Colon Surgery Diets Explained

NPO, Soft Diets, and Side Effects - Navigating Eating after Bowel Surgery

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You don't need a degree in nutrition to appreciate the dietary intricacies associated with colon surgery. Any time your bowels are touched or manipulated in some way, like during bowel surgery, they shut down in self-defense. This is a temporary mechanism, but one that will change the way you approach nutrition in the meantime.

Different Diets after Colon Surgery

Your doctor may order different diets based on your needs before, during and after your bowel surgery.

Some dietary terms you may hear include:

  • Nothing by mouth (NPO)
  • Clear liquid diet
  • Soft diet (or soft mechanical diet)
  • Low-residue diet

Your doctor will decide when and how to advance your diet following surgery, depending on your general health, the extent of surgery required and your nutritional needs.

Let's talk about the different diets which may be recommended, how to eat if you are having specific symptoms, and then how you can keep your colon healthy when you're recovering.

NPO

NPO stands for nil per os, which is Latin for nothing by mouth. Prior to certain procedures, such as a colonoscopy or bowel surgery, your doctor may tell you to stop all food and fluids six to eight hours beforehand. This time window allows any remaining food or fluid to leave your stomach, which decreases your risk of complications while receiving sedation. There is the potential that sedation can make you vomit. If you have food or fluids in your stomach and vomit when sedated, you could breathe the contents of your stomach into your lungs, resulting in problems such as aspiration pneumonia.

Most people are NPO after surgery as well, at least until they are alert enough to not worry about aspiration.

Nothing by mouth includes gum, hard candies, water, smoking (or smokeless tobacco) and medications. Talk to your doctor if you take prescription medication daily. You will be given intravenous fluids while you are NPO so that you don't become dehydrated.

If your lips and mouth become dry, your nurse may offer you ice chips to suck on until you are allowed to drink fluids.

Clear Liquids

The clear liquid diet may be prescribed for a few days prior to procedures or surgery on the colon. This diet includes all liquid (or liquid at room temperature, like gelatin) foods that you can easily see through. Prior to procedures or surgery, this diet allows all solid food and waste to exit your body, complementing colon-cleansing prep efforts.

Following surgery, a clear liquid diet is ordered to facilitate rest and begin the healing process in your colon, as the liquids are gentle on your digestive tract. Your doctor may also keep you on a clear liquid diet if you are having problems with nausea and vomiting. Most frequently, foods allowed on a clear liquid diet include:

  • Thin meat- or vegetable-based broth (without any solid parts)
  • Consommé or bouillon
  • Flavored gelatin
  • Water (plain or mineral)
  • Tea (mild without cream or milk)
  • Apple or Cranberry Juice
  • Clear sodas, such as lime, club soda or ginger ale

Soft Diet

The soft diet masquerades under many different names and varieties depending on the reason your doctor ordered it. There are two main types of soft diet, including the soft mechanical, for people with chewing or swallowing difficulties, and the soft digestive, for people who need to take it easy on their digestive tract.

If your doctor does not immediately progress you to a regular diet (from the clear liquid diet), he or she will probably order a soft digestive diet to prolong the rest period for your colon. The foods on a soft diet are still fairly easy to digest, but provide more healing nutrients than the liquid diet and may include:

  • All fluids and soups, including creams
  • Foods with mashed potato or scrambled egg consistency
  • Finely ground or soft meats, such as white fish or tender, fine-cut poultry
  • Fruits and vegetables that are well-cooked
  • Overcooked pasta and soft bread

A rule of thumb for most soft diets: if you can smash it with a fork, you can eat it.

Hard, chewy and crunchy foods are not allowed on the soft diet, including tough meats (any meat you have to bite or chew), jerky, raw fruits or vegetables, crackers, nuts, seeds or peanut butter.

Low Residue Diet

If you've had a colonoscopy, colon surgery with a resection, or suffer from diverticulitis or inflammatory bowel disease, your doctor may recommend a low residue diet.

"Residue" refers to what remains in your colon after digestion. This includes fiber and materials such as pulp and seeds. When you eat a low residue diet it's important to understand that your stools may occur less often and will be less bulky.

Foods to avoid on a low residue diet include:

  • "Grainy" breads such pumpernickel and rye and oatmeal
  • Nuts
  • Seeds - such as sesame seeds, poppy seeds, flax seed, and chia seeds
  • Dried fruits
  • Meat with gristle
  • Popcorn
  • Berries
  • Sauerkraut
  • Prune juice
  • Raw vegetables

In general, the foods on a low residue diet are the opposite of what you may consider a "healthy diet" or a colon cancer prevention diet. This diet is usually continued only while your colon is healing (except seeds may continue to remain on your taboo list if you suffer from diverticulosis.)

Decreasing Side Effects

Your doctor, nurse, and nutritionist can work with you during your recovery from bowel surgery to ensure your diet does not complicate any symptoms. Different approaches may help with the different symptoms you may experience:

Gas pain - While recovering from bowel surgery, you may experience cramping and bloating. Eating and drinking certain foods can exacerbate these symptoms. Foods and beverages that complicate gas pains may include:

  • Beans
  • Cruciferous vegetables, such as broccoli or cauliflower
  • Dairy
  • Foods containing yeast, such as bread
  • Carbonated drinks (or drinking through a straw)

Constipation/abdominal pain - If you are having abdominal pains or constipation, your doctor may restrict a number of hard-to-digest foods (such as meats and foods containing a lot of fiber) in your diet. You may also try eating smaller portions more frequently and drinking plenty of water to combat constipation or digestive pains. Don’t talk while eating and chew your food thoroughly to reduce gas and increase digestion.

Nausea - Nausea can sometimes be mitigated by eating a bland diet and refraining from greasy or fatty foods. You may want to try decreasing your intake of dairy, processed and salty foods until your stomach settles. If nausea persists, contact your doctor. He or she may anticipate this symptom with prescription medications. Do not "wait for it to pass”—most doctors encourage taking your anti-nausea medications as soon as you become uncomfortable.

Eating Healthy with Colon Cancer

Your diet will be advanced until you are eating regular foods and no longer have side effects. At that time it's a good idea to begin choosing foods that promote colon health regularly.

Sources

  • Kasper, Dennis L.., Anthony S. Fauci, and Stephen L.. Hauser. Harrison's Principles of Internal Medicine. New York: Mc Graw-Hill Education, 2015. Print.
  • U.S. National Library of Medicine. MedlinePlus. Large Bowel Resection – Discharge. Updated 05/09/17. 

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