Surgery is a blow to the patient. Only when the pain and harm of the condition are far greater than the harm of the surgery, the doctor will choose to perform the surgery, and the patient's recovery after the surgery is the doctor's biggest concern. This includes when patients can eat on their own. Surgeons, especially general surgeons, like to ask post-operative patients a question, that is, did they fart today? Generally, after the patient answers that they farted, they can choose to eat on their own! Why is this?
An important indicator of whether the intestinal tract is smooth and whether the gastrointestinal function has returned to normal is passing of gas. Under normal circumstances, the gas in the gastrointestinal tract moves downward with the peristalsis of the gastrointestinal tract, and finally Discharge from the anus is commonly known as fart.
When intestinal obstruction is caused by volvulus, intussusception, intestinal adhesions, etc., or when intestinal paralysis is caused by perforation of abdominal organs, inflammation, potassium deficiency or acidosis, etc., the patient will experience abdominal distension, Symptoms of abdominal pain, even vomiting and inability to pass gas. Therefore, when observing patients undergoing treatment for intestinal obstruction, it is always necessary to ask whether the patient farts as a basis for judging whether the intestinal obstruction has been relieved. In addition, especially after many patients undergo abdominal surgery, doctors also use whether the patient farts to determine whether the intestines are smooth.
Patients usually do not fart within one or two days after surgery, mainly because: 1. The effect of surgical anesthesia drugs, surgical operations, cold air, etc. enter the abdominal organs, causing temporary intestinal discomfort. of paralysis, so the patient cannot fart for a period of time after the surgery. 2. The use of drugs before or during surgery may affect and irritate the intestines.
After the operation, when the intestinal peristalsis gradually returns to normal, the patient will feel slight abdominal distension and pain, and may even hear a gurgling sound in the stomach, which is a precursor to farting. Therefore, patients cannot force the doctor to give the patient an analgesic injection or use atropine-type drugs to avoid inhibiting intestinal peristalsis. If abdominal distension, cramping, etc. are abnormal after surgery, you should inform your doctor in time so that the cause can be investigated and appropriate treatment can be carried out.
If the patient still cannot fart for many days after surgery, it is often due to intestinal paralysis. When encountering this situation, doctors and patients will be very anxious, because intestinal paralysis and intestinal flatulence may cause intestinal adhesion and anastomosis. Adverse consequences such as oral rupture and intestinal blood circulation disorder! Therefore, when doctors ask during ward rounds that surgical patients, especially abdominal surgery patients, have farted, it means that the patient's intestinal motility has returned to normal, and the gastrointestinal decompression tube can be pulled out and the patient can start eating.
In fact, the current theory of rapid postoperative recovery has changed this view.
Now our requirement for patients is that as long as the intestines are not cut, the sooner the better.
The main factor that limits our postoperative diet is actually the recovery status from anesthesia. If the patient is not sufficiently awakened from anesthesia and is eating, he may choke and choke the food into his lungs. This situation is very dangerous and may even put your life in danger.
Generally, the recovery time from anesthesia after surgery is two to three hours. For safety reasons and to allow the anesthetic to be fully metabolized, we usually wait six hours after the end of general anesthesia before allowing the patient to eat.
Similarly, our current theory of rapid recovery has also changed the preoperative preparation. We now believe that the shorter the period of fasting before surgery, the better the patient's intestinal recovery after surgery. If it were not for anesthesia, we would even hope that the patient could eat something or drink some sugar water two hours before the operation. However, this will lead to more stomach contents and increase the risk of anesthesia. The risk of this anesthesia is the same as the risk of eating without waking up from anesthesia after surgery. The main reason is that you are afraid that the contents of the stomach will be choked and coughed into the lungs, which will also lead to life-threatening injuries during the operation.
If our gastrointestinal system is not stimulated by food for a long time, it will enter a dormant state and become inactive. And we know that after surgery, especially after abdominal surgery, wounds and adhesions will appear on the surface of the intestines. The most effective way to prevent intestinal adhesion is to allow the intestines to run quickly and move quickly. Do not let the wounds touch the same position, and do not allow the chance of adhesion between the wounds.
So if we are fasting for a long time before or after surgery, our intestines will be in a dormant state for a long time. For a long time, the peristalsis of our intestines will be Very bad. In this case, the probability of intestinal adhesion will be higher. And if we have a shorter fasting time before and after the operation, the intestines will recover quickly and intestinal adhesion will be less likely to occur.
We know that the autonomic nervous system controls the gastrointestinal tract. Why do we feel that our vitality is severely damaged after major surgery? You will feel like your whole body can't hold your breath. In fact, the main reason is that our autonomic nervous system is paralyzed. So once the gastrointestinal tract starts moving, it means that our autonomic nervous system is also active. So naturally, we will feel that our overall mental outlook and recovery state will be much better.
Therefore, in the process of our clinical practice, we will find that surgical patients who do not fast before surgery and rarely eat after surgery will recover faster than patients who fast for a long time.
On the contrary, if we fast for a very long time and the operation time is very long, it will take longer for our intestinal peristalsis to recover. At this time, the intestines may have been dormant for a long time and have not recovered. When we take a bite of food, the front half of the intestines may recover a little, but the back half may not recover, which will cause intestinal flatulence. This creates a vicious cycle. The longer we are fasting, the less we dare to eat early. The less we eat, the slower our gut recovers. But as soon as we ate, our stomachs became extremely bloated. So once we recover slowly, you can only wait for the anus to pass gas and the intestines to recover naturally, and then you will feel better if you eat again.
Because every patient needs anesthesia during surgery, and anesthesia is generally divided into local anesthesia and general anesthesia. There are also many ways to use local anesthesia, such as brachial plexus anesthesia for upper limb surgery, spinal anesthesia for lumbar spine or abdominal surgery, and local anesthesia for breast nodule or anorectal surgery. Generally, major surgeries require general anesthesia. The advantage of general anesthesia is that it can maximize the patient's cooperation and reduce the patient's pain to the greatest extent.
However, after general anesthesia or spinal anesthesia, the patient's intestines are also paralyzed, and intestinal peristalsis slows down or disappears. Exhaust gas is an indirect manifestation of the recovery of intestinal peristalsis, indicating that the digestive system has returned to normal work, so at this time Eating is most appropriate. Otherwise, the food will not be digested after eating, which may easily cause intestinal obstruction.