Surgery Today - Special diets

Proper foods are as important as proper medicines in helping a patient recover from surgery. Despite the common complaints about hospital meals, the nutrients that are provided in certain special diets for surgical patients are as carefully prescribed and prepared as are some medications that are served in pill or capsule form.

Surgical nutrition has become increasingly important in recent years because of an awareness by physicians that an operation, minor or major, is not unlike an organic disease that creates physiological stresses and a nutritional imbalance in the patient's body. To help compensate for alterations in the patient's physiology as it recovers from the effects of surgery, special diets may be ordered.

Bland Soft Diet

A bland soft diet frequently is ordered for patients who are unable to handle a regular diet but whose condition is not serious enough to require a liquid diet. The foods are selected because they are low in cellulose and connective tissue; they are bland, smooth, and easily digested. The choice of food, nevertheless, represents as great a variety as one might be served in a restaurant or at home, except for an absence of spices and other substances that would be stimulating to the gastrointestinal tract. Included in the surgical soft diet might be lean meat, fish, poultry, eggs, milk, mild cheese, cooked tender or pureed fruits and vegetables, refined cereals and breads with butter or margarine, plus gelatin desserts, puddings, custards, and ice cream.

Liquid Diet

Liquid diets for surgical patients may be prepared with or without milk. They are usually ordered for patients with impaired function of the gastrointestinal tract. A liquid diet without milk may include a cereal gruel made with water, clear bouillon or broth, gelatin, strained fruit juce, and coffee or tea. Liquid diets with milk are similar but may also include creamed soups, sherbets, ice cream, cereal gruel made with milk instead of water, cocoa and beverages of milk or cream. Beverage options permitted are tomato juice and some carbonated beverages such as ginger ale.

Diets Following Particular Kinds of Surgery

Peptic Ulcers

A special diet for peptic ulcer patients may include a half-and-half mixture of milk and cream, plus mashed potatoes, eggs, toast and butter, pureed vegetables, cottage cheese, rice, plain puddings and gelatin desserts. But meat soups, tea, coffee, raw vegetables, and fried foods are prohibited.

Rectal Surgery

Following rectal surgery, and other procedures in which it is necessary to prevent bowel movements for a period of several days, a low residue diet is ordered. A low residue diet (or minimal residue diet , as it is also called) might offer eggs, poached or boiled, rice, soda crackers, cereals made with water, butter, bouillon or clear broths, carbonated beverages, tea, coffee, and certain meats, including oysters, sweetbreads, and tender bits of beef or veal. An alternative low residue diet is the bland soft diet with all milk-containing items eliminated.

Gallbladder Surgery

Gallbladder surgical patients may expect a modified fat diet that eliminates as much as possible fats and gas-producing food items. It includes foods that provide protein and carbohydrate sources of energy to replace fats and includes primarily fish, poultry, lean cuts of beef, cottage cheese, cereal products and bread, and certain fruits and vegetables. However, foods prohibited are mainly pork products and fatty cuts of other meats, cream, chocolate, melons, apples, fried foods of any kind, onions, cabbage, turnips, cucumbers, radishes, green peppers, and dried beans and peas.

Restricted Salt Intake

Chronic heart failure patients and those with liver ailments or edema are placed on a low-sodium diet before and after surgery. The low-sodium diet is fairly simple in that it is prepared mainly with foods from which sodium or salt either is naturally absent or has been removed. Many salt-free or low-sodium foods are available commercially from manufacturers that also supply special dietetic foods for persons suffering from diabetes.

Fractures or Burns

Special consideration is given the diets of patients who are recovering from accidents that result in fractures or burns. Because of complex body responses to such injuries, there may be an abnormal loss of nitrogen from the tissues and a breakdown of muscle tissue, which is a rich source of nitrogen, an important component of protein. As a result, adequate amounts of protein need to be provided to surgical patients with burn injuries and broken bones.

Potassium Loss

Normal body stores of potassium also may be diminished during and immediately after surgery, but potassium can be replaced in the tissues by including in the meals adequate amounts of meats, fish, poultry, bananas, raisins, figs, dates, and prunes, as well as dried peaches and dried apricots. Prune, tomato, orange, and pineapple juices also are a rich source of potassium for postoperative patients.

Replacement of Water Losses

While water is not always thought of as a food, it is an important part of the gastronomic intake of the surgical patient; adequate amounts of water need to be provided the person recovering from an operation. The postoperative patient usually requires larger than normal amounts of water even though he may not feel inclined to help himself to as much fluid intake as he would at home or on the job. In addition to normal water losses through perspiration, urine, and breathing, there may be additional water losses through vomiting. Water replacement may be provided through sufficient amounts of fruit juices and other beverages offered during meals and between meals.