When should early enteral feeding begin after surgery when feasible?

• A. Often within 24–48 hours postoperatively
• B. After 7 days
• C. Not until full GI function returns
• D. Only if parenteral nutrition is unavailable

Answer: (A)

Starting enteral feeding early after surgery, within about 24–48 hours when feasible, is best because it helps preserve gut lining and function, supports immune defenses, and reduces postoperative complications. Using the gut early maintains the mucosal barrier, lowers the risk of infections, and can speed recovery, provided the patient is hemodynamically stable and there isn’t a contraindication like a high-output obstruction or an anastomotic leak. Feedings can begin as small, tolerable amounts and be advanced as tolerated, rather than waiting for the entire GI tract to regain function.

Delaying feeding to 7 days misses these benefits and is associated with slower recovery. Waiting for full GI function to return before starting feeds is overly cautious in many patients, since the gut can respond to nutrition before complete motility returns. Starting only if parenteral nutrition is unavailable isn’t the rationale here; the goal is to use the gut whenever feasible, with PN reserved for when enteral feeding cannot be safely achieved.