【Learning Key Points】
- Practice deep breathing and coughing before surgery to prevent pulmonary complications after surgery.
- A clear liquid diet must be taken the day before surgery (such as honey water, sugar water, transparent fruit juice without fruit pieces, vegetable soup, broth, avoid milk and milk products).
- If you have an enterostomy after surgery, eat less gas-producing foods, such as cabbage, beans, sweet potatoes, etc.
I. Bowel preparation for surgery
Purpose: A “bowel preparation” is done to prepare the bowel for surgery or a procedure. Its purpose is to clear out all solid matter from the bowel. Please follow these instructions below.
II. Two preparing methods before operation
- One-day preparing method
- Take laxatives medication following the doctor’s orders and drink more water the day before operation.
- Take antibiotics following the doctor’s orders (depends on individual).
- Completion of the written consent formulation.
- Physical examination before operation including: electro cardiogram, liver and renal function examination,chest radiograph (chest X-ray), anesthesia interview and blood test.
- Depends on individual condition, we may consult to other experts for pre-operative surveys, e.g.Anesthesiology Department, Cardiology Department, Respiratory Therapy, Pain Management…etc.
- Having clear liquid diet. A clear liquid diet includes only liquids that don't have any pulp, bits of food or any other residue. These clear liquids diet are allowed: sports drinks, cherry juice, clear soft drinks, black coffee or tea(no milk or cream) fat-free clear vegetable broth, fat-free clear chicken broth, fat-free clear beef broth, honey water, syrup water, juice with no granules… etc., but NO MILK or MILK /CREAM PRODUCTS.
- Perform cleansing enema by prescription at night.
- NO FOOD and WATER after mid-night.
- Practice deep breathing and coughing exercises under nurse’s instruction.
- 2.Three-day preparing method
- Before 3 days of operation:
(a)Having low residue diet, low fiberfood, e.g. tender meat, noodles, juice without pulp (such as apple, grape, cranberry and prune)…etc., but NO MILK or MILK/ CREAM PRODUCTS.
(b)Have a warm saline enema at night.
- Before 2 days of operation:
(a)Having low fiber, low residue diet.
(b)Have a warm saline enema at night.
- Before 1 day of operation:
(a)Take laxatives medication following the doctor’s (depends on individual).
(b)Other preparations refer to One-day preparing method above.
III. Notes on operation day
- NO FOOD and DRINK.
- Take off all unnecessary accessories, e.g. watch, necklace, ring, denture tooth, nail polish... etc. Please BE WARE OF all valuables.
- Dress on the operation gown, wear the identification wristband, and wait until the operation room’s call.
- Please empty the bladder before the operation staff comes.
IV. Notes after operation
- Peripheral or central venous catheter,nasogastric tube, urinary catheterization, and wound drainage tube will be on after operation. Please keep all tubes steady and fluent.
- Elevating the head of the bed at approximately 45 degrees, turn the body over once around 1-2 hours,get out of bed and engage in light activity(as sitting, standing, or walking) as soon as possible, it can avoid pressure injury, improve bowel movements and flatus passage.
- Deep breathing and coughing exercise, using steam inhalation four times one day (if needed) and pat the back. It can help avoid sputum accumulation.
- If there is any pain, discomfort, or gauze is getting wet, please contact nurse on duty.
- If there were colostomy after surgery, patient and family need to learn colostomy home caring by following the nurse’s instruction and colostomy manual after patient’s condition is stable.
V. Dietary suggestion
- Patient is not allowed to eat for 1-5 days after operation generally. After bowel movement and flatus or stool passage, then food and water are allowed progressively following the doctor’s and nurse instruction.
- Having balance with high protein, vitamin C, E dietary, e.g. meat, egg, milk, orange, pear, grape, deep-color vegetable, grains, egg yolk… etc.
- Avoid smoking, alcohol, fatty, spicy and stodgy food
- If having diarrhea, please eating small frequent meals, multiple meals a day. Take Low-fiber food such as tender meat, grains, fruit and vegetable juice, and more water. Keep adequate hydration if necessary you may take some prescribed anti-diarrheal pills.
- If there were colostomy, please eat a bland diet and avoid the food that can make gas easily such as cabbage, beans, potato…etc.
VI.References
- Hanna, D. N. & Hawkins, A. T. (2021). Colorectal: Management of postoperative complications in colorectal Surgery. The Surgical Clinics of North America, 101, (5). 717-729. https://doi.org/10.1016/j.suc.2021.05.016
- Lo, P. S., Lin, Y. P., Hsu, H. H., Chang, S. H., Yang, S. P., Huang, W. C., & Wang, T. J. (2021). Health self-management experiences of colorectal cancer patients in postoperative recovery: A qualitative study. European Journal of Oncology Nursing, 51, 101906. https://doi.org/10.1016/j.ejon.2021.101906
- Tontini, G. E., Prada, A., Sferrazza, S., Ciprandi, G., & Vecchi, M. (2021). The unmet needs for identifying the ideal bowel preparation. Journal of Gastroenterology and Hepatology, 5 (2021), 1135-1141. https://doi.org/10.1002/jgh3.12653