Laparoscopic Total Colectomy & Ileoanal Pullthrough

Eating and drinking

The operation, anesthesia, and medication make your stomach and intestine (food tube) slow down for several days. You will be given fluids and nutrients through your IV during this time. A nasogastric tube (NGT) is used to help keep your stomach empty, rest the bowel while it heals and prevent nausea and vomiting. The NGT is passed through the nose down into the stomach during surgery. It will stay taped in place near you nose until your stomach and intestine start to pass air (gas) and stool ("poop") into you ostomy pouch. This means that the bowel has begun to function after surgery. You may hear noise from the stoma as it begins to function and air passes from it. Many patients say their stoma is "burping." The amount of air passing from the stoma will decrease in time. Your doctor and nurses will decide when it's time to remove the NGT. It takes a few moments to untape and remove the tube.

Within a few hours of removing your NGT, your nurse will start to give you a small amount of water and ice chips. Go slowly at first! Usually the next day, you can slowly begin having more clear liquid choices (like Jell-o, ginger ale, apple juice). If you do not have any nausea or vomiting, you can then start to eat ice cream, milk and pudding the next day. You will gradually be able to eat regular foods in small amounts. It may take one to two weeks for your appetite to return to normal.

It is very important to drink plenty of fluids once you go home to avoid getting dehydrated. Good choices are Gatorade (because of the potassium and sodium), water, and milk. During digestion, the colon absorbs fluids and some electrolytes (which are chemicals important to the function of many processes in the body). You no longer have the large bowel or colon to absorb water so must increase the amount of fluid you drink. The ileostomy will put out a moderate amount of fluid as part of the stool and increase the risk of dehydration and electrolyte imbalance. If you do become dehydrated, you may need to be hospitalized again.

In general:

• Avoid foods that may cause a blockage of the bowel (corn, seeds, nuts, celery, popcorn and raw vegetables such as carrots).

You nurse will review the Family Education Sheet "Ostomy Diet Guidelines" with you before you go home. These guidelines will help decrease your risk of obstruction. There is no need to follow a highly restrictive diet. This is a benefit of the surgery for many patients who have had to follow restricted diets before surgery.