After esophageal cancer surgery, you usually have to go through a phase of fasting and water fasting, waiting for the anus to pass and bowel movements to return before you can start eating normally.
How to gradually resume eating after surgery
Specifically, it can be divided into three stages:
Phase 1: Nasal feeding phase
Two to five days after surgery, you are in the trauma phase of your surgery, your anastomosis has not yet healed, your gastrointestinal function has not yet recovered, and your digestion is weak. During this time, your doctor will usually give you enteral or parenteral nutrition support.
Enteral nutrition (EN) is often referred to as “nasal feeding”: a very thin, specially designed nutrition tube is placed through the nose and goes straight to the duodenum to deliver nutrients. The nasal nutrition solution contains essential nutrients such as protein, fat, carbohydrates, vitamins, salt and water in the right proportions to meet the body’s needs. Moreover, enteral nutrition is more in line with the body’s physiological processes and is superior to parenteral nutrition in maintaining normal intestinal function and regulating immunity.
parenteralnutrition (PN) is supplied intravenously as nutritional support before and after surgery and in critically ill patients. Total nutrition is supplied parenterally and is called totalparenteralnutrtion (TPN). The routes of parenteral nutrition are peripheral intravenous nutrition and central intravenous nutrition. The goal is to maintain nutritional status, weight gain and wound healing in patients who are unable to eat normally. However, parenteral nutrition may bring complications such as catheter-derived infection, cholestasis, hyperglycemia, hepatic steatosis, and hypermetabolic stress, so it is not recommended for long-term use.
Phase 2: Feeding recovery phase
After the anastomosis has healed, you can gradually transition to the transoral feeding phase.
By this time, you are almost over the trauma of the surgery, your gastrointestinal function is gradually returning, you want to eat, and your anus is starting to pass gas (commonly known as farting). You can sit up straight and eat slowly with the help of your family or health care provider.
You can start with soft, smooth solid foods, such as bananas and solid yogurt, which can prevent accidental aspiration. If you experience nausea, vomiting, or other uncomfortable symptoms, stop eating immediately and call your healthcare provider for advice.
After about 1 week, most patients are able to walk and move around and eat gradually, except for a few patients who are too old or too old to get out of bed. You can gradually eat semi-liquid food, mainly easy-to-digest non-crumbly food, such as rice porridge, noodles, egg custard, etc., but do not eat liquid food and drink water for the time being.
It is important to caution against eating large amounts of food during this period to avoid gastrointestinal complications or anastomotic fistulas, and extra care should be taken for those who eat large amounts before surgery.
Phase 3: Normal diet phase
After 2 to 3 weeks, you are getting used to your swallowing function and in most cases have been discharged home. At this point, you can begin to drink slowly with your head down, taking care to avoid choking and coughing. Once you are proficient, you can resume your daily diet, expanding it as much as possible, but not eating fried foods.
You can do some moderate physical activity to facilitate digestion and absorption. Instead of lying down immediately after a meal, you should walk around for about 20 minutes to allow food to enter the abdominal cavity by gravity before resting.
To learn more about postoperative diet matching, read:
What is the post-operative and post-discharge diet to keep in mind?
As mentioned earlier, after discharge from the hospital, your swallowing function is gradually adapting and you can gradually resume a normal diet. The dietary principles at this time are:
Small, frequent meals (5-7 meals) with the same total amount of food as normal preoperatively (supplement with nutritional solutions if insufficient). Do not eat 2 to 3 hours before bedtime.
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What are the discomforts of eating after surgery?
You may still have difficulty swallowing after starting to eat, which is common with surgical anastomoses and can be improved in most cases with swallowing exercises.
Swallowing training begins 1 to 2 weeks after eating with 10 mL of honey or olive oil before eating, followed by a large swallow of a soft bun to dilate the anastomosis. This method is practiced before each meal.
If swallowing difficulties are still evident after 3 months of training, consult your doctor.