Ideas to improve food intake before and after your operation

Taking nutritional supplement drinks in the 24 hours prior to your surgery is a key part of the Enhanced Surgical Treatment and Recovery Programme that you are on. 

We will give you a supply of Ensure Plus® milkshake style or Ensure Plus Juce® (Abbott) along with two preOp® (Nutricia) carbohydrate drinks. 

These should be taken as follows: 

• The day before your admission / surgery: drink either three bottles of Ensure Plus® milkshake style drinks or five bottles of Ensure Plus Juce®. You should have these as well as your usual meals and drinks. 
• The morning of your admission / surgery: drink the two preOp® carbohydrate drinks two to three hours before your surgery.

To help your bowel recover from surgery, it is important that you start drinking water as soon as you are allowed. Most patients can start drinking in the Recovery Area. Please ask staff in the Recovery Area for a glass of water. 

If you tolerate this well, you will be able to progress gradually to free fluids, meaning you can have any liquid you want (such as milk, soup, fruit juice or tea). Aim to drink at least one litre of fluid each day. 

We will encourage you to start eating and drinking as soon as possible, as well as walking to the ward fridge and helping yourself to three bottles of Ensure Plus® milkshake style or Ensure Plus Juce® each day.

If you need more advice on eating and drinking, please ask nursing staff to refer you to a dietitian.

This is a common problem. There are several causes, including illness, anxiety, pain, depression, tiredness or nausea. 

If the surgeons have formed a stoma as part of your bowel surgery, you will need to follow separate advice about eating and drinking with a stoma. Please ask for the ‘Ostomy Diet Sheet’. 

Try the following ideas to help improve your food and fluid intake: 

• Have smaller meals with frequent snacks, e.g. have three small meals and three snacks daily, rather than three large meals. You may find it easier to snack every two hours. 
• Eating between meals and snacks often helps. Try nuts, dried or fresh fruit, crisps, biscuits or sweets. 
• Try to make the food as attractive as possible and serve it on a smaller plate. Do not overload the plate. You can always have second helpings or a dessert if you are still hungry. 
• Do not drink fluids just before a meal as they will fill you up. 
• Cold food may be better tolerated than hot food. Try sandwiches, salads, ice cream, jelly and yoghurts.
• Soft / moist foods may be easier to eat e.g. cauliflower cheese, soups, yogurt or ice cream. 
• Try to have your favourite foods more often to tempt your appetite. 
• Strong flavours may also tempt your appetite e.g. spicy food, sweet food, or bitter foods. 
• Smoking can decrease your appetite so cut down or stop if you can. 
• When eating, try to relax and eat slowly in comfortable surroundings with no distractions. After eating, sit quietly and relax for a while before lying down or moving around again. 
• If you have ‘good days’ or good times of the day – make the most of them. If you feel hungry, make sure you eat even if your meal is not due at that time. 
• Ensure that the food you eat is fortified (see 'How to get extra fuel by fortifying your food ' below) if it can be. 
• If you miss a meal completely due to poor appetite, you could have a milky drink or nutritious soup, e.g. Build-up® or Scandishake®. If this continues for more than a few days, you talk to your GP or Practice Nurse.

If you do not feel like eating a big meal, a lighter meal can be just as nutritious. 

Sandwiches, e.g. cold meat and salad, egg (hard boiled), cheese, tinned meat or fish, peanut butter. Spread filling thickly. Remember to use plenty of butter or margarine and add dressings (salad cream, mayonnaise, vinaigrette, etc.) where possible. 

Toast with e.g. beans, egg (hard boiled, scrambled, poached or fried), tinned spaghetti, cheese, tinned fish (e.g. tuna, pilchards or sardines). 

Other ideas

• Jacket potato with various toppings such as cheese, beans, tinned fish, meat with vegetables or salad. 
• Bacon, egg, tomatoes, beans and bread and butter. 
• Sausage / fish fingers with beans and chips or mashed potato. 
• Cauliflower or macaroni cheese and vegetables with salad and crusty bread roll and butter. 
• Corned beef hash and vegetables. 
• Pie, pasty or sausage roll and vegetables or salad. Stew, casserole, with bread or potatoes, pasta or rice. 
• Omelette, with beans, tinned tomatoes, grated cheese, bread and butter. 
• Soup with extra grated cheese or added milk with bread and butter.

Try to have small snacks between meals to improve your overall food intake. Some suitable snacks are: 

• Crackers with cheese and butter
• Biscuits
• Toast with butter and jam / honey
• Chocolate
• Crumpets with butter and jam / honey
• Nuts
• Fruit bread / teacakes with butter
• Ice Cream
• Fruit (fresh, dried or tinned)
• Mousse
• Yogurts (thick and creamy types)
• Bread and butter
• Cheese
• Sandwiches
• Soup with milk / cream / cheese
• Jelly / milk jelly
• Milky puddings
• Milky drinks
• Breakfast cereal and milk
• Crisps
• Dips with breadsticks, celery, carrots 

Make the most of friends and neighbours if they invite you round to have a snack or a meal. Eating a meal with friends can be enjoyable and can help you to eat more.

If you have unintentionally lost weight recently, or if you are concerned that you are not eating much, use the following advice to increase your energy and protein intake. 

Fortified milk

Add two to four tablespoons of dried skimmed milk powder to one pint of milk, preferably full fat. You can use this as a drink, in cereal or to replace ordinary milk when making custard, milk jellies, milky puddings, sauces, milky drinks (e.g. coffee, drinking chocolate) and soups. 

Potatoes and vegetables

Add butter or margarine, milk or double cream to mashed potato. Add butter or margarine to jacket potatoes and other vegetables, e.g. swede, carrots, parsnip. You can serve cheese sauce over vegetables. Try to use plenty of salad cream, mayonnaise and other dressings over salad vegetables. Also try stir fried vegetables. 

Soups and casseroles

Try adding grated cheese, dried milk powder or double cream just before serving. If you are having tinned soups, use ‘cream of’ which will contain more energy. You can make packet soups with milk to make them more nutritious. Add extra meat, lentils, pulses or pasta to soups and casseroles. Have dumplings, bread or croutons with your soups and casseroles. 

Breakfast

At breakfast time use fortified milk for your cereals and drinks. Add honey, syrup, yogurt or fruit (dried or fresh) to cereals. Try adding honey, peanut butter, jam, marmalade or chocolate spread to toast and butter. 

Desserts / puddings

Try these after your main course, or as between meal snacks. Have desserts with ice cream, evaporated milk, condensed milk or custard. Add dried fruit, fresh fruit, honey or jam to milky puddings. Avoid ‘low fat’, ‘low sugar’, or ‘healthy eating’ desserts. 

Drinks

Include Ensure Plus® nutrition drinks (see the introduction). Other nourishing drinks include fruit juice, milkshakes, non-diet squashes and malted drinks (e.g. Horlicks® and Ovaltine®), hot chocolate and Build-up®.

Some days you may not be able to go shopping, either due to your illness, or because of bad weather, etc.

Below are some ideas for foods for you to have in your home, so you always have a good supply of basic foods. Remember to check ‘best before’ dates before using the foods. Do not use them if they are out of date, as they may be harmful to you. 

Milk products

Long life (UHT) milk or milk powder, evaporated or condensed milk, canned cream, cheese spread. 

Meat and fish

Tinned varieties such as tuna, pilchards, salmon, sardines, ham, pork, corned beef, stewed meat in gravy, chicken in white sauce. 

Starchy foods

Tinned spaghetti, crackers, breakfast cereals, pasta, rice, biscuits, tinned or instant mashed potatoes, packet or canned soup, crisps. 

Fruit and vegetables

Tinned varieties such as beans, soups, dried fruit, lentils and other pulses. 

Desserts

Ready-made custard, milky puddings, jelly, packet mousse, ‘long life’ yogurt, ‘instant whip’ dessert. 

Drinks

Squash, drinking chocolate, malted milk, milky drinks, ‘long life’ fruit juice.

Others

Jam, honey, sweets, chocolate, peanut butter, syrup. Make the most of your freezer – keep a few ‘ready-made’ meals in your freezer for use on days when you really do not feel like cooking.

Enhanced Recovery Nurse (Tuesday  to Friday 08:00-17:00)

Mobile: 07852 905 980 

Switchboard: 0845 155 5000 / 020 3456 7890 

Address: Enhanced Recovery Programme, University College Hospital, 235 Euston Road, London, NW1 2BU