DISCHARGE AND AFTERCARE

Discharge Instructions for Esophagectomy

September 04, 2017

Discharge Instructions for Esophagectomy

You had a procedure called esophagectomy. This means that part or all of your esophagus was removed. After this type of surgery, it often takes a few months for eating habits to return to normal. Here's what you can do at home to help with your recovery.

Diet changes

  • Follow the diet your healthcare provider prescribed for you.

  • Choose foods that are soft and moist. They may be easier to digest.

  • Avoid foods that produce gas. This includes broccoli, cabbage, cauliflower, corn, dried beans, lentils, onions, and peas.

  • Avoid spicy foods and any foods that cause indigestion.

How to eat

  • Eat small, frequent meals (6 to 8 times per day).

  • Eat your last meal or snack at least 2 to 3 hours before you go to bed.

  • Take small bites, and chew your food well.

  • Sit up straight when you eat. This way, gravity can help food move through your digestive tract.

  • Keep sitting upright for 30 to 60 minutes after you eat.

  • Don’t use a straw, smoke, or chew gum. These activities make you swallow air, which can increase gas.

Drinking fluids

  • Drink most of your fluids between meals. Limit your fluid with meals to ½ cup (4 ounces).

  • When you eat snacks, limit fluids you drink with them to 1 cup (8 ounces).

Other home care

  • Check your incision site daily for 1 week after discharge. Change the dressing according to the directions you were given. 

  • Use pain medicine as needed. But try not to take pain relievers for longer than 4 to 7 days. To prevent constipation while using the pain medicine, take stool softeners. 

  • If you were sent home with antibiotics, take them as prescribed. Finish all of the medicine, even if you feel better.

  • Crush all pills to make swallowing easier.

  • Bathe and shower as usual.

  • Weigh yourself a few times a week and keep a record.  Bring it with you to your next appointment. 

  • Avoid driving for the first 3 weeks after returning home. Avoid driving after that if you are still taking pain medicine.

  • Avoid strenuous activities for 12 weeks. Ask you provider when you can go back to daily activities, work, and having sex.

  • Plan frequent rest times to avoid shortness of breath.

  • Do deep breathing and controlled coughing exercises. Ask your provider for instructions.

  • Break the smoking habit:

    • Join a stop-smoking program to increase your chances of success.

    • Ask your provider about medicines or other methods to help you quit.

    • Ask family members to quit smoking as well.

    • Don't allow smoking in your home or around you.

Follow-Up

Report any problems to your provider right away.  Follow up with your healthcare provider, or as advised. Be sure to keep all follow-up appointments. Ask your provider about patient and family support groups for people who have had this procedure.

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

  • Trouble breathing (call 911)

  • Fever of 100.4°F (38.0°C) or higher, or as advised by your healthcare provider

  • More pain or swelling around the incision site

  • Black, tarry stools

  • Ongoing weight loss for no reason (a change of more than 10 pounds in 2 weeks)

  • Diarrhea that won’t go away 

  • New, unexplained symptoms (treatment-related medicines may be causing side effects)

  • Signs of infection around the incision (redness, drainage, warmth, pain)

  • Shortness of breath without exertion

  • Trouble swallowing

  • Upset stomach (nausea) or vomiting

  • Excessive weakness

Updated:  

September 04, 2017

Sources:  

Care of Patients After Esophagectomy. Mackenzie, D. Critical Care Nurse. 2004, is. 24, pp. 16-29., Esophagectomy: Complications and Management, UpToDate, Pathophysiology and Treatment of Fever in Adults. UpToDate.

Reviewed By:  

Adler, Liora C., MD,Fraser, Marianne, MSN, RN