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Inpatient Diet

Now that you are here in the hospital, you have to eat here.  When you get admitted the doctor will assign a diet order to your chart.  There is many different options for your food category.
Some are obvious.  If you are diabetic, you are ordered a diabetic diet.  The carbohydrates are controlled.  If you are going to go to surgery,  you have no diet at all and that is called NPO, or nothing by mouth, technically NPO is nil per os, a Latin term.  But what do all these diets mean and why?

I have some examples of typical foods, what a grocery list and daily meals would look like. Click here for Specific Diets under Lingo Section.

 
NPO – “nil per os” or “nothing by mouth”

Some conditions require bowel rest.  When we put food in our mouth, we stimulate reflexes throughout the bowel. There are many reflexes of the bowel to food. The bowel must get ready to receive food.  For example pancreatitis.  When you put food in your mouth the reflex of the pancreas is to contract.  If the pancreas contracts, you will feel pain.  With inflammatory bowel disease, the migrating motor complex of the bowel is stimulated.  This is the muscle surrounding the bowel starting to contract in a coordinated manner to push food through the bowel to get ready for more food.  If your bowel is inflamed, this will hurt.

Sometimes a procedure is planned.  Typically nothing by mouth at least 6-8 hours prior to the procedure.  Why is that important?  When you undergo sedation you are not able to protect your gag reflex or swallowing very well.  Fluid from the stomach can come up in the esophagus and go down into your lungs.  This is called aspiration, when anything goes into your lungs other than air.  Aspiration can lead to a pneumonitis (lung irritation) or a pneumonia, which is a bacterial infection of the lung. 

Often times we allow a patient to take sips of water to get their morning pills even though they are NPO.  The benefit of the daily medication outweighs the small amount of water into the stomach.
To help relieve the dry mouth often times the hospital stocks little green sponges on a stick, almost like a sucker that will absorb water. You can use that to switch around your mouth. 
 
 
Clear Liquid Diet

This is anything that is clear.  It is very easy to digest.  Usually this is the 1st step after  a surgery or recovering from any stomach or bowel issue.  This usually includes jello, chicken or beef broth, popsicles, apple juice, water, tea and coffee.  This is important diet because if a complication occurs as you begin eating again, the clear liquids are easily absorbed into the stomach.  If you have to go back to the operating room there is less risk of an aspiration, as mentioned above.  Or if you have to go for an emergency scope, you do not have solid food that might block what the doctor is trying to see in the bowel.


Full Liquid Diet

Still liquid but does not have to be clear.  This is making sure the bowel is going to be able to digest more complex foods.  Everything on the clear liquid diet is allowed.  Milk is okay at this time, soup with no solid particles.  Now you can add the creamer to your coffee.  Ice cream, milk shakes, smoothies, yogurt, Boost, Ensure, Glucerna. 

Diabetic Diet

People who are diabetic are well familiarized with this.  It avoids refined sugar, regular soda or honey.  Typically this will include fresh fruit  (the benefit of fruit outweighs the natural sugars), vegetables, low-fat dairy products,  oatmeal and grits.  Protein such as chicken, turkey and fish.  The goal is  having a blood sugar less than 200 at all times.  Please note, sugars often rise with infections.  This is temporary.


Cardiac Diet

The first question you will ask is, where is the salt?!  This is also known as a heart healthy diet.  The goal salt (NaCl), or sodium (Na), content of the entire day should not be more than 2000 mg or 2 grams.  That is slightly less than 1 tsp of salt today.  That includes the salt that you add, salt that is naturally in food and the salt that is added during processing.   This diet usually means fresh foods only.  Proteins such as chicken, turkey and fish. Deli meats usually have added salt.  Whole grains are good.  Fruits and vegetables. 


Renal Diet

If you have kidney failure you may be placed on a renal diet.  It gets rather tricky as most people with chronic renal failure also have cardiac issues or are diabetic.  You may be placed on a cardiac or diabetic diet instead of a renal diet.  This diet emphasizes high-protein, low potassium, and low calcium foods.  Foods to avoid include potassium rich foods such as bananas, oranges, avocado, tomatoes, dried beans, cooked greens, broccoli, Brussels sprouts, nuts and melons.  Phosphorus should be avoided were limited to 1 cup a week.  Foods high in phosphorous include dry beans, brussel sprouts, mushrooms, broccoli, oatmeal, granola, and bran.

High-protein diet

 If you are having trouble with wound healing or have been chronically ill, your protein levels may be low.  The liver can make protein.  However, the best way to increase protein is by eating more protein.  A nutritionist might come see you and start counting your daily protein intake. Often they add supplements such as Ensure, Boost or Glucerna to your diet once or twice a day.  Some hospitals are able to make Smoothies that add protein.  These can be a delicious option.


Further reading

American Society for Nutrition.

American Diabetes Association 

American Heart Association

National Kidney Foundation

Crohn’s and Colitis Foundation

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