Early Feeding After A Cesarean Delivery Hastens Recovery Time for Bowel Function
Condition: Gastrointestinal Disorders, Functional
MeSH terms: Gastrointestinal Diseases; Digestive System Diseases
Study type: Interventional

Summary: 
      After institutional review approval, pregnant women that are scheduled for elective cesarean
      delivery will be approached for participation in the study. The study informed consent will
      be obtained. The study's time frame inclusive will be from 2013 till 2016.

      Patients will be randomized to regular diet within 6 hrs postoperative (Early group) versus
      remaining nothing per os (NPO, i.e nothing per mouth) for 12hrs, and the diet then advanced
      as tolerated after 12hrs (Routine Group) as standard postoperative protocol in the
      investigators' institution.

      Primary outcome will be time to pass flatus. Secondary outcomes will include hospital length
      of stay, postoperative nausea, vomiting and patient satisfaction. Randomization will be
      performed using a computer generated random list of numbers assigning patients to the 2
      groups of the study. This list of random number assignments will be kept secure in an opaque
      envelope until the end of the study. Patients in the Early group will be started on regular
      diet within 6 hrs of surgery, whereas the routine group patients will be kept strict NPO
      12hrs, and clear liquid diet will be started after 12hrs. Diet will be advanced as tolerated,
      i.e. if clears were tolerated or flatus or bowel movement occurred, patients will be started
      on solid foods. If diet not tolerated, a full liquid diet will be given instead. Consequently
      if patient tolerated full liquid diet, a regular diet will be then initiated. Patients will
      be discharged home only if they tolerate solid food with absence of emesis, have flatus or
      bowel movement. Time Zero is defined as time of skin incision.
    

Detailed description: 
      After institutional review approval, pregnant women that are scheduled for elective cesarean
      delivery will be approached by Principal investigator or any of the co-investigators for
      participation in the study during the the preoperative visit which coincides with the same
      day of scheduled cesarean in a private patient room. . Prospective subjects will be
      presenting for their preoperative appointment (same day of scheduled cesarean delivery) in
      labor and delivery and will be asked to participate in the study. The study will be explained
      as in the consent form and if agreed patients will elect either to or not to participate in
      the study after all risks and benefits are explained. Data to be collected will consist of
      time in minutes of passing flatus, time in minutes of having a bowel movement, hospital
      length of stay, postoperative nausea, vomiting and presence of ileus (unable to tolerate
      diet, abdominal distention, no bowel movement nor flatus, abdominal x-ray demonstrating
      air/fluid levels in bowel). Patients will be contacted once to twice a day for assessment of
      data points mentioned above. If elected to participate consents will be obtained.
      Randomization will be done at time of consents. The study's time frame inclusive will be from
      2013 till 2016.
    

Intervention name(s): Regular diet within 6hrs postoperative
Intervention type(s): Other
Intervention description(s): Patients will be randomized to regular diet within 6 hrs postoperative (Early group) versus remaining nothing per os (NPO, i.e nothing per mouth) for 12hrs, and the diet then advanced as tolerated after 12hrs (Routine Group) as standard postoperative protocol in the investigators' institution.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)