Diet is one aspect which causes a lot of anxiety in people young or old, rich or poor alike. When patients are slotted for surgery, this worries them all the more… Doctors are often flooded with various questions about the type, periodicity, nutrient value of the food they should or should not take! Consultant Surgeon Dr G. Sivakumar explains the link between diet and surgery…
“Nil by Mouth” reads the instruction in the case sheet. ‘Why? My surgery is in my hand’., the- to- be operated patient is worried.
Alteration in one’s diet for surgical procedures is essential for both safe anaesthesia and better healing. Food intake after certain abdominal operations is also restricted or forbidden.
Anaesthesia is often induced through the lung and during the induction of general anaesthesia, the stomach contents and acid can regurgitate and flood the lung and drown the patient. Hence starvation of minimum six hours prior to elective surgery is important
Nil by mouth- is it correct?
The rationale of nil by mouth is to prevent postoperative nausea and vomiting and to protect the anastomosis, allowing it time to heal before being stressed by food. It is, still a point of debate whether deferral of enteral feeding is beneficial.
A period of starvation (“nil by mouth”) is common practice after gastrointestinal surgery during which an intestinal anastomosis has been formed. The stomach is decompressed with a Ryles’/nasogastric tube and intravenous fluids are given, with oral feeding being introduced after gastric and intestinal function resolves.
As the gastrointestinal function recovers oral fluid intake is permitted and gradually depending on the clinical improvement, frequent small soft solid feeds are permitted. Spicy sugary food is avoided to prevent increased secretion and distension of the stomach. Patients with a good appetite and who pass wind in the postoperative period are on the road to his recovery. Loss of appetite and nausea are commonly experienced after surgery. Taste perceptions often change.
Early postoperative feeding after non-gastrointestinal surgery has also been shown to reduce the length of stay in hospital. There seems to be no clear advantage in keeping patients nil by mouth after elective gastrointestinal resection. Rather an early feeding may be beneficial. It is advisable to eat judiciously during post-op convalescence.
Fatigue can be reduced by nutrition and physical activity. After surgery, many patients become fatigued because they do not eat enough, do not drink enough fluids, or do not exercise enough. Starting slowly with an exercise regimen, even if only for a few minutes a day can help restore energy. The frequency and duration of a simple activity like walking can be steadily increased.
The right way to do it:
Try to drink at least eight cups of water each day. Many symptoms of fatigue, lightheadedness, and nausea can be due to dehydration. It is not necessary to eliminate meat from the diet after surgery, but reducing spicy foods can reduce one’s risk of gastritis, and may also reduce risk of enterocolitis.
The best source of vitamins and minerals is foods. During illness and recovery, dietary intake may not be optimal, so a vitamin and mineral supplement may be needed. Some people believe that if a little bit of a nutrient is good for you, then a lot must be better. There is no scientific evidence to support that idea. In fact, high doses of nutrients can have harmful effects. Be sure to discuss vitamin and mineral supplement use with your doctor.
Higher dose supplements should be avoided because studies have shown that higher doses may cause accumulation of trace elements. High doses of antioxidants may interfere with the effectiveness of any further therapy such as chemotherapy or radiation therapy.
As a working rule, the surgeon often advises a diet regimen that is simple, easily digestible and liked by the patient.