Why is a post-surgery diet important?
The day of your operation is critical to treat your condition. Dr. Maher Abbas will provide you with world class surgical expertise. He is committed to guiding your recovery in order to achieve a superior outcome. After a surgical procedure, the body requires additional nutritional “building blocks” to heal. A well-balanced diet customized to your need is crucial for your recovery. The bigger the operation, the higher the nutritional need to maintain body functions and to restore good health. The recommendations in this handout are geared towards most patients following anorectal (proctologic) surgery or major abdominal surgery. If these instructions need to be customized based on your condition and situation, Dr. Maher Abbas and his team will discuss them with you.
After anorectal (proctologic) surgery
For operations performed for hemorrhoids, fissure, fistula, warts, anal skin tags and lesions, incontinence, and anal prolapse
Immediately after your operation and once you are awake from the anesthetic, you will be given a liquid meal. If you received a spinal anesthetic without general or intravenous anesthesia, you will be given solid food. Once tolerating oral intake of either type, you will be started on fiber supplementation and/or a laxative (if you are a day case, you will take the first dose when you get home). If you are discharged on a liquid diet the day of surgery, advance to solid food by the following morning. At home avoid spicy food or citrus containing food such as lemons and oranges for 2 weeks. This will minimize the amount of anal burning. Be on a high fiber diet [see section on High Fiber Food]. Avoid constipating food and if you eat red meat, pasta, or white bread, take smaller portions [see section on Constipation]. Use fiber supplementation and/or the laxative you are prescribed. Ideally you need to have passage of stool within 48 hours of surgery. Do not avoid defecation or hold on stool as it will become harder to pass and more painful.
For major anorectal surgical procedures involving reconstructive techniques with skin grafting or muscle flaps on the anal area, vagina, perineum, prostate, or urethra, Dr. Maher Abbas will advise you about a customized diet as indicated for your condition.
After major abdominal or pelvic surgery
For operations performed on the small bowel, colon, rectum, or anus for cancer, abdominal tumors, inflammatory bowel disease, diverticulitis, complex intestinal fistulas, abdominal infections, and hernia
Dr. Maher Abbas performs most of his operations using minimally invasive camera surgery to expedite recovery, minimize pain, and provide patients with better cosmesis, shorter hospital stay, and faster return to work. The majority of patients are enrolled in the Enhanced Recovery After Surgery (ERAS) protocol. ERAS has many proven advantages to the patient including earlier mobilization, faster return of bowel function, and less pain. By the early removal of tubes and catheters, early ambulation, same day feeding, and minimizing the use of opioids pain medications, you will be able to recover much faster. For more on the ERAS protocol, read the section on Anesthesia Team Visit. By the evening of the day of your surgery, you will be given a full liquid diet unless you have nausea related to the anesthetic. Within 48 hours, you are often advanced to a low residue soft diet (if your procedure involved removal of bowel) or a regular diet. By the time of your discharge, you will either be on a full liquid (if discharged within 48 hours of surgery) or soft diet. If you had bowel resection (portion of the intestine or colon removed), stay on a low fiber diet for the first 2 weeks then you can resume your usual diet unless instructed otherwise by Dr. Maher Abbas. If you have a colostomy or ileostomy bag, follow the instructions in the sections on Colostomy Care and Ileostomy Care. Early during your recovery, it is important to have smaller but more frequent meals (5 to 6) rather than the 3 traditional meals. You can expect to lose on average 5 to 8 kilograms after major abdominal and pelvic surgery. Do not get alarmed and often the weight is regained within a period of 6 months.
For major open (non-minimally invasive) abdominal operations in patients with very complex conditions (such as multiple previous operations, infections, emergency colorectal surgery, intestinal perforation, complicated intestinal fistula), you will most likely remain fasting for a few days to rest the abdomen. Dr. Maher Abbas will customize your care to ensure a safe recovery.
Medications
You can resume your home medications unless instructed otherwise. If you are on any blood thinner, ask Dr. Maher Abbas for specific instructions. Take pain medications and other medications as prescribed. If mild ache or discomfort, you can take 1 to 2 tablets of Tylenol [paracetamol 500 mg] every six hours as needed [can take up to 6 tablets per day]. If you are prescribed a non-steroidal anti-inflammatory medication (NSAID) such as Voltaren, Advil, Aleve, Ibuprofen, always take it with food. Do not exceed the prescribed dose or frequency. Sometimes you will be prescribed an anti-acid medication to protect your stomach (such as Gaviscon, Zantac, Pepcid, Tagamet, Nexium, Prilosec, Pantazol). If another type of pain medication is prescribed, Dr. Maher Abbas or his nurse will give you the proper instructions. Drink plenty of water with medications.
Any questions? Contact Dr. Maher A. Abbas’ office nurse here.