Nutrition Post-Transplant

Eating after intestinal transplant can be a blessing and a curse. For some, it is the first time that you are eating in years, or truly for the first time to sustain yourself. It may be difficult to regulate yourself or it may be hard to eat enough to get the nutrition you need. 

In some instances, adults will have aversions to eating, as seen in the pediatric population. This often occurs due to a fear of eating from the discomfort it used to cause. Restructuring beliefs, the use of appetite stimulants, and motility agents such as Reglan, help to encourage oral intake in the post-transplant period (1). It also helps to consume small, frequent meals throughout the day and suggest consumption of foods that the person enjoys. Your transplant team and dieticians will be there to support you to help you navigate this new territory.

In general, the main goals of your diet should be:

• Promote and maintain good nutrition.

• Maintain ideal body weight.

• Control blood pressure.

• Control blood lipids (cholesterol and triglycerides).

• Control blood sugar levels.

The best rule of thumb is eating everything in moderation- limit your consumption of carbohydrates, sweets, salt, and fats. 

Reduce your use of margarine, oil, butter, sugar etc.

Hydration is of utmost importance, especially if you have a high output ostomy or diarrhea after stoma closure.

• Drinking the appropriate amounts of water or oral rehydration solutions will help to keep your creatinine (kidneys happy) low and keep the rest of your electrolytes in balance.

• You should attempt to drink 8-10 cups of water or oral rehydration solution per day.

• Your urine should be a pale, yellow color.

• Avoid consumption of caffeine as it is a natural diuretic and will make you lose more fluids.

• Remember to avoid drinking grapefruit and pomegranate juice as this can interact with medications (as well as any alcoholic beverages).

• If you exercise, particularly in hot weather, you will need to increase your fluid intake for the day.

• If you have increased output, either in the form of diarrhea or vomiting, you also will need to increase you hydration in order to avoid dehydration.

If you feel you are getting dehydrated, please contact your transplant team so they can advise you on the appropriate steps to take; signs of dehydration include:

• Dark or brown urine

• Rapid heartbeat

• Extreme thirst

• Fatigue

• Less frequent urination

• Dizziness

Reference:

1. Materese L. Nutrition Interventions Before and After Adult Intestinal Transplantation: The Pittsburgh Experience. Pract Gastroenterol 2010; Nov: 11-26.