Georgina Giebner3 May 2021 10:03am

Nutrition tips after bowel cancer surgery


I may have just missed bowel cancer awareness month, but for people affected by it, knowing what to expect around treatment is important at any time. So here are my support tips if you have had treatment for bowel cancer:


If you have bowel cancer and have had surgery, you may be still struggling with side effects, even a long time after.


How long will you have side effects from bowel surgery?


Everyone is different.  Depending on the type of operation, your bowel action will be affected in various ways.


Typically it takes around 2 weeks for your bowel action to get to its new pattern; however there are some things to look out for after this time.


Your dietitian, doctor, surgeon or specialist nurse can advise and support you if you continue to have problems after treatment. Adaptations to your diet can really make a big difference.


If you have diarrhoea every hour or so, or are emptying your stoma bag too often, and your urine is getting darker and less, please seek help from your doctor - you could be getting dehydrated.


Resolving this may not be as simple as just drinking more – for some people, adaptations in the composition of drinks are needed, such as electrolyte drinks (always under direction of your healthcare professional). You can find further information about checking your hydration here: https://www.nhsinform.scot/campaigns/hydration


What can be done to reduce these side effects?

With careful assessment of your symptoms, taking into consideration the type of surgery, medication, and your diet, a professional can help develop a plan to alleviate or better manage your symptoms.


Should you seek advice from a registered dietitian?

You may need to speak to a registered dietitian if you are losing weight, are following a restrictive diet, or if you feel that your diet is making your symptoms worse.


You may also be confused about advice found online about the best diet - NHS or Freelance dietitians, suitably qualified in cancer rehabilitation and the consequences of cancer treatment, can help you decide on what’s right for you, and avoid following wrong advice.


What type of diets may be advised?

This again depends on the assessment - if you have a stoma for example, or have had your bowel re-joined, the advice may be different. The advice for rectal cancer may differ substantially from the one given for anterior resection.


Some common things a dietitian consider:

  • The types of fluids you are drinking and when you’re having them
  • The type and timing of fibre and carbohydrates you are eating
  • Your intake of fat,  and if you have any problems with bile acids following your operation
  • The impact your individual eating habits may have on the health of your friendly gut bacteria
  • If you need any extra vitamins and minerals – some types of treatment reduce your guts ability to absorb those or you may be losing some if you have diarrhoea/high stoma losses
  • Quantity and timing of your food intake


Some foods are known to be especially good for bowel health (depending on individual circumstances), for example ground flaxseeds (linseeds). Best to start off with a small portion (1 teaspoon a day) and gradually increase to 1 tablespoon (spread out through the day). It can help keeping stools formed, and improve control over bowel action in many cases. Although often useful this does not help everyone, and if you have problems with bile and fats, seeds in too high quantities may cause you problems. Speak to a professional if you are unsure.


For those trying them, I have found the best way to take flaxseeds is with a Greek Style High Protein Yoghurt, sprinkled on top and adding soft peeled/stewed fruit or compote for flavour. This may also help stoma thickening – everyone is different though so try it in a small amounts first and then see how you get on!


So you have had all of your cancer removed that’s amazing! The other good news is, a healthy diet and lifestyle can greatly improve your chances of staying well! Other TIPS if you can!


  • Stop smoking and minimising alcohol
  • Taking regular exercise
  • Eat varied, healthy diet which includes different fruits and vegetables, calcium containing dairy foods (found to reduce bowel cancer risk), minimise red meat, and include sustainably sourced oily fish. And don’t forget some wholegrains, unless you’re unable to have them.
  • Take 10mcg of vitamin D daily


How to eat better if you have to have a low fibre diet, especially if also choosing eating plant based foods

  • Remove skins from fruits and vegetables and have them cooked
  • Start with smaller portions
  • Chew your foods well and eat slowly.
  • Always make sure you maintain your hydration through the day - we need both fibre and fluid to maintain bowel action and health.
  • Foods like oats, flaxseeds, soft fruits and root vegetables tend to be well tolerated so start with these
  • It may help to time certain medications with eating – however this should be discussed with your GP, specialist nurse or suitably trained registered dietitian.



Is there anything else you can do to support your health after bowel cancer surgery?

Yes, lots. Keep your mind and body in good shape generally  - start exercise to suit your ability. If you’ve just had surgery, discuss with your surgical team if it is safe to exercise. 

Keep your mind active, and make sure you take time to relax in whatever way you find works best for you. I like to go for a walk in the woods or along the coast, and pottering in the garden.


For further advice see these recommended sites

https://www.bowelcanceruk.org.uk/about-bowel-cancer/living-with-and-beyond-bowel-cancer/

https://www.macmillan.org.uk/cancer-information-and-support/after-treatment

https://www.wcrf.org/dietandcancer/colorectal-cancer


If you have any more questions please comment or contact me via my website www.therehabdietitian.com or email ginag@therehabdietitian.com I am a cancer specialist dietitian and personal trainer providing private telehealth consultations within the UK and internationally.


#bowelcancer #lateeffects #rehabilitation #nutrition #cancernutrition #dietitian #stomaadvice #wellbeing


References:

Foods and beverages and colorectal cancer risk: a systematic review and meta-analysis of cohort studies, an update of the evidence of the WCRF-AICR Continuous Update Project. Vieira AR, Abar L, Chan DSM, Vingeliene S, Polemiti E, Stevens C, Greenwood D, Norat T. Ann Oncol. 2017 Aug 1;28(8):1788-1802.

Recent Evidence for Colorectal Cancer Prevention Through Healthy Food, Nutrition, and Physical Activity: Implications for Recommendations. Perera PS, Thompson RL & Wiseman MJ. Curr Nutr Rep. 2012 DOI 10.1007/s13668-011-0006-7

Dairy products and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. Aune D, Lau R, Chan DS, Vieira R, Greenwood DC, Kampman E & Norat T. Ann Oncol. 2012 (1); 23: 37-45

Meta-analyses of vitamin D intake, 25-hydroxyvitamin D status, vitamin D receptor polymorphisms and colorectal cancer risk. Touvier M, Chan DS, Lau R, Aune D, Vieira R, Greenwood DC, Kampman E, Riboli E, Hercberg S & Norat T. Cancer Epidemiol Biomarkers Prev. 2011; 20: 1003-16.

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