title: Special postoperative diet orders: Irrational, obsolete, and imprudent.
abstract: There are no indications to prescribed special diets for postoperative patients. Low-sodium and low-fat or low-cholesterol diets are examples of restricted diets, especially in patients with heart disease and atherosclerosis. These restricted diets are unpalatable. Postoperative nausea, paralytic ileus, and vomiting caused by residual anesthetic effects and opioids used for pain control further contribute to the problem. Long-term adherence to these diets is necessary to derive benefits. Prescribing regular and palatable diets in the immediate postoperative period to meet protein and energy goals is important for wound healing and is commensurate with best clinical practices. In the following, we review the pertinent literature and offer clinical evidence that routine special diet orders for postoperative patients are not necessary.
authors.affiliation: Adult Critical Care and eICU, Advocate Health Care, Oakbrook, IL; Division of Surgical Critical Care, Stroger Hospital of Cook County, Chicago, IL. Electronic address: Krishnan.sriram@advocatehealth.com.
authors.forename: Krishnan
authors.initials: K
authors.lastname: Sriram
authors.affiliation: Cloudnine Hospital, Jayanagar, Bangalore, India.
authors.forename: Vidhya
authors.initials: V
authors.lastname: Ramasubramanian
authors.affiliation: Professor Emeritus, Surgery, Neuroscience and Nutrition, Department of Surgery, Upstate Medical University, University Hospital, Syracuse, NY.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Meguid
mesh_terms: D050197:Atherosclerosis / Q000178:diet therapy; D002253:Carbonated Beverages; D003324:Coronary Artery Disease / Q000178:diet therapy; D018752:Diet, Fat-Restricted; D004039:Diet, Sodium-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005705:Gallbladder Diseases / Q000178:diet therapy; D006801:Humans; D006973:Hypertension / Q000178:diet therapy; D008107:Liver Diseases / Q000178:diet therapy; D015201:Meta-Analysis as Topic; D010349:Patient Compliance; D011182:Postoperative Care / Q000379:methods*; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000032:analysis; D014945:Wound Healing
chemical_list: D004044:Dietary Proteins; D012982:Sodium, Dietary
keywords: Low sodium diet; Low-fat/low-cholesterol diet; Postoperative clear liquid diet; Special diets