Guidelines for a liquid diet
If the patient is not confined to hospital where the appropriate liquid diet should be supplied either intravenously or by tube, then the following factors should be taken into consideration:

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• Need for extra energy after surgery to build up a weakened patient
• Need for extra protein after surgery to meet additional requirements
• Weight of the patient, i.e. overweight or underweight or normal weight
• Need for additional protective nutrients such as vitamins and minerals
• Level of activity - bedridden or ambulatory

First phase foods
During the initial few days after discharge when the patient is still weak, recovering from the trauma of the operation and the after-effects of surgery and anaesthesia, and is not able to move around a great deal, the first priority it to get the patient to start eating again. Many patients may suffer from nausea and/or lack of appetite.

In such cases it is important to offer the patient her/his favourite foods in liquid form, such as jelly, ice cream, custard, milk shakes, fruit juice or liquidised fruit.

Preparation tips

• Prepare soft jelly by adding more water than normal (about ½ a cup of extra liquid)
• Let ice cream soften and whip up with milk if the patient has difficulty swallowing
• Use runny custard to make it easier for the patient to swallow
• Prepare milk shakes
• Use 1 cup of cold full-cream milk, ½ cup of mashed canned or fresh fruit (without pips or peels) and 1 tablespoon of honey or sugar and liquidise in a blender - serve cold
• Mashed banana, canned pears, peaches, apple puree and mashed avocado make delicious and high-energy milk shakes
• Add up to 3 tablespoons of fat-free milk powder to the milkshake to increase the protein content for patients with an increased protein requirement
• Use low-fat or fat-free milk for patients who need to restrict their energy intake
• Serve less acid fruit juices - apple, or grape juice
• Use Yogi-sip or flavoured milk drinks or dilute flavoured yoghurt with additional milk (if the yoghurt contains pieces of fruit or pips, it may have to be strained before serving)
• Serve milkshakes, custard, jelly and fruit juices well chilled as nauseous patients are less likely to reject chilled food
• Use energy drinks such as Energade to boost patients with high-energy requirements
• Use a liquid meal replacement such as Ensure or Nutren 1.0, or Peptamen or Lifegain, which should all be available from your chemist
• Prepare clear soups by dissolving Marmite, Bovril or stock cubes in boiling water (allow to cool so that the patient does not burn her/his mouth)
• Ensure that the patient is drinking enough water to meet her/his needs - also serve chilled if the patient is nauseous

The following should be avoided:

• Fizzy cold drinks
• Excessive intakes of tea or coffee - serve with milk
• Any fruit that contains pips, such as guavas or berries
• Acid fruits, like pineapple or orange

Second phase foods
Once the patient starts to recover and has conquered nausea and post-operative lack of appetite and food aversions, the food and drinks listed above can be expanded to include the following:

• Homemade soups - make potato, butternut or vegetable soup and either strain or liquidise - add more liquid if the patient has difficulty swallowing the soup. Add 2-3 tablespoons of fat-free milk powder if the patient requires additional protein.
• Cook minced lean beef or lamb (cut off all visible fat) with a stock cube and liquidise
• Liquidise cooked vegetables such as potato, butternut, pumpkin, squash, or carrots and mix with liquidised meat - dilute with milk or stock to assist swallowing
• Make soft porridge (oats, Maltabella, Creemy-Meal, maize meal), add sugar or honey and dilute with milk to aid swallowing
• Use Purity baby foods (vegetables, fruit and yoghurt) when you need to feed the patient and have no time to prepare liquidised dishes

Other considerations
The use of a liquid diet may cause constipation, as such diets are usually low in dietary fibre. Discuss this problem with the surgeon before the operation to make sure that the patient does not damage the digestive tract by using the wrong type of laxative. Nutren Fibre is a meal replacement that contains prebiotic fibre to promote normal bowel function in patients on liquid diets.

Multivitamin and mineral supplements may also be required if the patient has to use a liquid diet for longer periods of time. A liquid vitamin and mineral supplement is usually advisable such as Vi-Daylin, Clusivol, Vi-Daylin with Minerals, or Viteral.

By applying the above-mentioned guidelines you can ensure that you or any member of your family who needs a liquid diet will not develop deficiencies and recover fully from his or her operation. – (Dr I.V. van Heerden, DietDoc)

Any questions? Ask DietDoc

 

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