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Esophagectomy

WHAT YOU NEED TO KNOW:

An esophagectomy is surgery to remove part or all of your esophagus. An esophagectomy is usually done to treat cancer of the esophagus. It can also be done if your esophagus does not work properly or has severe damage or trauma.

DISCHARGE INSTRUCTIONS:

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.
  • Antibiotics help treat or prevent a bacterial infection.
  • Medicine may be given to prevent reflux. Reflux is when food or fluid moves up into the esophagus from the stomach.
  • 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 diabetic medicines until you can eat normally. Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. 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 anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her 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.

Prevent reflux:

  • Sit up when you eat or drink. Remain sitting up at least 30 minutes after your meal.
  • 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 have spicy foods. Do not have drinks that contain caffeine, such as coffee or colas. Do not drink alcohol.
  • Do not eat large meals. When you eat a lot of food at one time, your stomach needs more acid to digest it. Eat 6 small meals each day instead of 3 large ones, and eat slowly. Do not eat meals 2 to 3 hours before bedtime.
  • 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.

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:

  • Eat small meals throughout the day. Eat small meals to prevent food from moving too quickly into your intestine.
  • 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.

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

Wound care:

Keep your incision and feeding tube site clean and dry. Change your dressings if they are wet or dirty. Check your incision and feeding tube site for signs of infection such as pus or swelling. Wash your incision and feeding tube site as directed by your healthcare provider.

Empty your drains as directed:

You may need to write down how much you empty from your drain.

Follow up with your healthcare provider as directed:

You may need more tests or more treatment. Write down your questions so you remember to ask them at your visits.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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