Why is eating well important after surgery?
- eating a range of nutritious foods before and after surgery will help you recover and heal, as well as improve your energy levels
- having enough of the key nutrients and calories in your diet may also reduce the risk of infections
- eating too little, even if you have a poor appetite, which is common, may lead to you losing weight, feeling weak and may lead to a longer recovery time
- initially, you may experience loose and / or more frequent bowel movements. Eating well after bowel surgery can normalise functioning of the bowel, digestion of food and absorption of nutrients.
Starting to drink and eat after bowel surgery
- your surgical team may have specific recommendations about the stages of introducing drinks and food after your surgery. This will depend on the procedure you had and how your bowel is recovering. Remember everyone’s response to surgery is different and some people’s gut function takes longer to return
- often, you will be advised to start on ‘clear fluids’ first, such as water, fruit squash, black tea or coffee, clear soup, fruit jelly, Ensure Plus supplements
- then, you may progress to ‘free fluids’ such as clear fluids plus tea /or coffee with milk, milk, milkshakes, smooth soups, fruit juice, yoghurt, ice cream, Ensure Plus Milkshake or Ensure Compact supplements
- once your surgical team is happy you can manage drinks, they will encourage you to introduce food as well. Often, softer foods are easier to eat in the initial stages.
What type of foods and drinks should I include?
Protein-rich foods
Foods rich in protein help you to heal and recover, especially after any surgical wounds, and are important for building muscles and strength. Examples include meat, fish, pulses, eggs, dairy products such as milk, yoghurt and cheese, or dairy alternatives, such as soya milk). Also smooth nut butter and meat alternatives, such as Quorn, tempeh or tofu. Try to include one of these with each meal or snack.
Carbohydrate-rich foods
These are a good source of energy, which your body needs to recover after surgery. In the initial stages after surgery, try to choose white or refined starchy carbohydrate foods, which are easier to digest, such as white bread or crackers, white pasta, rice, potato without skin, cornflakes or Rice Krispies. Aim to have as part of each meal or snack.
Fruits and vegetables
These provide vitamins and minerals, which can help in the healing process. Introduce them gradually, aiming to build up to five portions per day. You may find lower fibre options easier to digest – see the section below on fibre. Examples include fruit or vegetable juice, cooked vegetables such as carrots and broccoli, fresh, tinned or stewed fruit, for example banana, mandarins, apple.
Fluids
It is important to remain well hydrated and to make sure you drink enough fluid. Aim to drink 8-10 cups per day of water or squash, tea or coffee or herbal tea. You can have caffeinated tea or coffee in moderation, but excessive caffeine can increase the speed that food and drinks move through the gut. Moderate your intake of alcohol, which may irritate the gut.
Fibre
It may be necessary to moderate your intake of fibre in your diet after bowel surgery. Your dietitian will be able to provide additional detailed written information on the low fibre, low residue diet, if this is helpful for you.
Certain foods containing fibre are not digested or fully broken down by humans and normally aid the movement of food and fluid through your gut. This ‘roughage’ adds bulk to the stools and is usually encouraged as part of a healthy diet. However, soon after bowel surgery, it may be advisable to avoid large amounts of these foods because they are more difficult to digest and may make your bowel movements looser.
Some fruit and vegetables, especially if raw or they contain skins or pips, such as raw tomato or apple with skin, pulses, nuts, seeds and wholegrain cereals are high-fibre foods to reduce if you have been advised to follow a lower fibre diet.
A lower fibre diet may be advised either long-term or short-term, depending on your condition and symptoms. Speak to your surgical team and dietitian for more guidance and advice about reintroducing fibre, if this is appropriate to you.
Introducing a balanced diet
The lists of foods in the left-hand column of the table below are suitable to be introduced initially after your operation, once you can eat solid food. The foods in the right-hand column should be introduced gradually. Your dietitian will be able to guide you on timelines of introducing foods in the right-hand column, depending on your condition and surgery.
| Food groups |
Foods to introduce initially
|
Foods to introduce gradually
|
|
Fruits and vegetables
|
Cooked or stewed fruits such as apple
Tinned fruits such as mandarins
Fresh fruits with the skin removed such as pear, plum, banana, melon, mango Smooth fruit juice
Well cooked or mashed root vegetables such as carrot, swede, parsnip, turnip, squash, sweet potato, marrow, courgette, pumpkin, yam, Indian squash, bitter gourd, taro root (flesh only; no peel, seeds or skin)
Other very well cooked vegetables as advised by dietitian, such as spinach, broccoli, cauliflower (no tough stalks), peeled and de-seeded peppers or aubergine
Canned, de-seeded tomatoes, passata, tomato puree
Strained vegetable juices
|
All fruit skins, stalks, seeds, pith and stones
Berries such as blackberries, raspberries and pomegranate
All dried fruit such as raisins, dried apricots, dates
Smoothies made with whole fruit, pips, skin or fruit juice with ‘bits.’
‘Gaseous’ vegetables such as Brussels sprouts, cabbage
All vegetable stalks, skins, seeds and peel
Raw or undercooked vegetables and salads such as crunchy stir-fried vegetables, beansprouts, coleslaw, raw pepper, tomato, celery, mushroom, sweetcorn, green beans, kale, radish, mooli
|
|
Potatoes, bread, rice, pasta and other starchy carbohydrates |
White potato with skin removed, such as boiled, mashed, flesh only of baked potato, chips, potato waffles, hash browns
White pasta, rice, noodles etc.
Tapioca, semolina
White bread, thepla, roti, poppadums, chapatti, naan, crumpets, crackers etc.
Potato crisps
Plain biscuits or cakes
Refined cereals such as cornflakes, sugar-frosted cornflakes, Rice Krispies |
Potatoes with skin such as whole baked potato, new potatoes, skin-on potato wedges Brown pasta, rice, noodles etc. Wholegrain bread, thepla, roti, poppadums, chapatti, naan, crumpets, crackers etc. Fruit cake Un-refined cereals such as wheat biscuits, Bran Flakes, muesli, Fruit 'n' Fibre |
|
Beans, pulses, fish, eggs, meat and other proteins |
Lean, tender meats
Tinned, fresh or frozen fish or seafood
Eggs
Smooth nut butter
Vegetarian meat alternatives such as Quorn
Tofu
If you are vegetarian, speak to your dietitian because you may be able to have one portion of very well cooked lentils or smooth hummus per day |
Gristly and fatty meat, tough skin
Fish skin and bones
Beans and pulses such as baked beans, butter beans, kidney beans, peas, lentils, dhal, dosa, soya beans, chickpeas
Whole nuts such as almonds, peanuts; coconut
Seeds, for example pumpkin, sunflower and sesame seeds
Crunchy nut butter |
| Dairy and alternatives |
Milk — all types such as cow, goat, sheep
Milk — alternatives such as rice, soya, almond
Cream, sour cream, crème fraiche, buttermilk
Fromage frais, smooth yoghurt, kefir, plain sweet or salty lassi
Cheese — any, including cream cheese, cheddar, paneer
Butter, spread, margarine in moderation
|
Any milk products containing fruits, nuts, seeds or cereals, such as cheese with dried fruit or yoghurt with whole berries |
| Oil and spreads |
Butter, margarine, ghee and oils should be used in moderation |
Large quantities of butter, margarine, ghee and oils |
| Miscellaneous |
Smooth or sieved soup Sugar, honey, golden syrup, lemon curd, jelly jam
Boiled sweets, caramel, plain mithai or barfi without nuts or fruit
Dark, milk or white chocolate
Pepper, salt, herbs and spices in moderation — dried or finely chopped
Gravy, tomato sauce, soy sauce, mayonnaise
Plain crisps, plain pretzels without sesame seeds |
Soup with vegetables or pulses, for example minestrone
Jam or marmalade with skin, peel or pips, mincemeat
Confectionary with dried fruit, nuts, seeds or coconut, such as nougat, barfi, halwa, baklava
Wholegrain mustard, pickles, relish
Popcorn, corn chips, Twiglets, vegetable, lentil or quinoa crisps, Bombay mix, sev, ghatia, chevda |
Handy hints
We also have written information about eating well with a poor appetite. Your dietitian will be able to provide you with more details if you feel this would be helpful.
You may find it easier to eat and drink ‘little and often’ with smaller meals, puddings, drinks and snacks through the day, instead of three big meals, particularly if you have a poor appetite.
Try to choose nutritious foods and drinks that are high in calories and protein. You can further enrich your food and drinks by adding ingredients such as cream, cheese, butter, sugar or honey.
Chew your food well and take time with eating.
Some people find very fatty, fried or spicy foods soon after surgery are poorly tolerated, so trial a small portion at first and increase gradually, if you wish to try these foods.
Example initial meal plan
Breakfast
- low-fibre cereal with milk and pot of yoghurt
- white toast with spread or smooth nut butter, egg or cheese
- glass smooth fruit juice or milky tea or coffee
Mid-morning snack
- hot chocolate with shortbread biscuit or
- smooth fruit compote with plain yoghurt or kefir
Lunch
- meat or chicken or fish, cheese or egg or tofu dish with white bread or white pasta or white rice or mashed potato
- one portion of well cooked vegetables such as carrot, squash
- tinned or stewed fruit
Mid-afternoon snack
- cheese and cream crackers or
- smooth nut butter on white toast
Evening meal
- similar to lunchtime meal
Evening snack or dessert
- rice pudding or jelly or
- tinned fruit or
- vanilla ice cream or
- sponge cake and custard
Contact
If you have had a colostomy or ileostomy, please speak to your stoma nurse on 01895 279391.