How Medical Tradition Can Worsen Your Health

Health Alert 269

Dear Subscriber:

If you’ve ever had surgery, you probably remember your doctor telling you not to eat or drink anything after 12 a.m. the day of surgery. Surgical fasting is a common practice that leaves you feeling weak at a time when you need all your strength. But you follow the advice because you feel you’re doing the right thing for your body.

Recent clinical studies show the tradition of limiting food and drink before surgery is not only unnecessary; it’s bad for your health. Today you’ll find out why and how traditions like this live on in modern medicine longer than they should.

* The Trouble with Tradition *

Years ago, surgical fasting was necessary. Doctors feared that a patient with food or drink in his stomach might vomit while under anesthesia. This would cause serious respiratory problems.1 Was it a valid concern? Absolutely. Early in the 20th century this could and did happen. But not anymore.

With modern anesthetics and better methods of administering them, pulmonary aspiration is extremely rare. In 1999, The American Society of Anesthesiology changed its guidelines. You’re now allowed to drink as little as two hours before surgery but you can have a regular meal eight hours before surgery.2

But despite the changes, doctors are still prescribing midnight surgical fasts. A study in The American Journal of Nursing in 2002 showed some patients waiting for surgery fasted for 20 hours from liquids, and 37 hours from solids.3

This is not only unhealthy, but it’s not worth it. Studies showed no difference in stomach contents between patients who had juice or coffee two to three hours before surgery and those who fasted overnight. So why then, are doctors still prescribing surgical fasts? Because of tradition.

* Who’s Research Is It? *

Doctors need to base their treatments on evidence medicine based on evidence. The problem is, in recent decades, research by drug companies has dictateed the ‘evidence’ most doctors are familiar with.

Drug companies have nothing to gain by sponsoring research to determine if a surgical fast is actually necessary. As a result, millions of people went hungry for no good reason.

To Your Good Health,

Al Sears MD


1 Brody, Jane E. “A Serving of Reality with Surgical Fasts” Personal Health, New York Times, November 30, 2004.

2 The American Society of Anesthesiology (ASA), practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, 1999.

3 Crenshaw JT, Winslow EH. “Preoperative fasting: old habits die hard.” Am J Nurs. 2002 May;102(5):36-44; quiz 45