Post-Operative Care for Peritonitis: Boosting Immunity and Recovery Tips

How should one care for themselves after surgery for peritonitis?

Hello Dr.
Hsiao: My father was in a car accident over a month ago (colliding with a utility pole), which resulted in a small bowel rupture that went unnoticed, leading to a 20-day delay in receiving medical attention.
This caused abdominal inflammation and the formation of an abscess, resulting in severe abdominal pain and fever.
After surgery, he spent 7 days in the intensive care unit before being transferred to a general ward.
The doctor mentioned that he could be discharged in a few days, but he currently has three drainage tubes and one colostomy tube (connected from the colon to the abdomen).
Is it appropriate for him to be discharged under these circumstances?
The doctor also advised that during his recovery at home, we should focus on boosting his immune system to facilitate the drainage of the infected fluid from the abdominal cavity.
However, when my mother inquired about how to enhance his immune system, the doctor was unable to provide a clear answer.
Therefore, I would like to ask you, Dr.
Hsiao, how can we help improve the patient's immune system post-peritonitis surgery to expedite the drainage of the infected fluid? What specific foods should he consume, and what precautions should our family take?
P.S.
We initially considered having my father drink wheatgrass juice, as my mother bought a professional juicer to prepare it, and he felt it had a positive effect.
However, the doctor advised against consuming raw or cold foods.
What is your opinion on this? If we do not add ice, would it be acceptable for him to drink it?

Yu Jing, 20~29 year old female. Ask Date: 2007/10/15

Dr. Xiao Jingqin reply Internal Medicine

After surgery for peritonitis, it is recommended to resume eating as soon as bowel motility returns to normal and gas is passed.
Due to the surgery and peritonitis, there is a significant loss of body fluids into the abdominal cavity, which often leads to a marked decrease in serum albumin levels.
Additionally, other essential proteins and vitamins in the blood may also become deficient in a short period, which can reduce immunity and increase the risk of infection.
Low albumin levels can also lead to peripheral edema, ascites, and intestinal wall swelling, causing digestive issues and increased drainage output.
Therefore, it is advisable to supplement with high-protein foods.
Currently, several brands offer high-protein milk that is nutritionally suitable for postoperative patients, containing vitamins and minerals as well.
For those with poor appetite after surgery, it is ideal to consume over 1600 calories daily.
It is important to monitor for lactose intolerance, which may cause diarrhea.
In principle, this should be complemented with juices, broths, and meats, and food intake can be gradually increased.
As for multivitamins and other supplements, they can be tried as long as they do not cause diarrhea, allergies, or burden the liver and kidneys.
Additionally, it is best to remove any drainage tubes as soon as possible.
The remaining bowel management tube (possibly a stoma?) can be closed surgically once the patient's condition has improved, which may require waiting several months.
It is advisable to consult the surgeon regarding future plans for this.

Reply Date: 2007/10/15

More Info

Post-operative care for patients recovering from peritonitis, especially after a significant surgical intervention, is crucial for promoting healing and boosting immunity. Given your father's recent surgery and ongoing recovery, there are several key aspects to consider for his care at home.

1. Understanding the Recovery Process
After surgery for peritonitis, particularly when there has been a delay in treatment, the body requires time to heal. The presence of drainage tubes indicates that the body is still managing fluid and waste removal, which is a normal part of recovery. While your father may be ready for discharge from the hospital, it is essential to follow the medical team's advice regarding home care and monitoring.

2. Boosting Immunity
To enhance your father's immune system and support recovery, consider the following:
- Nutrition: A balanced diet rich in vitamins and minerals is vital. Focus on:
- Protein: Essential for tissue repair. Include lean meats, fish, eggs, dairy, legumes, and nuts.

- Fruits and Vegetables: These are high in antioxidants and vitamins (like Vitamin C and A) that help boost immunity. Aim for a variety of colors to ensure a range of nutrients.

- Whole Grains: Foods like brown rice, quinoa, and whole grain bread provide energy and fiber, which is important for digestive health.

- Hydration: Ensure he drinks plenty of fluids, preferably water, to stay hydrated and help flush out toxins.

- Supplements: Depending on his dietary intake, consider discussing with his healthcare provider the possibility of vitamin supplements, particularly Vitamin C, Vitamin D, and Zinc, which are known to support immune function.

3. Avoiding Certain Foods
Regarding your question about wheatgrass juice, while it is generally considered healthy, it is essential to follow the doctor's advice about avoiding raw or cold foods. This is particularly important after abdominal surgery, as the digestive system may be sensitive. If you choose to give him wheatgrass juice, ensure it is at room temperature and not chilled.

4. Monitoring and Care
- Wound Care: Keep an eye on the surgical site and drainage tubes. Look for signs of infection such as increased redness, swelling, or discharge. Follow the discharge instructions provided by the hospital regarding wound care.

- Pain Management: Ensure he is comfortable and manage pain as prescribed by his physician. Pain can hinder recovery, so it’s essential to address it promptly.

- Activity Level: Encourage gentle movement as tolerated. While rest is crucial, light activity can promote circulation and healing. Avoid strenuous activities until cleared by his healthcare provider.

5. Follow-Up Appointments
Ensure that he attends all follow-up appointments with his healthcare provider. These visits are critical for monitoring his recovery, managing any complications, and adjusting care as needed.

6. Emotional Support
Recovery from a significant health event can be emotionally taxing. Provide emotional support and encourage open communication about how he feels physically and mentally.

Conclusion
In summary, post-operative care for your father should focus on nutrition, hydration, careful monitoring of his surgical site, and emotional support. While boosting immunity through diet is essential, it is equally important to adhere to medical advice regarding food and activity restrictions. Always consult with his healthcare provider before introducing new foods or supplements into his diet. This comprehensive approach will help facilitate a smoother recovery process and enhance his overall well-being.

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