Nil by mouth

Dr Rosemary GETTING TO THE HEART OF MEDICAL MATTERS

QWE are encouraged to drink enough water to stay hydrated so could there be risks with hospitals still imposing nil by mouth?

In April 2012 it was reported that research showed it could be harmful to make elderly people have nothing to eat or drink for hours before and after surgery. What is the situation now?

ATHE reason for nil by mouth guidelines is that if the contents of the stomach accidently enter the lungs, they can rapidly cause inflammation and pneumonia.

Normally the airway is protected by reflexes such as gagging or coughing which prevent this from occurring. But the gag reflex doesn’t work when you are under a general anaesthetic. For this reason the stomach should be empty before an operation so there is nothing that can accidentally enter the lungs.

The usual guidance is that food should be avoided for six hours and water avoided for two hours before a general anaesthetic. Sometimes these time limits are exceeded if operations do not run to time. There is little that can be done about this.

Most patients are able to drink soon after they come round but if this is not possible, for example, after having surgery on the stomach or intestines, then fluid will be provided via intravenous drip. Certainly patients should not be left for hours on end with no water, especially older people and after some unfortunate incidents, nursing staff are now alert to this problem and the length of time that a patient is nil by mouth should be carefully monitored.

I READ with interest the letter from the reader who has receding gums who asked if there was anything that could be done to delay this.

I have been oil pulling with coconut oil and believe it has strengthened my gums and made them healthier. I have read it also kills bacteria which cause the problem and whitens the teeth.

What do you think of this practice?

AOIL pulling is the practice of swishing or holding oils from plants in the mouth with the aim of removing bacteria and other harmful substances from the teeth and gums.

Research studies have suggested it may reduce organisms in plaque and that it can reduce bad breath but the trials were small and not done in a