Four aspects of postoperative diet should be considered: burden reduction, contraindication, nutrition, and diet therapy.
I. Reduce gastrointestinal burden
Surgery will make the gastrointestinal function suppressed. From a few hours to a few days after surgery, the gastrointestinal function will gradually recover, as shown by the disappearance of distension and pain, anal venting, active gastrointestinal peristalsis or bowel sounds, and appetite. Corresponding to this process, there should be a gradual transition from a liquid diet to a semi-liquid and normal diet, and generally one diet lasts 1-3 days.
Fluid food (liquid food): It is a kind of food in liquid state at room temperature and is suitable for extreme weakness, difficulty in eating, and nutritional supplementation on the day of major surgery.
Common liquid foods include sugar and salt water, honey water, fruit juice, lean meat soup, thick rice soup, lotus root powder, soy milk, milk, almond tea, over roasted oatmeal porridge, egg flower soup, meat soup with egg, milk with egg, yogurt, cocoa milk, milk with lotus root powder, clear chicken soup, clear meat soup, liver soup, etc.
Should be a small number of meals, 6 meals per day, 250-300 ml each time, special circumstances according to medical advice. It is advisable to adopt short-term, long-term fluid diet should be supplemented parenteral nutrition.
The total energy and protein content of soy milk and milk are almost equal, but the fat content of milk is higher, and 2/3 is saturated fatty acids, cholesterol content is relatively high, milk also contains lactose, most adults intestinal fluid and pancreatic fluid and other digestive juices do not contain lactase that hydrolyzes lactose, milk to the stomach coagulate into large and relatively hard blocks, so poor digestive function of people who eat milk will feel bloated. In case of intestinal flatulence, the amount of milk should be limited.
Semi-liquid diet: is a diet between soft rice and liquid. It is easier to chew and easier to digest than soft rice. It contains very little fiber and enough protein and calories. Children with fever, oral disease, chewing difficulties, gastritis, enteritis, etc., whose digestive function is not yet able to adapt to a normal diet, can use a semi-liquid diet, and should eat less and more meals.
Commonly used semi-liquid food are porridge, soup noodles, wontons, minced meat, vegetable puree, steamed eggs, etc.
Less dregs diet: things to less dregs as a feature. Do not use vegetables containing more fiber, such as celery, leeks, etc.. Can be used tofu, shredded potatoes, lean mashed meat, vermicelli, etc. Less residue diet is suitable for children recovering from dysentery, enteritis and typhoid or recovering from gastrointestinal surgery.
Second, avoid the mouth, the first three days after major surgery should generally pay attention to the following points.
1, eating cold, overheated, coarse and hard food.
2, avoid eating spicy and stimulating condiments, such as pepper, mustard, etc.
3, strictly forbidden to drink strong wine, strong tea and other stimulating food.
4, avoid overly oily and too coarse food, such as fried chicken, doughnuts and other fried food.
5, early should not eat coarse grains, dried beans, hard fruits, vegetables with high crude fiber content (bamboo shoots, celery, etc.), and gas-producing foods (such as radish, garlic, sweet potatoes, chestnuts, etc.).
These foods are not completely unacceptable, but the amount and personal tolerance of these foods need to be considered.
People with special health conditions also have their own contraindications.
People with G-6PD deficiency should not eat fava beans
People with food allergies, such as shrimp and crab, should not eat foods containing allergic food ingredients.
Gout and hyperuricemia Avoid foods with high purine content, limit the consumption of foods with medium purine content; avoid alcohol and alcoholic beverages because alcohol can inhibit uric acid excretion. For patients with gout, medication is also required.
The first category: food containing high purine (100 to 1000mg of purine per 100g of food) try not to eat.
1, fish and shrimp: white scallops, dried small fish, calf neck meat, mackerel, wind-tailed fish, salmon, sardines, swordfish, oysters, silver carp, shark, moray eel, black eel, fish eggs, grass carp, carp, caviar, grass shrimp, shrimp, lobster, shark fins, sailfish
2, shellfish: mussels, clams, oysters, tamari, dried shellfish
3, meat: pork bones, pork loin, pork belly, raw steak, lamb, meat pies, gravy, broth, horse meat, venison, rabbit meat, goose meat, chicken, spotted chicken, stone chicken
4, animal offal: animal liver, kidney, pancreas, heart, brain, intestines, stomach, heart and other offal
5. Vegetables: soybeans, yeast, nori, shiitake mushrooms, bean sprouts, malt, dried sunflower seeds
The second category: food containing medium purine (75-100mg of purine per 100g of food), can be eaten in small quantities. Do not eat during a gout attack.
1, fish: carp, cod, halibut, sea bass, barracuda, shellfish, eel, eel, squid, crab
2, meat: smoked ham, pork, pork brain, beef, tripe, tongue, veal, rabbit, venison Poultry: duck, pigeon, quail, pheasant, turkey
3, vegetables: silver fungus, kelp, peanuts, white sesame, cauliflower, cashew nuts, peas, green beans
The third category: foods containing less purine (purine <75mg per 100g of food need not be restricted.
1. Fish: mackerel, herring, salmon, anchovy, tuna, white fish, lobster, shark skin
2. Meat: ham, lamb, beef soup, chicken, bacon, shark skin
3. Bran: cereals, bread, coarse grains
4. Vegetables: asparagus, string beans, green beans, peas, green beans, navy beans, red beans, spinach, mushrooms, enoki mushrooms dried beans, tofu, dried tofu, figs, dried plums, black sesame, tofu, enoki mushrooms.
Category 4: Foods containing very little purine can be eaten boldly.
1.Grains: rice, wheat, millet, rice, caper wheat, cornmeal, refined white flour, rich flour, macaroni, noodles, bread, steamed buns, soda crackers, butter snacks.
2.Vegetables: cabbage, cabbage, carrot, celery, cucumber, eggplant, kale, turnip greens, collard greens, lettuce, cut beans, pumpkin, bonito, zucchini, tomato, yam, potato, kimchi, pickles
3.Fruit: various fruits. Eggs, dairy: fresh milk, condensed milk, cheese, yogurt, cream of wheat Beverages: soft drinks, tea, coffee, cocoa, chocolate
4.Other: all kinds of fats and oils, peanut butter, foreign vegetable jelly, jam, dried fruit, etc.
Third, nutrition
A balanced nutrition should be incorporated. The proportion of the three major nutritional elements of sugar, fat and protein should be reasonable.
1, sugar includes both sucrose, maltose, glucose and other sweetened foods. It also includes rice, flour, cereals and other staple foods with starch as the main nutrient; because starch is also eventually metabolized into glucose. Excessive sugar should not be consumed after gastrointestinal surgery, otherwise it will predispose to hyperosmolar dumping syndrome (discomfort after eating caused by gastrectomy). Sugar energy supply should account for 50 – 60% of total calories, avoid intake of overly sweet foods, and starchy foods should be the mainstay. The daily calorie requirement for an adult male light worker weighing 70 kg is about 2000 kcal. Sugar should contribute 1100 kcal, which is equivalent to 5 bowls of rice (150g wet weight per bowl) or 5 white buns (140g wet weight each). Diabetic patients should be appropriate to reduce the proportion of sugar intake.
2, fat energy supply does not exceed 35% of the total energy, avoid eating animal fat, should choose easy to digest and absorb the fat, such as vegetable oil, cream, egg yolk, etc.. The daily intake of vegetable oil should be 10ml
or so. If steatorrhea occurs in a few patients after surgery (refers to diarrhea when pulling out a lot of fat particles), the fat intake should be reduced.
3, should be supplemented with a high protein diet, choose easy to digest, a full range of essential amino acids, such as fish, eggs, shrimp, lean meat, soybean products, etc., protein for energy accounts for 15 – 20% of the total energy, such as a person weighing 70 kg, the daily intake of protein 70 – 140 grams. The best source of animal protein is fish, because fish is not only rich in protein, the composition of amino acids and the ratio between each other are similar to the human body, the utilization rate of fish protein can reach 96%, the fat of fish contains high unsaturated fatty acids, and easy for the body to digest and absorb, so we encourage more fish, such as yellow croaker, carp, etc.
After entering the ordinary diet should eat more vegetables, fruits and other foods containing high fiber, in order to keep the bowel movement smooth and promote the excretion of toxins.
Fourth, food therapy
1, to develop good eating habits
(1) Eat less and more meals
After major surgery, the digestive capacity is weakened, and the feeding capacity is significantly reduced compared with the original, only by increasing the number of meals can make up for the lack of food and meet the body’s demand for nutrients. Therefore, patients should eat at regular intervals, eat regularly and quantitatively, and insist on eating less and more meals, with 5–6 meals per day being appropriate. The main food and side dishes should be soft and easy to digest. Never overeat.
(2) Chew carefully and swallow slowly
After surgery, the grinding function of the stomach is lacking, so the chewing function of the teeth should play a more important role. For coarse and indigestible food, chew and swallow slowly. If you want to eat soups or drinks, you should pay attention to the separation of dry and thin, and try to eat soups 30 minutes before or after meals to prevent food from being discharged too quickly and affecting digestion and absorption.
(3) do not eat food containing carcinogens such as nitrosamines, benzo(a)pyrene and aflatoxin.
Such as salted fish, barbecued smoked meat, pickled vegetables, stinky tofu, moldy and spoiled food;
2.Anemia diet
Postoperative patients are mostly anemic, so they can eat animal blood, lean meat, fish, shrimp, animal liver, egg yolk, soybean products, and foods rich in protein and iron such as dates, green leafy vegetables and sesame paste to prevent and treat anemia.
3.After long-term extra-gastrointestinal nutrition, attention should be paid to the supplementation of trace elements after resuming food intake
Trace elements are required for the maintenance of muscle enzymes. Foods rich in trace elements include garlic, mushrooms, asparagus, corn, seaweed, kelp, seaweed, sea fish, egg yolk, beans, whole wheat pasta, nuts, adzuki beans and animal liver, kidney and ginseng, wolfberry, yam, reishi, etc.
4, to promote bone healing: fracture or spinal fusion after surgery need to promote fracture healing, postoperative different periods of dietary therapy methods differ.
1-2 weeks after surgery
At this time, the fracture site or the surgical area is stagnant and swollen, the meridians are blocked, the qi and blood are blocked, so attention should be paid to activating blood circulation and removing stasis, moving the qi and dispersing. The patient’s appetite and gastrointestinal function are reduced because of the pain at the fracture site, so the diet should be based on light and appetizing, easily digestible and easily absorbed foods, such as vegetables, eggs, soy products, fruits, fish soup, lean meat, etc. The production is mainly steamed and stewed, avoiding spicy, hot and oily foods that are fried and stir-fried. As for soy bone soup, belongs to the category of fatty tonic, contains more fat, not easy to digest and absorb, there is a suspicion of inducing dry stools, this stage is best not to eat.
Food therapy formula: 10 grams of panax ginseng, 10 grams of angelica, 1 pigeon, stewing cooked and rotten, soup and meat, once a day for 7-10 days.
2-4 weeks after surgery
By this time, the pain has been relieved, most of the stasis and swelling disappeared, and appetite and gastrointestinal function have been restored. The diet should be changed from light to appropriate high nutrition to meet the needs of bone scab growth. Bone broth, chicken with Tian Qi, fish, eggs and animal liver can be added to the initial recipes to supplement more vitamins A and D, calcium and protein. Eat more vitamin C rich vegetables such as green pepper, tomato, amaranth, bok choy, cabbage, radish, etc. to promote the growth of bone scabs and wound healing.
Food therapy formula: 10 grams of angelica, 15 grams of bone marrow, 10 grams of sequestra, 250 grams of fresh pork chops or beef ribs, stewed for more than 1 hour, soup and meat together, for two weeks.
More than 5 weeks after surgery
The swelling in the operated area is basically absorbed, and the growth of bone scab has already started, and the transformation from bone scab to bone tissue. The patient’s appetite is broadened and there is no contraindication in diet, and he can eat any highly nutritious food and food rich in calcium, phosphorus, iron and other minerals. Traditional Chinese medicine has studied this issue and believes that recipes for this period can be accompanied by old hen soup, pig bone soup, sheep bone soup, deer tendon soup, stewed water fish, etc.
Recipe: 10 grams of Chinese wolfberry, 15 grams of bone marrow, 10 grams of sequelae, 50 grams of coic rice. Decoct the dregs of the bone crushed tonic and sequestra first, then add the remaining 2 flavors to cook the porridge and eat. Take the congee once a day for 7 days. Each course of treatment is 3~5 days apart and can be used for 3~4 courses of treatment.