Inflammatory bowel disease (IBD): Using nutrition to improve recovery

Meet with a dietitian for nutrition counseling who is familiar with ERAS guidelines. They will screen for malnutrition, including specific nutrients such as iron and vitamin D levels. They may suggest a meal plan, standard nutritional shakes (ex: Boost®, Ensure®, Kate Farms®), and certain vitamins/ minerals to optimize your nutrition before a planned surgery. These recommendations may help to manage your weight and correct nutritional deficiencies.

Your team may recommend you drink immunonutrition shakes 2-3 times a day. These contain specific nutrients that help with wound healing, inflammation, and recovery, such as: L-arginine, L-glutamine, and omega-3 fatty acids. Some examples of shakes are: Ensure® Surgery, Nestle® Impact Advanced Recovery, and Juven® powder.

You may be allowed to eat solid foods up to 6 hours before your procedure.

You may be given a drink high in carbohydrates 12 hours before, plus up to 2 hours before surgery. Some common drinks include:

• Ensure® Pre-Surgery (2 bottles the night before, 1 bottle 2 hours prior to surgery).
• Nestle® PreLoad (2 sachet mixed in 400ml water each the night before, 1 sachet in 400ml water 2 hours prior to surgery).
• Clear Fast® Pre-op (1 bottle the night before, 1 bottle 2 hours prior to surgery).

Depending on hospital guidelines, surgery type, and recovery, your team may suggest you start eating within 4 hours after surgery. Nutrition recommendations may include a light meal, shakes (including immunonutrition types), and ideas for hydration. These can help reduce nausea or upset stomach that may happen after surgery, resume bowel function, and possibly decrease your hospital stay. Additional calories are helpful for overall recovery from surgery.

• A dietitian may meet with you before you leave the hospital to discuss your dietary recommendations. They may give you suggestions on your specific calorie and protein needs through balanced meal planning, texture modifications of food if needed, oral nutrition supplements, vitamins, and proper hydration techniques.
• See the oral rehydration solutions handout to maintain adequate hydration if you have fluid losses from diarrhea, high ostomy output, or short bowel syndrome.