The nutritional therapeutic options Intestinal surgery depend both on the time after the operation and on the extent and location of the operation.
Up to one 50% removal of the small intestine After some time of adaptation, the rest of the intestine can usually ensure the digestion of the nutrients. The more small intestinal tissue is removed, the more likely there is a lack of nutrients, energy and water.
Missing 75% of the small intestine this deficiency is serious. With a remaining length of 30 to 50 cm, parenteral (with the help of an infusion) are fed.
The decisive factor is which part of the small intestine was removed. For example, in the End of the small intestine (terminal ileum) reabsorbs the bile salts. If a part is missing, bile salts enter the Large intestine over, they inhibit the withdrawal of water through the intestinal wall and diarrhea occurs (chologic diarrhea).
In addition, more bile salts are excreted and the resulting deficiency disrupts fat digestion and leads to Fatty stools and lack of energy. In addition, more fatty acids remain in the intestinal lumen and can get along with them Calcium combine to form insoluble lime soaps. Calcium Also combines with the oxalic acid from food to form water-insoluble calcium oxalate. If less calcium is available, more oxalic acid is absorbed by the intestinal wall and there is a risk of stone formation (Oxalate stones) in the urinary tract. In addition, an increased bile salt concentration probably increases the absorption of oxalic acid. Oxalic acid-rich foods should therefore be avoided (Swiss chard, rhubarb, Spinach, cocoa, beetroot, parsley). Preventive against Kidney stones A sufficient fluid intake of 1.5 to 2 liters per day is also effective.
$config[ads_text1] not found
If necessary, the usual Fats up to 75% through MCT fats replaced. This can contribute to a significant improvement in the nutritional status. The lower part of the small intestine has to be removed Vitamin B12 be administered via medication. Since fat digestion is often disturbed, it is also important to ensure that there is an adequate supply of fat-soluble vitamins. Drinking fluids during the meal accelerates the passage of the porridge through the stomach and small intestine and thus worsens the absorption of nutrients. To avoid this, it is recommended to drink 1 hour after eating.
From a residual length of the small intestine of 30 to 50 cm, permanent artificial feeding via infusion. From a remaining length of the small intestine of 60 to 80 cm after the operation, start eating as soon as possible in the form of light whole foods. So-called formula diets can also be used on their own or in combination with a normal diet at first. These are nutrient concentrates in liquid form that are easily absorbed in the digestive tract.
$config[ads_text2] not found1. Breakfast
1. Snack
2. Snack in between
Having lunch
Snack in between
$config[ads_text3] not found
dinner
Late meal
MCT fats and their use are described in detail in the chapter "Condition after gastric surgery".
$config[ads_text2] not foundWith this type of diet, the need for unsaturated and polyunsaturated fatty acids is not guaranteed. In addition, the lack of dairy products means that the calcium requirement is not met. Plan calcium-rich mineral waters! Lactose sugar is usually tolerated again some time after the operation. Essential fatty acids can also be given in capsule form. The aim is to make the transition to light whole foods as quickly as possible in order to avoid malnutrition.
This diet plan contains on average: 90 g protein, 60 g fat (of which 32 g MCT fat), 350 g carbohydrates and 2500 kcal.