by Professor Lynn Basford
There are many reasons to consider your nutritional intake prior to your upcoming Hysterectomy. This could be because you are: Overweight, Underweight, Undernourished, Vitamin and Mineral Deficient, Have IBS ( Irritable Bowel Syndrome); Anaemic, Alcoholic, Generally Constipated, or, have a compromised Immune System.
If yours is an elective surgery there is normally an 18 weeks waiting period. This waiting time provides you with the opportunity to make life style changes that will assist your surgical recovery and restoration to a feeling of well being and whole health.
Remember it is YOUR body!
However, ignoring some fundamental advice can cost you your Speedy Surgical Recovery and well being
To assist you we have broken it down into bite size chunks.
ARM 1. Personal Assessment of your Nutritional Intake: ( Be Honest)
Having a Gynaecological Health Issue usually drives you to take a good look at your current health state. Take your personal diary and ask yourself the following questions:
- How many units of Alcohol do I drink per week? (14 units per week and no more than 3 units per day is the government recommendation)
- How many meals per week contain fresh vegetables? (5 portions per day now recommended)
- How much fresh fruit do you eat per day? (2-3 portions per day now recommended)
- How many meals per week are ready cooked meals from takeaways or supermarkets?
- How many meals do you make from scratch per week?
- Do you have a lot of sugary drinks or food?
- Do you have white bread, white rice and wheat pasta?
ARM 2. General Well Being
- Do you feel tired and lethargic all the time?
- Are you easily irritable?
- Do you sleep well?
- Do you suffer from indigestion, or acid reflux?
- Is your skin dry and flaky?
- Is your hair lank and lack lustre?
- Are you constipated? or have bouts of Diarrhoea, or feel bloated?
- Do you have bleeding Gums?
- Do you feel run down and pick up colds/sore throats/ easily?
- Is having a sexual relationship with your partner a chore/painful?
- Do you feel depressed?
It is well acknowledged that having Gynaecological issues over long period of time depletes your body of vital nutrients, especially iron. However, the nutrients we take in through our digestive system are also often depleted of much needed vitamins and minerals for cellular activity, healing and renewal.
Without these fundamental micro nutrients our bodies do not have the reserve stores necessary to assist in your surgical recovery, or indeed your total health and well being. Once you have established your own (honest) assessment then you have a chance to do something about it.
ARM 3 Over Weight- Obesity
It is interesting that people who are overweight can also be malnourished! i.e there bodies are devoid of the essential building blocks to sustain cellular life.
Further, there is also an added danger if you are overweight or obese from undergoing surgery. This can be from the affects of anaesthesia, traumas/nicks in the wrong place because your surgeon does not have a clear vision due to the fat layer, delay in post surgical recovery, susceptibility to chest infections, slow wound healing, succumbing to wound infections etc.
Should you be overweight you would be encouraged to undertake a balanced diet (protein, carbohydrates, and fats) that will enable you to loose weight, have sufficient energy and provide your body with much needed micro nutrients.
Taking that first step is crucial to your success, but also engage in family help and support as it is never easy. See our diet pages for more help with this.
ARM 4 Underweight
As with the overweight person those that are underweight are also likely to be malnourished lacking in those all important micronutrients.
At this stage it is not about bulking up, but eating a healthy nutritious diet that will provide you with much needed essential elements.
If eating large amounts of food at any one time is problematic for you then eat several small meals often. Consider in investing in a good multi-vitamin and mineral supplement to give your body the boost it needs.
ARM 5 Undernourished
In this category you can be the normal weight for your height and age, but lacking in essential nutrients for your body to repair and renew.
In a chronic situation your body can start to attack itself resulting in a plethora of maladies that range from auto immune syndrome, arthritis, compromised immune system etc.
Putting rubbish into your system means your chief detoxification organs: bowels, liver, kidneys, respiratory system and skin have to work excessively hard to reduce the burden of toxicity. Overtime, this may result in overburden, then malfunction.
If you believe you are in this category then start to readdress your nutritional intake.
ARM 6 Vitamin and Mineral Deficiency.
If you are anaemic due to heavy bleeding for a sustained period of time, you may be suffering from iron deficiency anaemia.
During your investigation phase your blood results would have indicated if this was the case. If so your doctor may have already prescribed iron tablets. If this is the case it should also be remembered when taking iron tablets, such as, Ferrous Sulphate, you may become constipated and, further, your absorption of the iron may be hindered.
It is advisable to always take vitamin C at the same time as your iron tablet. This is to enhance absorption and assimilation of iron into your system.
Should your blood results not indicate the need for iron replacement, but you feel tired and exhausted most of the time, then a boost from iron/vitamin C replacement may be of help. Consult with your GP of your individual needs.
You may also consider taking a good multi vitamin and multi mineral tablet if you have assessed you live mainly on junk processed food that has little or no nutrient value. This should be short term until you have stabilised with good wholesome, balanced nutritional foods.
Always consult with your health care professional particularly nearer the time of your operation. AND, always disclose what you are taking as part of your preoperative assessment.
ARM 7 IBS ( irritable Bowel Syndrome)
Over the last few decades more and more people are suffering from IBS. the question arises is the prevalence of IBS on the increase, or increasingly being diagnosed?
If you suffer from acute bloating, alternative diarrhoea /constipation the chances are you may be suffering some form of IBS. If your Gut is not healthy and malfunctioning i.e the friendly bacteria out of balance with too many pathogenic bacteria it can cause you a lot of pain and suffering.
For instance, on an average we have about 3 pounds of bacteria — 500 species — in your gut. In fact, it is surprising that there is more bacterial DNA in your body than there is human DNA! Some are good, some not so good and some down right ugly! The latter move into areas where they can create havoc through a process of fermentation. Guess what they like to feed on? Yes that’s right, Sugar and Starches (carbohydrates) This is called small bowel bacterial overgrowth, and it’s a major cause of IBS.
How do you know you have IBS? Easy, by a breath test that measures gas production by the bacteria, or by a urine test that measures the by products of the bacteria after they have absorbed into your system.
There is another cause of IBS that is linked to food intolerance’s or allergies. People often know when a certain food disagrees with them because they immediately feel bloated and have related symptoms. The American Journal of gastroenterology published an article that found through eliminating foods identified through a process of , ‘delayed food allergy testing’ ( IgG antibodies) resulted in dramatic improvements in IBS.
Other considerations that link to IBS are: lack of digestive enzymes, parasites living in the gut, zinc /magnesium deficiency and heavy metal toxicity. It is therefore important that your personal situation is explored by your health professional team on an individual basis.
But what else can you do prior to surgery? Avoid foods that you know to be troublesome to you, often these are wheat based, sugary foods, alcohol such as beer etc. Take a good quality probiotic daily, and eat foods that have a high percentage of zinc and magnesium. Most of all drink plenty of good quality water.
ARM 8 Alcohol
If you know you drink too much alcohol (see recommended government units above) it is common that you gain a lot of your calories from this route. They are empty calories devoid of the micronutrients we have been talking about for repair and renewal.
If you can not do without drinking alcohol each day you may be a true dependent alcoholic. The dangers for you prior to surgery is that you will suffer withdrawal symptoms at the same time as your post operative phase. If your Doctor does not know about your alcohol dependency they will not be treating you accordingly, and this could be dangerous to your health. It is therefore imperative that you share this information with your health care team.
You will know that you are able to mask your issue, but honesty is the best policy. It is recommended that you attend AA for help and advice before hand. If however, you are just a heavy social drinker without dependency then you need to reduce your intake to the safe recommended levels, if not undertaking total abstinence.
NB Your liver will thank you for this rest, and will be in a better shape to cope with your anaesthetic drugs!
ARM 9 Constipation
This is often an embarrassing situation that is either discussed in an hilarious fashion or head in the sand. Poor dietary habits, lack of water intake and little or no exercise are a contributory factor to chronic constipation. In addition, if you have a large Fibroid/Cyst/Tumour it may press on your bowel area and contribute to your perpetual constipation.
If we take a look at what is happening…
You take food and water in your mouth and it moves slowly along a 22’ ( approximately) intestinal track. Nutrients are absorbed, plus water, leaving waste matter. The further down the line it goes, water is removed and the harder the stool becomes.
If you do not defeacate (open your bowels) daily the stool starts to ferment and get even harder. Toxic gas is produced.
To get rid of this very hard stool you have to thrust down, over time this could result in haemorrhoids, or rectal prolapse of the vaginal wall.
The first line of approach to rectify your constipation is drink at least 3-5 pints of water per day, eat foods rich in roughage, such as plenty of whole fruit and vegetables and take a mild laxative. If this does not resolve your situation then again discuss with your Doctor and they may prescribe enemas/laxatives.
The danger of an impacted bowel system prior to your hysterectomy is that it can obscure the surgeons area for surgical removal of reproductive organs/ and or tumours/cysts/fibroids etc. It can also add the risk of incision into the rectal wall, thus further complicating the surgery.
It is common in some surgical centres for you to be prescribed a laxative a few days prior to surgery and then to consume a light diet the day before and to only drink clear liquids after midnight of the day of your operation. This is to prevent the risk of vomit aspiration and that your body is not undertaking a process of digestion during and as part of your recovery phase.
What is Considered to be a light diet?
The following list is only a guide but may consist of :
- lean meats,
- bread and rolls,
- cold cereal,
- cooked vegetables without skin or seeds,
- peeled apples
- fruit juice without pulp.
Prepare foods with as little fat as possible.
ARM 10 Immune System
The health of your immune system is vitally important prior to your surgery. Eating a balanced diet with high levels of micro-nutrient and rich in minerals is key to maintaining a healthy immune system.
If you are constantly feeling run down, prone to colds and chest infections it is highly probable that your immune system is compromised.
Further, your gynaecological situation may also have contributed to you feeling low.
Take stock, assess your personal situation and start improving the state of your immune system by eating fresh wholesome foods and drinking good quality water.
Shanahan, F. and P.J. Whorwell, M.D. (2005). IgG-mediated food intolerance in irritable bowel syndrome: A real phenomenon or an epiphenomenom? The American Journal of Gastroenterology. 100:1558–1559.