【Learning Key Points】
- Practice deep breathing and coughing exercises before surgery to help prevent postoperative pulmonary complications.
- Follow a clear liquid diet on the day before surgery. Appropriate fluids include honey water, sugar water, clear fruit juice without pulp, vegetable broth, and clear broth. Avoid milk and all dairy products.
- If you have an enterostomy (stoma) after surgery, avoid foods that easily produce gas, such as cabbage, beans, and sweet potatoes.
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
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Take the prescribed laxatives as directed by your physician and drink plenty of water on the day before surgery.
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Take prescribed antibiotics if indicated.
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Complete all required informed consent forms.
- Physical examination before operation including: electro cardiogram, liver and renal function examination,chest radiograph (chest X-ray), anesthesia interview and blood test.
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Depending on your medical condition, additional consultations may be arranged with specialists, such as the Department of Anesthesiology, Cardiology, Respiratory Therapy, or the Pain Management Team.
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Follow a clear liquid diet. Clear liquids include sports drinks, cherry juice, clear soft drinks, black coffee or tea (without milk or cream), fat-free clear vegetable broth, chicken broth, beef broth, honey water, sugar water, and pulp-free fruit juice. Do not consume milk or any dairy products.
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Receive a cleansing enema as prescribed in the evening.
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Do not eat or drink anything after midnight.
- Practice deep breathing and coughing exercises under nurse’s instruction.
- 2.Three-day preparing method
- Before 3 days of operation:
(a)Follow a low-residue, low-fiber diet, such as tender meat, noodles, and pulp-free fruit juices (e.g., apple, grape, cranberry, or prune juice). Avoid milk and dairy products.
(b)Receive a warm saline enema at night.
- Before 2 days of operation:
(a)Continue the low-residue, low-fiber diet.
(b)Receive a warm saline enema at night.
- Before 1 day of operation:
(a)
Take prescribed laxatives as directed by your physician (if indicated).
(b)
Complete all other preparations according to the One-Day Preparation Method above.
III. Notes on operation day
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Do not eat or drink anything.
- 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
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After surgery, you may have peripheral or central intravenous catheters, a nasogastric tube, a urinary catheter, and wound drainage tubes. Please keep all tubes secure and unobstructed.
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Keep the head of the bed elevated to approximately 45°. Change position every 1–2 hours and begin light activities such as sitting, standing, or walking as soon as permitted. These measures help prevent pressure injuries and promote bowel movement and passage of gas.
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Perform deep breathing and coughing exercises. If necessary, use steam inhalation four times daily and receive chest percussion (back patting) to help loosen and clear sputum.
- 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
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Generally, patients should not eat for 1–5 days after surgery. Oral intake will be resumed gradually after bowel sounds return and the passage of flatus or stool, according to the physician's and nurse's instructions.
- 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
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If diarrhea occurs, eat small, frequent meals. Choose low-fiber foods such as tender meat, white toast, white noodles, and pulp-free fruit or vegetable juice. Drink plenty of fluids to prevent dehydration. Take prescribed antidiarrheal medications if necessary.
- 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.Conclusion
Patients undergoing intestinal surgery require appropriate preoperative bowel preparation, postoperative care, and nutritional management to reduce the risk of infection and postoperative complications. After surgery, maintaining the patency of tubes and drains, providing proper wound care, changing position regularly, and gradually increasing physical activity are essential for recovery. Performing deep breathing and coughing exercises also promotes lung expansion, facilitates sputum clearance, and enhances the recovery of bowel function. A balanced diet that is high in protein and easy to digest supports wound healing. Patients with diarrhea or an intestinal stoma should avoid high-fiber and gas-producing foods to promote recovery and improve their quality of life.
VII.References
- Shahini E, Sinagra E, Vitello A, et al: Factors affecting the
quality of bowel preparation for colonoscopy in hard-to-prepare patients:
Evidence from the literature. World
Journal of Gastroenterology 2023; 29(11): 1685-1707.
- Tamai, N. and Sumiyama, K.
Optimal bowel preparation for colonoscopy. Digestive
Endoscopy 2025；37: 139-146.
- Zhang Y, Wang L, Wu W,
et al: Predictors of inadequate bowel preparation in older patients
undergoing colonoscopy: A systematic review and meta-analysis. International Journal of Nursing Studies
2024; 149:104631.