Diet after surgery
DrNDTV: What does a patient need to be doing before going in for surgery?
Dr. Sood: The first rule is that you have to be fasting prior to surgery usually for six to eight hours. The next is that you should avoid all anticoagulant drugs primarily aspirin. Other drugs too should be usually avoided for four to five days before surgery. The third rule is to avoid smoking for several days before surgery, and there are no exceptions to this rule.
DrNDTV: If a lady is going in for a caesarean section operation does that hold true for her too i.e. not eating six to eight hours prior to the surgery?
Dr. Sood: Yes, this is true for most cesareans are done under general anaesthesia and this would apply for her too even if the caesarean is done in another form of anaesthesia, for example, spinal anesthesia.
DrNDTV: When someone is specifically going in for a gastrointestinal surgery, what all needs to be done before it?
Dr. Shanmugham: Before surgery if the patient has not been taking enough food and the nutrition level is very poor, then we should build it up by some means. If, for example, the enteral route is not possible, that means it is not possible by mouth, then we should use the intravenous routes. The patient should be made fit for surgery beforehand because after surgery for several days he may not be able to eat well. We also have to build him up beforehand so that after any resectional surgery in the gastrointestinal system the healing process takes place without any delay or without any complication.
DrNDTV: As you mentioned that before going for surgery a person has to be fit nutritionally because after surgery he might not be able to eat for a while. So, is it fine to stuff him up with ghee because the family may think that ghee would be the best thing to keep them going?
Dr. Sood: Prior to surgery you should not stuff yourself with nutrition like ghee. Prior to surgery you should be eating as healthy a meal as possible for several days so that the body remains fit and incase you are not fit we then resort to artificial measures. But binge eating prior to surgery is not going to solve the problem.
DrNDTV: If you do need to give a diet chart to someone who is planning a gastrointestinal surgery, what would you advise them to have?
Dr. Sood: I would advise him to take proteins to the tune of about 40 to 60 grams per day. They should also take an adequate number of calories that would be about 2000 to 3000 calories per day.
Caller: Is it true that a lady having two caesareans is bound to suffer deterioration in health if proper diet is not taken?
Dr. Sood: This question is not specifically related to diet. In general, the body becomes weak or rather the healing ability becomes a little weak after two caesareans, and the third pregnancy is usually followed by a caesarean. This is not related to diet, this is related to local surgical factors.
DrNDTV: After a gastrointestinal surgery, what precautions need to be taken and can a person start eating normally right after the surgery or does it take sometime?
Dr. Sood: It is conventional that after surgery on the alimentary tract we disallow the patient from taking meals for about two days. This is a very rough rule. In general, studies show that the sooner you start oral nutritient the better it is. However, the intestines are not ready to take the meals because their propulsive activity is affected after surgery. So after surgery on the gastrointestinal tract you are not permitted to take oral diet for about 24 to 48 hours.
DrNDTV: What are the alternatives to this?
Dr. Shanmugham: We use the intravenous route. We use the peripheral veins as well as central veins. Through the central vein we can give lots of nutrients in the form of high carbohydrates, fatty and protein preparations that are available. All this can be given through it while monitoring the amount of calories.
Caller: My wife has undergone an ectopic pregnancy surgery. After surgery what precautions should be taken, especially regarding diet?
Dr. Sood: If a lady has an ectopic pregnancy and the surgery is over for more than a couple of days she should take a normal diet.
Caller: What is the best for a patient with stomach cancer?
Dr. Shanmugham: Stomach cancer patients cannot eat much. They have a poor appetite. If they undergo surgery and a part of the stomach is removed, what they need is small quantities of food with enriched nutrition like high protein, little fat and carbohydrate.
Caller: There is a belief in South India that if a person undergoes surgery he should not eat pulses. Is this true?
Dr. Shanmugham: This is a wrong notion. I don't think they can stop any of these things. They can continue all these nutritional items.
Caller: What should be eaten after a heart surgery?
Dr. Sood: After a heart surgery I presume that one must follow the advice of a cardiologist. However, as a basic rule eat what you wonít eat well.
Caller: My father is 71 years old. He has a problem in swallowing food so we consulted a doctor. He said that he is having a balloon type thing in his food pipe near his heart so surgery was recommended but he is 71 years old and we are not willing to do that. Are there any medicines available for this and what type of food will help?
Dr. Sood: I don't think any medicine will cure this and my own recommendation would be to follow your doctor's advice and go in for surgery. The quality of life will improve and your father will likely gain weight well and feel a lot better after surgery.
Caller: What should be the diet for a person after surgery suffering from diabetes?
Dr. Shanmugham: After surgery there is no special diet for diabetic and non-diabetic patients. Diabetic patients can take whatever kind of food is being given after surgery, but we suggest they take a high fiber diet, reduce the cereals and take little more proteins.
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