Pre- and Post-Surgery Health (Holistic)

Glutamine , one of the most abundant amino acids in the body, supports the health of the cells lining the gastrointestinal tract and is important for immune function. Glutamine is depleted when the body is under stress, including the stress of surgery. Blood levels of glutamine decrease following surgery, and as they return to normal, their increase parallels the increase in immune cells. Two controlled trials have shown that the use of glutamine-enriched intravenous formulas, providing approximately 20 grams of glutamine per day, resulted in increased immune cell activity and shorter hospital stays. Double-blind studies report that patients receiving intravenous formulas supplemented with glutamine after surgery had better nutritional status and better health outcomes, including fewer infections and other complications, compared with patients receiving regular formulas. Less.

Omega-3 fatty acids have anti-inflammatory properties, and animal studies suggest that supplementation with omega-3 fatty acids may improve recovery and prevent infection after surgery. A controlled human trial found that intravenous nutritional formulas containing omega-3 fatty acids given post-operatively lowered the production of inflammatory chemicals compared with standard nutritional formulas. Other human studies of omega-3 fatty acid-supplemented nutritional formulas used in surgery patients have included other supplemental nutrients as well and are discussed below. Less.

One preliminary study found iron levels to be reduced after both minor and major surgeries, and iron supplementation prior to surgery was not able to prevent this reduction. A controlled trial found that intravenous iron was more effective than oral iron for restoring normal iron levels after spinal surgery in children. One animal study reported that supplementation with fructo-oligosaccharides (FOS) improved the absorption of iron and prevented anemia after surgery, but no human trials have been done to confirm this finding. Some researchers speculate that iron deficiency after a trauma such as surgery is an important mechanism for avoiding infection, and they suggest that iron supplements should not be given after surgery.

Patients who have undergone major surgery frequently need blood transfusions to replace blood lost during the procedure. Studies have found that 18 to 21% of surgery patients were anemic prior to surgery, and these anemic patients required more blood after surgery than did non-anemic surgery patients. Supplementation with iron prior to surgery was found in a controlled trial to reduce the need for blood transfusions, whether or not iron deficiency was present.Iron supplements (99 mg per day) given before and for two months after joint surgery in another controlled trial improved blood values but did not change the length of hospitalization or the risk of post-operative fever. Pre-operative iron supplementation in combination with a medication that stimulates red blood cell production in the bone marrow is considered by some doctors to be an effective way to minimize the need for post-operative blood transfusions. Less.

Ribonucleic acid (RNA) is a member of the nucleotide family of biomolecules and supports protein synthesis and cell growth. During times of physical stress, RNA helps stimulate immune cell division and activity, and is needed in greater amounts. Animal studies show that nucleotides given in the diet support the immune response and decrease death rates in infected animals. In human infants, those fed nucleotide-enriched formulas have healthier gastrointestinal systems and better immune function than do those fed ordinary formulas. RNA is included in some oral and intravenous nutritional formulas used for surgery patients, and these formulas are discussed below. Less.

AKG (alpha-ketoglutarate) is used by cells during growth and in healing from injuries and other wounds, and is especially important in the healing of muscle tissue. Controlled studies have found intravenous AKG helpful for supporting protein synthesis, which often declines as a result of surgery, and for protecting the heart muscle from damage during heart surgery, but no research has investigated whether oral AKG would be similarly effective. Less.

Selenium is a mineral nutrient with an important role in immune function and infection prevention, and selenium deficiency has been reported in patients after intestinal surgery. A controlled trial of critically ill patients, including some with recent major surgery, found that those receiving daily intravenous selenium injections for three weeks showed less biochemical signs of body stress compared with unsupplemented patients. The amount used in this trial was 500 mcg twice daily for the first week, 500 mcg once daily for the second week, and 100 mcg three times daily for the third week. Less.

Vitamin A plays an important role in wound healing, and one animal study suggests that vitamin A deficiency might contribute to poor recovery after surgery. Vitamin A may be particularly beneficial to post-surgical patients who are using corticosteroid medications. These medications typically slow wound healing, and a number of animal studies have found that both topical and oral vitamin A reverse this effect; however, vitamin A does not change healing time in animals not given corticosteroids. Similar results have been reported for topical vitamin A in some human cases, and these researchers suggest a topical preparation containing 200,000 IU of vitamin A per ounce for improved surgical wound healing in patients using corticosteroids after surgery. Topical vitamin A may also reduce scarring in patients taking corticosteroids. Less.

Vitamin B1 , given as intramuscular injections of 120 mg daily for several days before surgery, resulted in less reduction of immune system activity after surgery in a preliminary trial. In a controlled trial, an oral B vitamin combination providing 100 mg of B1, 200 mg of vitamin B6, and 200 mcg of vitamin B12 daily given for five weeks before surgery and for two weeks following surgery also prevented post-surgical reductions in immune activity. However, no research has explored any other benefits of B vitamin supplementation in surgery patients. Less.

Some studies of surgery patients, though not all, have found that blood levels of vitamin E decrease during and after surgery. Animal research suggests that vitamin E may prevent skin scarring when used topically after surgery, but a human study reported disappointing results. Vitamin E taken by mouth may interfere with blood clotting; therefore, use of vitamin E before surgery should be discussed with the surgeon. No research on either the usefulness or hazards of vitamin E supplementation around surgery has been done. Less.