After Esophagectomy
Medically reviewed by Drugs.com. Last updated on May 6, 2024.
AMBULATORY CARE:
An esophagectomy
is surgery to remove part or all of your esophagus. You may need to stay in the hospital for up to 2 weeks after surgery. You will use a feeding tube to eat for several weeks after surgery. Once you can eat normally, you may need to change or stop eating certain foods.
Seek care immediately if:
- You have new difficulty swallowing.
- You have difficulty breathing.
Contact your healthcare provider if:
- You have a fever.
- Your incisions become red, swollen, and warm to the touch.
- You have increased pain.
- You have leaking or bleeding from your incision site.
- Your drains come out of your skin or are not draining.
- You have repeated vomiting or diarrhea.
- You have questions or concerns about your condition or care.
Medicines:
- Prescription pain medicine may be given. Ask how to take prescription pain medicine safely. Do not wait until the pain is severe before you take your pain medicine.
- Medicine may be given to reduce pain or prevent reflux. Reflux is when fluid backs up from your stomach into your esophagus.
- Antibiotics treat or prevent a bacterial infection.
- Restart your home medicines as directed by your healthcare provider. Ask when you can start taking blood thinners. If you have diabetes, you may need to adjust your medicines until you can eat normally.
- Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. Many types of blood thinners are available. Your healthcare provider will give you specific instructions for the type you are given. The following are general safety guidelines to follow while you are taking a blood thinner:
- Watch for bleeding and bruising. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
- Do not start or stop any other medicines or supplements unless your healthcare provider tells you to. Many medicines and supplements cannot be used with blood thinners.
- Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Wound care:
- Keep your incision clean and dry. Change your dressings if they are wet or dirty.
- Check your incision for signs of infection, such as pus, swelling, or redness.
- Wash your incision with soap and water. Do not scrub your incision. Pat dry after washing. Apply new bandages as directed by your healthcare provider.
- Do not put lotions or powders on your incision.
- Do not take baths or sit in hot tubs. You may shower when your healthcare provider tells you it is okay.
Empty your drains as directed:
You may need to write down how much you empty from your drain.
Do not smoke:
Nicotine can damage blood vessels and make it more difficult to heal from an esophagectomy. Smoking also increases your risk for cancer to return after treatment. You will need to remain a nonsmoker after surgery to prevent damage to your esophagus. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help to quit.
- Smokefree.gov
Phone: 1- 800 - 784-8669
Web Address: www.smokefree.gov
Use your feeding tube as directed:
You may be sent home with a feeding (PEG) tube. Your healthcare provider will tell you when and how often to use your feeding tube. You may also get instructions for the following:
- Schedule your feedings as directed by your healthcare provider. You may give yourself a small amount of formula on a continuous pump, or several times throughout the day. Do not put a large amount of formula into your feeding tube at one time. This may cause reflux and dumping syndrome. Ask your healthcare provider how much formula to put through your feeding tube each time you use it.
- Clean the skin around your feeding tube. Keep your skin around your feeding tube dry to prevent infection. Ask your healthcare provider how to clean your feeding tube site.
- Check for redness and swelling in the area where the tube goes into your body. Check for fluid draining from your feeding tube site.
- Wear loose-fitting clothing so you do not put pressure on your incision or feeding tube.
Eat small meals throughout the day:
When your feeding tube is removed, you will need to change how you eat your meals. Eat 6 small meals each day instead of 3 large meals. Eat slowly. Do not eat meals 2 to 3 hours before bedtime. This may prevent reflux and dumping syndrome.
Prevent reflux:
Your healthcare provider will give you instructions to prevent reflux while you are using a feeding tube. If you can eat normally, your healthcare provider may tell you to do the following to prevent reflux:
- Sit up when you eat or drink. Remain sitting up at least 30 minutes after you eat.
- Drink liquids between meals. Do not drink liquids with meals unless directed by your dietitian.
- Do not have foods or drinks that may increase heartburn. Do not eat spicy foods. Do not have drinks that contain caffeine, such as coffee or colas. Do not drink alcohol.
- Elevate the head of your bed. Place 6-inch blocks under the head of your bed frame. You may also use more than one pillow under your head and shoulders while you sleep. Do not lie down for 1 hour after you eat or drink.
Prevent dumping syndrome:
Dumping syndrome happens when high-sugar or high-fat foods and drinks go into your intestine too quickly after a meal. Dumping syndrome may cause you to sweat, or feel faint, weak, and dizzy. It may cause you to feel full, have a fast heart rate, or have stomach cramps. Dumping syndrome may cause you to have an upset stomach and loose bowel movements. Your healthcare provider may tell you to do the following to prevent dumping syndrome:
- Limit carbohydrates in your meals. Your body turns carbohydrates into sugar. Too much sugar can cause dumping syndrome. Large amounts of carbohydrates are found in pasta, breads, and pastries. Read labels to find out how many grams of carbohydrates are in your food. Ask your healthcare provider how many carbohydrates you should eat in a meal.
- Increase protein in your meals. Protein slows down your digestion. Foods that are high in protein include meat, fish, and beans. Read labels to find out how many grams of protein are in your food. Ask your healthcare provider how much protein you should eat in a meal.
- Drink liquids between meals. Drink liquids before or after meals to help food move slower through into your intestine. Ask how much liquid to drink each day and which liquids are best for you.
- Lie down for 30 minutes after you eat. Lie flat to help your body move food more slowly into your intestine. Do not lie down after a meal if you have reflux.
Driving after an esophagectomy:
You may not be allowed to drive for up to 3 weeks. You will need to stop taking prescription pain medicine before you can start driving again. Your healthcare provider may tell you not to drive until your incisions heal.
Activity after an esophagectomy:
Your healthcare provider may suggest the following:
- Limit stair climbing. Plan your activities on one level of your home. Do not walk up and down stairs more than a few times in a day.
- Do not lift anything heavy. Heavy lifting places stress on your incision and may cause it to come apart. Ask your healthcare provider how much weight is safe to lift.
- Take short walks. Do not walk alone. Walk with a family member or friend in case you feel dizzy or tired and need to rest. Walk on flat surfaces 2 to 3 times per day. Walking prevents blood clots and helps you heal. Ask your healthcare provider when you can begin more intense exercises.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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