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New developments facilitating nutritional intake after gastrointestinal surgery
Centre of Gastrointestinal Disease, Karolinska Institute at Ersta Hospital, Huddinge University Hospital, Stockholm; Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm.
Centre of Gastrointestinal Disease, Karolinska Institute at Ersta Hospital, Huddinge University Hospital, Stockholm.
Centre of Gastrointestinal Disease, Karolinska Institute at Ersta Hospital, Huddinge University Hospital, Stockholm.ORCID iD: 0000-0003-2636-4745
2003 (English)In: Current opinion in clinical nutrition and metabolic care, ISSN 1363-1950, E-ISSN 1473-6519, Vol. 6, no 5, p. 593-7Article, review/survey (Refereed) Published
Abstract [en]

Purpose of review: Conventional perioperative care includes a period of semistarvation before bowel function returns and adequate oral intake is allowed. It has been clearly shown that there is no need for restriction in oral intake after, at least lower, gastrointestinal surgery, and that early oral feeding does not increase the risk for dehiscense of the anastomosis. In contrast, early feeding reduces postoperative complications. Even if early oral intake is allowed, however, it is common that side effects such as nausea and vomiting prevent patients from reaching the target energy intakes. Thus, developing routines and treatments that promote sufficient early oral intake after surgery and maintain adequate energy intake in the postoperative period are probably of great importance for the outcome from surgery.

Recent findings: There are a number of factors which may facilitate early oral intake after gastrointestinal surgery including effective pain relief using epidural anaesthesia while avoiding opioids, minimizing sodium and fluid administration perioperatively and substantially reducing preoperative fasting. In addition, sufficient preoperative information, intensive mobilization, energy-dense hospital food and oral supplements may all contribute to improved energy intake after surgery.

Summary: In general, there is a great need for randomized controlled trials examining factors important for the regulation of oral intake after surgery and also the effects of early oral intake after upper gastrointestinal surgery. Future areas of research may also include regulation of appetite and use of peripherally acting opioid antagonists.

Place, publisher, year, edition, pages
Philadelphia, USA: Lippincott Williams & Wilkins, 2003. Vol. 6, no 5, p. 593-7
Keywords [en]
Early oral intake, abdominal surgery, epidural anesthesia, energy, intake, enteral nutrition, postoperative care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-40386DOI: 10.1097/00075197-200309000-00015ISI: 000185193400015PubMedID: 12913679Scopus ID: 2-s2.0-1542466528OAI: oai:DiVA.org:oru-40386DiVA, id: diva2:777148
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2017-12-05Bibliographically approved

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