Rehabilitation after bowel surgery

Recovery after bowel surgery is a mandatory therapeutic measure to ensure the normal functioning of the body. During surgery, the patient receives a powerful dose of anesthesia and other potent drugs, so it is necessary to carry out certain rehabilitation techniques.

The need for bowel surgery

Operations on the intestines are performed in the presence of the following indications:

• malignant neoplasms;
• intestinal obstruction;
• ulcer of the intestine, duodenum;
• necrosis of individual parts of the organ;
• mechanical injury of the intestine.

Varieties of operations

Surgical operations on the intestines have various varieties and are prescribed depending on the presence of indications and the general condition of the patient:

• Laparoscopy is a minimally invasive operation in which several small incisions are made in the abdominal cavity and the necessary manipulations are carried out. Recovery occurs in 3–5 days;
• Laparotomy is a classic operation with a wide incision in the abdominal cavity. After this manipulation, the recovery is longer, and the restrictions for the patient have a wider list;
• performing an operation without removing a part of the organ;
• removal of one of the sections of the small intestine, since the elimination of the entire part implies a complete change in lifestyle and the provision of nutrition with special mixtures through intravenous administration;
• resection of the colon (removal of part of the organ in the presence of relevant indications);
• colonectomy (removal of the colon). If part of the intestine is cut out, then the manipulation is called hemicolonectomy.

The main tasks in the restoration of the intestine after surgery

A rehabilitation technique for restoring the intestines after surgery should include the following tasks:

• normalization of intestinal perilstatics (restoration of physiological motility with regular stools);
• preventive measures to prevent dysbacteriosis of medicinal origin, dyspepsia;
• improvement of the process of digestion and assimilation of food, restoration of damaged intestinal mucosa;
• preventing the development of possible postoperative complications;
• improving the quality of life of the operated patient.

Gut Recovery Techniques

Recovery of the intestine during surgery consists in the use of basic methods, which are discussed in more detail in the list below.

1. Medical therapy. For recovery, enzymes, probiotics, and regulatory agents for the restoration of motor skills are most often prescribed. This category of drugs has a temporary effect, since after the end of the intake, the discomfort that has gone away may return.
2. Phytotherapy. Medicinal herbs, with the right selection, give the proper result and help restore impaired motor skills in a fairly short time. Folk remedies improve metabolic processes, stabilize the liver, stomach, gallbladder, which is necessary after a surgical operation.
3. Compliance with a therapeutic diet. This method is one of the main ones in the restoration of the body, and the principles of nutrition are prescribed individually, depending on the general condition of the patient.

Food should be fractional up to 5-7 times a day every 3-4 hours. Dishes are prepared using safe culinary processing methods (steaming, baking). It is best to use grated vegetable purees, soups, drink plenty of water in the form of rosehip broth, warm non-carbonated mineral water.

4. Appointment of breathing exercises. Surgical intervention involves performing special exercises (forced exhalations, inhalations, balloon inflation). Such manipulations allow to ensure normal ventilation of the lungs and prevent the development of bronchitis, pneumonia. It is recommended to perform the procedures daily with prolonged bed rest.
5. Painkillers. Reception of analgesics, antispasmodics depends on the type of surgical intervention used and the general condition of the patient. With open wounds, the first 2-3 days are intravenous administration of narcotic drugs (Droperidol). With further recovery, drugs of non-narcotic origin are taken (Ketorolac, Ketanov, Diclofenac).
6. Seam processing. Postoperative sutures should be inspected daily and treated with antiseptic solutions. The patient should not scratch or wet the scars. If any complications (swelling, redness, bleeding) occur, you should immediately see a doctor.
7. Carrying out physical therapy. Recovery of the patient after surgery largely depends on the individual characteristics of the body. All manipulations (sitting, walking) should be carried out only with the permission of the attending physician.

At the initial stage of recovery, a complex is prescribed in a supine position (performing simple movements with arms and legs). In the future, training expands to strengthen the abdominal cavity. Such exercises can be carried out with complete healing of the suture.

8. Physiotherapy procedures. Rehabilitation during surgical intervention on the intestines is possible with the appointment of such manipulations as electrophoresis, magnetotherapy, laser therapy, UHF therapy, diadynamic therapy. The duration of treatment is prescribed by the attending physician.

Recovery for various types of operations

The speed of recovery of the patient depends on the type of operation performed, therefore, detailed information on this issue is discussed below.

Surgery to remove part of the intestine

Recovery from such operations is quite fast. Parenteral nutrition is based on the administration of glucose during the first days after surgery. Nutrient mixtures are administered on the 2nd or 3rd day, and a week later the patient begins a full-fledged diet according to a therapeutic diet.

Resection of the small intestine

With resection of the small intestine, the duration of parenteral treatment is 7 days. After the elapsed time, the gradual introduction of adapted mixtures in the amount of 250 ml is started and the total volume is brought to 2 liters.

After 10–14 days, the patient is prescribed diet No. 0a, and subsequently No. 1a. If the recovery is successful, and the patient assimilates the food consumed well, then the surgical diet No. 1 with pureed food is prescribed, and subsequently food intake is normal.

Removal of the small intestine

Parenteral nutrition is prescribed for up to 14 days. In the future, the general diet is expanded to liquid, puree-like dishes. At the same time, the duration of taking adapted mixtures is 1-2 months.

The peculiarity of dieting during such an operation is that adapted mixtures are administered orally in a small volume using a tube or a special probe. These manipulations are necessary to restore the normal functioning of the gastrointestinal tract. With a favorable recovery, the remaining part of the intestine begins to function as an integral organ.

Diets prescribed after surgery

When considering how to restore the intestines during surgery, doctors most often prescribe therapeutic diets, depending on the type of surgical procedure performed.

Diet number 0a

Diet No. 0a involves the consumption of warm, unsalted and liquid foods. The diet should consist of the following dishes:

• weak meat broths made from dietary meat (rabbit, chicken, veal);
• decoction of rice;
• fruit jelly;
• jelly from berries;
• weak tea.

Diet No. 1a

Diet No. 1a is prescribed for a period of 5-7 days and involves the restoration of normal bowel function. Recommended fractional meals up to 6 times a day every 3-4 hours. The diet should be dominated by warm, liquid, mashed dishes.

Allowed meals:

• rice, buckwheat porridge in low-fat broth or diluted milk with low fat content;
• vegetable soups with the addition of cereals;
• steamed protein omelet;
• meatballs, soufflé, cutlets from lean meats (chicken, veal, rabbit);
• jelly, jelly, weak tea.

Diet #1

Diet No. 1 with the pureed option has an extended range, since the patient can consume the following foods:

• stale bread, biscuit cookies;
• vegetable soups with cereals;
• cutlets, souffle, meatballs from dietary meat (chicken, rabbit, young veal);
• lean fish (cod, flounder, pollock). With good assimilation, in the future, you can introduce fish of moderate fat content (perch, herring, pink salmon);
• dairy products (skimmed milk, low-fat cream, yogurt, kefir, fermented baked milk, cottage cheese, making lazy dumplings);
• semolina, oatmeal, rice, buckwheat porridge, boiled in a mixture of water and milk;
• omelet, steamed eggs;
• the use of vegetables in a baked, boiled and grated form (potatoes, zucchini, carrots, cauliflower).

With an unmashed version, the diet has a similar composition, but at the same time, dishes can be consumed in the form of pieces, and cereals in a crumbly consistency.

Complete adaptation of the intestine occurs within 2 years after the surgical intervention. Therefore, it is important to draw up an individual diet depending on the general condition of the patient.

To ensure normal recovery, the following dietary options must be observed:

• proper and healthy nutrition;
• provision of therapeutic nutrition;
• temporary compliance with parenteral nutrition;
• continuous parenteral nutrition.

The patient should exclude from the daily diet such prohibited foods:

• salted, smoked, pickled, spicy, sour, peppery foods;
• fatty meat, fish;
• mushrooms, fish caviar;
• fresh bakery;
• dough dishes containing yeast;
• alcoholic, carbonated drinks;
• chocolate, coffee;
• confectionery;
• energetic drinks;
• very hot and cold dishes;
• radish, radish, cabbage;
• sour greens (sorrel, rhubarb).

Folk remedies

Folk remedies are quite effective in the postoperative recovery period, but all selected methods must be agreed with the attending physician without fail. The most popular ways:

• the use of vegetable oils (sunflower, olive, corn). Taking the drug on an empty stomach in the amount of 1 teaspoon prevents the development of constipation;
• the use of a decoction of buckthorn, blackthorn, field harrow, licorice, rhubarb, marshmallow allows you to restore intestinal motility and establish stool regularity;
• herbs fennel, anise are carminative and eliminate severe colic;
• eating dried fruits (dried apricots, prunes), as they have a pronounced laxative effect;
• beets contain a large amount of fiber, which cleanses the body well and prevents the development of fermentation processes in the intestines;
• wheat, oat, corn flakes help to improve digestion and absorb toxins well, which are then removed from the body.

If a sick patient has diarrhea, then you can use special means to fix the stool:

• a decoction of walnut shells, dried rye bread, oak bark. Prepared funds are taken in the prescribed dosage of 2 tbsp. spoons three times a day before direct meals;
• rice broth during long-term cooking, the cereals are pre-filtered through gauze and taken in small portions every 2-3 hours.

Operations on the intestines have serious consequences for the body, so it is important to follow the prescribed therapeutic diet for a long time, since the restoration of the normal functioning of the organ can take several years.