Strategies to improve tolerance to peri-operative enteral feeding

A major surgical procedure results in injury resulting in systemic response resulting in a negative nitrogen balance. The conventional management of a patient in the peri-operative period involves pre- and post-operative fasting, which potentiates the caloric deficit. Early feeding has been shown to result in a positive clinical outcome. How-ever, the physiologic response to surgery impedes successful initiation of early enteral feeds. This article discusses the various strategies to improve tolerance to early enteral feeds in the immediate post-operative period.