Effect of oral feeding following elective caesarean section on paralytic ileus among participants in a tertiary institution in Southern Nigeria

Background: Studies suggest that early initiation of oral feeding after caesarean delivery is well-tolerated by patients, but it is not yet practiced in most institutions. Traditionally, patients are kept on nil per oral until bowel functions return. This practice is associated with complications including paralytic ileus. However, the time for commencing oral feeding after elective caesarean delivery is still controversial. The aim of this study was to compare the effect of 2-hour (early) and 24-hour (delayed) post-operative oral feeding on the outcome of elective caesarean delivery in Rivers State University Teaching Hospital Port Harcourt. Methods: This was a randomised controlled trial done in Rivers State University Teaching Hospital, Port Harcourt, between May 2023 and September 2023. 166 participants were selected consecutively during the period of study and randomised into two groups with 83 participants in each group. Using a structured questionnaire, data were collected and analysed with SPSS version 25 software. Results: The proportion of post-operative ileus symptoms was 6.0% vs. 3.6% in the early and delayed groups showing no statistical difference (ꭓ2=0.52; p–0.473). The time interval for return of bowel function (3.7±0.7 hours vs. 13.6±2.7 hours), passage of flatus (6.1±1.3 hours vs. 20.4±3.8 hours) and bowel movement (32.9±15.1 hour vs. 64.7±14.6 hours) were significantly higher (p<0.05) in the delayed group than the early group. Conclusions: Early initiation of oral feeding after elective caesarean section is safe and is associated with earlier return of normal bowel function without fear of gastrointestinal symptoms or paralytic ileus.