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Original poster

How long can someone be kept nil by mouth?

46 replies

princesshasnocrown · 26/05/2022 06:19

I have been nil by mouth for 2 days now.

I've had IV fluids of course but it's utterly miserable and I feel so dizzy without any food (sugar levels related I'd imagine)

How long can they reasonably keep me like this?

It is suppose to be until the surgical team come and see more on the ward. But they still haven't come Sad

I kept being told 'you need to stay nil by mouth until the surgical team come and review you'

OP posts:
FOJN · 26/05/2022 08:15

Have they told you why you need to be nbm? I don't think it's reasonable to deny you food for two days in case you need surgery and if there is another reason they don't want you to eat then I would expect them to make investigating the problem a priority rather than starve you.

It's difficult to comment without more detail but the fact you've had nothing but fluids for two days without being reviewed by the surgical team makes me thinks it's unreasonable.

I would ask for an explanation and how long they think they can keep you nmb. It's not particularly helpful for post op recovery if you are nutritionally depleted before surgery.

Are they checking your blood sugars?

Original poster
princesshasnocrown · 26/05/2022 08:18

@FOJN they aren't checking my blood sugars

They haven't said how long they plan to keep me this way, or for what reason. Nobody has said

All they keep repeating is I need to wait for the surgical team to review me so must stay nil by mouth for now

Not much background other than I came into A&E unable to pass wind or go to the toilet. Really bad waves of cramping and noisy stomach. Vomiting.

Then I was admitted up here to gynae (I am pregnant). Gynae team confirmed it isn't pregnancy related (like I thought), so I just have to wait for surgical team to review

OP posts:
RoyKentsChestHair · 26/05/2022 08:19

God bless the NHS! This is awful, but sadly doesn’t surprise me as every time my parents or myself had any dealing with hospitals it’s been an absolute shit show. I know they’re underfunded and overworked etc but this isn’t ok. Ask them how you make a complaint about being left in limbo with no food for 2 days and see if that lights a fire under someone’s arse.

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Discovereads · 26/05/2022 08:20

I’m sure one of your IV fluids has glucose in it. You can be nil by mouth indefinitely as that’s how they keep coma patients alive for years. Try not to worry too much.

Milliesmummy92 · 26/05/2022 08:21

100% ask them to check your blood sugars if you're pregnant they can put up a glucose drip if they're low x

Original poster
princesshasnocrown · 26/05/2022 08:21

Discovereads · 26/05/2022 08:20

I’m sure one of your IV fluids has glucose in it. You can be nil by mouth indefinitely as that’s how they keep coma patients alive for years. Try not to worry too much.

Try not to worry too much? I feel shocking! Sad the pregnancy doesn't help

The fluids don't have glucose in. I can tell from the packaging they've put up. It is pretty clear they're just fluids

OP posts:
MiseryWIthAStent · 26/05/2022 08:22

You need to say something OP, I was NBM earlier this year, after 24 hours of no food and nothing from the surgical team I told them I needed to eat and I would have to be NBM again after I ate, the nurse agreed and went and got me some food!

FOJN · 26/05/2022 08:29

Discovereads · 26/05/2022 08:20

I’m sure one of your IV fluids has glucose in it. You can be nil by mouth indefinitely as that’s how they keep coma patients alive for years. Try not to worry too much.

A patient in a coma would be getting far more than IV fluids. They would either enteral or parenteral nutrition.

OP on the basis of what you have said I would guess they are concerned about bowel obstruction. I think you are being forgotten about by the appropriate surgeons because you are on the gynae ward. I would start making a bit of a fuss, please remind whoever is caring for you that you have had no food for two days and ask them what they intend to do about it. Ask of they have referred you to a dietician if they intend to keep you nbm?

Mirrorball2022 · 26/05/2022 08:29

Surgeons can be hard to get hold of to come and review. However they can’t just leave you waiting that long. Ask to speak to nurse in charge and ask what’s happening as it’s been 2 days on NBM. It only needs to be a few hours prior to surgery.it’s not on.

Or if that doesn’t work. Email/ring Pals from your phone. Your blood sugars should be checked to, your fluids probably have glucose in to help.

Original poster
princesshasnocrown · 26/05/2022 08:38

Thanks so much for your support

I asked when they planned to review. They said they had no idea when surgical team would come up but 'should be today'

I said 'this isn't acceptable. Please check my sugar levels, if you can'

The nurse agreed and low and behold, 3.5.

She then spoke to the nurse in charge and theyve agreed to let me eat Confused

OP posts:
CraftyBugger · 26/05/2022 08:49

I presume due to pregnancy you can't have scans to see if you're in bowel obstruction. I deal with patients with bowel obstruction symptoms often and they're usually scanned quickly then junior doctor makes decision wether to allow food or not based on the report. But due to pregnancy they're unable to do this so will need surgical review.

Pasithea · 26/05/2022 08:52

I’ve been nil by mouth for months don’t worry.

BadNomad · 26/05/2022 08:53

Hmm. Are they're querying a bowel obstruction? If that ruptures and you've eaten you have a higher risk of complications if they have to operate in an emergency. The surgical team needs to pull their fingers out and come review you.

FOJN · 26/05/2022 08:53

Please insist they contact the relevant surgical team to review you today, it usually helps if you ask for the details for PALS whilst having this conversation. Yes it's a manipulative way of getting seen but patience and politeness aren't working.

I won't list all of my concerns about the treatment you have received but it's not good enough.

Original poster
princesshasnocrown · 26/05/2022 09:01

BadNomad · 26/05/2022 08:53

Hmm. Are they're querying a bowel obstruction? If that ruptures and you've eaten you have a higher risk of complications if they have to operate in an emergency. The surgical team needs to pull their fingers out and come review you.

I asked them on admission if it could be that... only because if all points to it - abdominal pain is high up (not near baby), comes on in waves and is like a cramping strangling sensation, can't pass any wind despite feeling like I need to, haven't been to the toilet in 4 days now, stomach making lots of noises. Doctor that reviewed me in A&E said that it sounded like a noisy tummy so agreed, but then palmed me off to gynae

Gynae doctor visibly annoyed that I'd been sent to her for review (she scanned me), and said it was the case that unfortunately they'd rather not be responsible for pregnant ladies

So now on gynae ward and awaiting surgical review. Which in my view should've been priority yesterday but they kept pushing gynae and kept asking me if I was having vaginal bleeding or waters leaking. No! It is clear that's not the problem here but you didn't even bother to rule it out, you've just left it

OP posts:
Original poster
princesshasnocrown · 26/05/2022 09:04

Could anyone kindly advise me how they diagnose a bowel obstruction? I know it'll be something like an x ray, but I've read that actually x rays, if they do come back clear, don't rule out a bowel obstruction and other things like CT scans or a dye x ray are better?

OP posts:
MissSmiley · 26/05/2022 12:07

I've had a major abdominal op earlier this year and they did CT scans to check things like this. I was NBM for weeks but I was having fluids and being fed into my intestine. They can't leave you like that, having said that when I was constipated post op I didn't feel like eating at all. Are you actually wanting to eat?

Kingharoldshairstyle · 26/05/2022 12:19

I had this, it went to the third day, I didn’t think to say as I assumed they knew and I was very unwell, on the third day a midwife looked at my notes, looked up and said to me with concern, when is the last time you ate, and rushed off to get me some tea and toast.

so in my experience you need to say I’ve been nil by mouth for x time, as they don’t look at how long, they just glance at your notes and see nil by mouth and crack on, which can result in you going days unfortunately.

Toddlerteaplease · 26/05/2022 12:30

Out guidelines are that you can have clear fluids up to an hour before theatre. I work in paediatrics and we let kids drink but adult surgical teams give IV fluids and don't understand that the patients can actually drink. And that keeping people NBM for days is unacceptable.

Toddlerteaplease · 26/05/2022 12:31

Discovereads · 26/05/2022 08:20

I’m sure one of your IV fluids has glucose in it. You can be nil by mouth indefinitely as that’s how they keep coma patients alive for years. Try not to worry too much.

Patients in Comas are given feed it TPN. Not just plain 0.9% saline.

Fluffycloudland77 · 26/05/2022 12:35

Is there anyone there who can advocate for you? They left my dh nbm for over 24hrs when he was post op, infected, no meds, food, water.

Odessafile · 26/05/2022 13:15

If OP has a bowel obstruction the worst thing they can do is eat and drink freely.
Appreciate that the NHS is struggling but a pregnant lady with a potential bowel obstruction would be seen pretty rapidly in our trust. Flagged up immediately as it's a surgical emergency.
Op needs to contact her surgeon's secretary and find out what's going on.

EvelynBeatrice · 26/05/2022 16:24

Symptoms sound like me with gallstones - diagnosed by ultrasound which is obviously pregnancy safe.
First sympathy- poor you. Second, you need to get your mum assertiveness started because im afraid it's the people who shout who get looked after and you have your baby to think about too. I don't know how English hospitals work but can you ask for the name of the senior doctor in charge of your welfare and how to make a complaint as you'll need to do that if there isn't an action plan today to diagnose and treat you. Sounds like the nursing staff are doing their best and may not have enough clout to get doctor in to look at you, but urgency tends to get ramped up when complaints are made

hells456 · 26/05/2022 16:30

I was nil by mouth for 5 days to "give my digestive system a rest" when my gallbladder was very inflamed a few years back. I had a clear drip, no idea what was in it, and another of antibiotics. It was odd, I didn't even feel hungry.

I hope you get sorted out soon OP.

ProclivityForPyrotechnics · 26/05/2022 16:32

@Toddlerteaplease however if op has a bowel obstruction, eating and drink can cause massive complications

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