Hygienic-Dietary Advice for People Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

You have been discharged from the hospital after undergoing heavy treatment. Today, your body is in the process of healing, and let’s be honest, it takes time. Following this treatment, there is significant inflammation throughout your abdomen. This inflammation, associated with post-operative adhesions that will gradually disappear, explains why you may feel abdominal pain and sometimes have difficulty eating. This condition is relatively unpleasant but temporary. Each passing week will bring gradual improvement in this discomfort. In any case, know that there is nothing you can do to speed up this healing process. You just have to wait for time to pass and be patient.
Normal healing is characterized by increasing inflammation that peaks around the 6th week post-operation and then gradually decreases, returning to normal between 3 and 6 months after the intervention. Remember that when you get a deep skin cut, the scar becomes redder and then gradually fades to leave only a linear scar at 6 months. The same thing happens throughout the abdominal cavity.

During this entire recovery period, the first few weeks are the most difficult. Subsequently, progress is slow but steady. In some cases, you may leave the hospital without being able to eat adequately by mouth. Your body indeed needs many calories to heal calmly while allowing you to resume gentle activity outside. If this is the case, your surgeon will prescribe nutritional supplements that can be taken orally or, if you cannot tolerate them, may choose to continue intravenous feeding for a few weeks. These infusions are done at home by a certified nurse, mainly at night to inconvenience you as little as possible. The duration can vary from a few days to a few weeks.

During this recovery period, the important thing is not to lose too much strength and to regain it.

Accès rapide

Split your meals

Your intestine is inflamed. It contracts more slowly than a normal intestine and has reduced storage capacity. So as soon as you eat a few bites, you’re not hungry anymore and feel “full.” This prevents you from having the traditional three daily meals. To overcome these difficulties, because you still need to eat, you must split your meals significantly. Eating 6 small meals a day is highly recommended. The best is to eat a little every hour. To do this, you need to think about it. Think of a snack at 10 a.m. and 4 p.m., snack whenever you can… In short, do everything you have always been forbidden to do. Eat what you want when you want. A little tip: since you cannot absorb much at once, separate drinking and eating. Drink less during meals and more outside of them.

Walk

It’s easy to say, of course, but it’s really important. Indeed, walking plays a significant role in the proper resumption of intestinal transit. Obviously, at the beginning of your convalescence, you will be tired, and walking will be an obligation you won’t want to undertake. But remember that it is essential to break the vicious circle that can sometimes set in. Some don’t walk because they feel weak and not hungry. Yes, but walking expends energy, stimulates the appetite, and makes you hungry. So by trying to go a little further every day, you will progress and see for yourself all the benefits of this exercise.

Enrich Your Diet

Since you eat small quantities, it’s better if they are “useful.” So think about enriching them with proteins and energy. Add proteins to your foods by putting in powdered milk or egg yolks. Add energetic elements to your dishes by putting in butter, cream, and sauces. Add sugar, whole milk, or powdered milk to your drinks. You can also use high-calorie and high-protein preparations available in pharmacies by prescription. Don’t hesitate to talk to your surgeon or general practitioner. If you don’t feel like cooking or don’t know how, know that you can perfectly eat prepared or frozen dishes. However, initially avoid foods that are too fatty, fried, or very spicy, which are difficult to digest.

Combat Nausea

Nausea is common after the treatment you have undergone. They are both the consequences of the surgical intervention and chemotherapy. If you are easily disgusted, don’t force yourself to eat your favorite dishes. You might be permanently disgusted by them. Take the treatment prescribed by your surgeon as mentioned in the prescription. Avoid eating in the kitchen, where lingering smells can worsen nausea. Think about resting in a semi-sitting position after meals; this improves transit and reduces “reflux.” Limit cigarettes before or after meals and help yourself if necessary with carbonated drinks like Badoit or Coca-Cola (a tip: let them sit for a bit before drinking to allow the gas to evaporate, which will reduce bloating).

Monitor Your Weight

If you didn’t have a scale, it might be time to invest in one. Indeed, it is recommended to weigh yourself regularly, at least once a week. If you notice that your weight, far from stabilizing or increasing, continues to decrease despite your efforts, don’t panic. Make an appointment with your general practitioner to discuss better ideas for eating and overcoming this temporary difficulty. An outside perspective can provide a very simple solution to resolve the problem.

Treat Your Diarrhea

Post-operative diarrhea lasting about ten days is common and secondary to the chemotherapy you received. However, if a more or less large part of the colon or small intestine was removed during the operation, this diarrhea may persist longer. In this specific case, it may require specific treatment by your surgeon, such as transit retarders. Be careful to only take the prescribed treatment according to the indicated doses. A few small tips can make your life easier. Remember to drink at least 2.5 liters of liquid per day (tea, herbal tea, rice water, vegetable broth, carrot juice… all at room temperature, neither too hot nor too cold). Avoid icy drinks. Eat foods low in fiber (rice, pasta, steamed apples, ripe bananas, applesauce, cooked cheese, toasted bread or well-toasted bread). Avoid all raw fruits and vegetables, cereals, and wholemeal bread, and milk. Only after a significant improvement in your diarrhea should you reintroduce these foods little by little, one by one. Remember that the transit retarders (like Imodium* and Tiorfan*) given to you upon discharge from the hospital are prescribed at a given dosage. Think about distributing them harmoniously throughout the day. The main principle is not to change the dosage abruptly. The rule is not to play “yo-yo.” If you need to adjust the doses, do it slowly, whether in quantity or duration. Don’t stop everything in case of constipation and don’t take a massive dose in case of diarrhea. For example, if you have very severe diarrhea, increase your dosage by one or two tablets daily (one in the morning and one at noon) and don’t change anything for 24 or 48 hours. This way, you can see the actual effects of your action.

Advice sheets created and validated by the Gustave Roussy Institute (January 2010).