The best diet plan for 15 days after intestinal surgery

There is no completely universal standardized best diet for 15 days after intestinal surgery, but the core principles are Low residue, high nutrition, small amounts and frequent meals, with one's own intestinal tolerance as the first criterion. The vast majority of patients who recover smoothly are in the stage of transition from liquid diet to semi-liquid diet, and some people with good tolerance can try soft food in small amounts. The primary goal is not to burden the incompletely healed intestines, while ensuring nutritional supply to promote wound recovery.。

Don’t believe it. Last week, I just received a 28-year-old patient with intestinal polyps from the emergency department after ESD surgery. 12 days after the operation, I felt that nothing was wrong with me. I went out with my friends to eat skewers and iced Coke. That night, I had a stomachache and broke out in a cold sweat. When I came for a check-up, luckily there was no anastomotic bleeding. It was just intestinal irritation and spasm. It took me two days of starvation to recover. It happens to be stuck at the 15th day after surgery, when most people "feel like they are better", and there are really a lot of people who fall into this trap.

There are actually two different ideas in the industry regarding diet control at this stage. It’s not clear who is right or wrong, but the applicable groups are different. The traditional surgical nutritional guidelines are rather strict, requiring strict avoidance of crude fiber, gas-producing, and spicy foods within 2 weeks after surgery. Even steamed apples must be peeled and dregs removed, and only filtered rice soup, lotus root starch, steamed eggs, enteral nutrients, etc. can be consumed, for fear that crude fiber may rub against the anastomosis that is not yet firmly established, causing the risk of bleeding and perforation. The concept of enhanced recovery after surgery (ERAS) promoted in recent years is much more relaxed. As long as there are no abnormalities such as bleeding, obstruction, or fever after the operation, you can try a small amount of semi-liquids 3-5 days after the operation. As long as you are not uncomfortable after eating for about 15 days, you can even eat some boiled lean pork and soft rice. You don’t need to completely block the diet ladder. It is believed that appropriate food stimulation can promote the recovery of intestinal function.

How do you choose for ordinary people? In fact, it’s very simple. If you have a small intestinal polypectomy, the trauma is very small, and you can have normal gas and bowel movements a week after the operation, and you don’t have stomachaches at ordinary times, then you can completely relax a little more as recommended by ERAS. ； But if you had a radical resection for bowel cancer and cut out more than ten centimeters of intestine, the anastomosis was relatively large, and you experienced abdominal distension and difficulty in defecation after the operation, then you should stick to the traditional plan. There is no harm in being more stable.

The 15-day dietary guideline I usually prescribe to the patients I manage is actually very flexible. The first one is a minefield that should never be touched: alcohol, iced drinks, spicy foods, fried foods, crude fiber celery/leeks/corn/bamboo shoots, glutinous rice cakes/zongzi, fruits with cores and seeds such as kiwi fruit and dragon fruit. These either irritate the intestines, are easy to scratch the anastomosis, or are difficult to digest. I really can’t bear the burden of eating just one bite.

If the recovery condition is average and the stomach is usually weak, it is better to eat clear liquids plus fluids. Rice oil, filtered vegetable soup, steamed eggs, lotus root starch, and sugar-free enteral nutrition powder are all acceptable. Eat five or six meals a day, each meal should not exceed half a bowl. Don't wait until you are very hungry before eating, and don't overeat. If you are recovering well and don’t have bloating and abdominal pain after eating, you can add a little cooked asparagus noodles, peeled steamed pumpkin and steamed sweet potatoes (no more than 1/4 fist size at a time), scraped and pureed peeled steamed apples, or even two small spoons of cooked lean minced meat with all the tendons removed, chew it up and then swallow it, don’t gobble it up.

Many family members especially like to make bone soup and old hen soup for patients at this stage. They say it is to replenish the body, but really don’t do it blindly. 90% of the soup is fat and purine, and the protein content is less than 1%. Not only can it not be replenished by drinking it, but it can also easily increase the burden on the intestines and cause flatulence. If you really want to replenish nutrients, it is better to eat more steamed eggs or make a cup of enteral nutrition, which can be absorbed well without causing trouble. Some people think that constipation after surgery requires taking dietary fiber to relieve constipation. This is really not possible at this stage. Thick dietary fiber is the "little brush" in the intestines. The anastomosis is originally very tender, and it is easy to cause problems if you brush it back and forth. If you are really constipated, ask your doctor to prescribe some medicine to soften the stool. It will be more effective than eating three pounds of celery.

If you have an ostomy surgery, you should pay more attention during the 15-day period. Don't eat onions, beans, carbonated drinks and other things that easily produce gas. Otherwise, the ostomy bag will bulge in a short time, causing embarrassment and easy leakage. Try not to touch persimmons and glutinous rice cakes that are easy to block the ostomy. Wait until the intestinal function is fully restored before trying a small amount later.

I often tell my patients that there is no "absolutely best" diet at this stage. Your own body is the best yardstick. If there is no bloating, abdominal pain, bleeding, and normal bowel movements after eating, then that is a good plan for you. Just like taking care of a baby who has just learned to eat, try more and observe more, don't rush to supplement, give the intestines some time, and it will slowly return to normal.