There’s a reason they tell you not to eat before surgery

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You may not even want to eat after midnight until a doctor tells you that you can’t. Suddenly, you feel hungrier than ever. More than likely, during your preoperative appointment, no one took the time to explain why this rule exists. Surely, something small wouldn’t make a difference. Actually, it could.
Your body has natural defenses that prevent food, stomach juices and other foreign matter from moving from your stomach into your lungs. When under anesthesia, those defenses, such as your gag reflex, are suppressed. If the anesthesiologist fails to take certain precautions prior to the administration of anesthesia and monitor you closely during your procedure, you could aspirate, which means that particulates from your stomach moved into your lungs. It could cause a number of respiratory issues, some of which could endanger your life.
You could suffer from a lung infection
If you aspirate during surgery, you could develop a lung abscess, in which pus builds up in the lungs, or pneumonia. Both infections share similar symptoms, including the following:

  • Fever
  • Wheezing
  • Fatigue
  • Cough
  • Shortness of breath
  • Chest pain

You could also suffer from cyanosis, which causes a bluish tinge to the skin due to a lack of oxygen. Your sputum could also have a foul smell. If you suffer from a lung infection, your doctor will prescribe antibiotics, and if you have a lung abscess, it may be necessary to undergo surgery to drain it.
You could develop penumonitis
This inflammation of your lungs comes from the aspiration of gastric juices during surgery. The acids from your stomach irritate and burn your airway and lungs, which causes the following:

  • Swelling
  • Rapid breathing
  • Bronchial tube restriction
  • Wheezing
  • Bleeding from your alveoli
  • Rapid pulse
  • Partial lung collapse
  • Fever
  • Coughing

You may need to be on a respirator or supplemental oxygen therapy, especially if you develop this condition within the first two hours after your procedure.
You could suffer from ARDS
If you suffer from adult respiratory distress syndrome, the air sacs in your lungs have filled with fluid. Medical personnel should monitor you for the following symptoms:

  • Labored and rapid breathing
  • Fever
  • Shortness of breath
  • Confusion
  • Cough
  • Extreme fatigue
  • Low blood pressure

You may require mechanical ventilation or supplemental oxygen. If placed on mechanical ventilation, you run the risk of a lung collapsing. Even after successful treatment, the tissue between the air sacs in your lungs could sustain significant scarring. Pulmonary fibrosis, the term used for this scarring, makes your lung stiff. You could suffer permanent cognitive and lung damage. Anywhere from 25 to 40 percent of patients who suffer from ARDS don’t survive.
Could any of these conditions have been prevented?
The answer to this question is maybe. The only way to know whether your anesthesiologist made an error that could have prevented the additional harm you suffered due to aspiration is through a thorough investigation of the preoperative, operative and post-operative circumstances. Any irregularities could lead to allegations of medical malpractice.