Is gastrointestinal surgery a contraindication to early enteral nutrition?

• A. Yes
• B. No
• C. Only if there is an anastomotic leak
• D. Only if there is ongoing ileus

Answer: (B)

Early enteral nutrition after gastrointestinal surgery is generally safe and encouraged when the patient is stable and there are no absolute gut-only contraindications. Feeding via the gut soon after surgery helps preserve mucosal integrity, reduce bacterial translocation, support immune function, and can lead to quicker recovery and fewer infections. The decision to feed relies on the overall clinical picture rather than the fact that GI surgery occurred, so GI surgery by itself is not a blanket reason to withhold early nutrition. Of course, if there are specific problems—such as persistent hemodynamic instability, peritonitis, a nonfunctional or severely dilated gut, or a confirmed or highly suspected anastomotic leak—feeding is approached with caution or delayed. In typical post-op patients without those issues, initiating small amounts and progressing as tolerated is appropriate.