglish
Pages (from-to)99-105
Number of pages7
JournalClinical Nutrition ESPEN
Early online date27 Jan 2020
Publication statusPublished - 1 Apr 2020


  • colorectal surgery
  • early post-operative feeding
  • enhanced recovery
  • perioperative care


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