Digestive tract surgeon Dr. Andréa Furlan explains how malnutrition and muscle loss can increase complications and how to better prepare before digestive surgery
Imagine starting a marathon without having trained, sleeping poorly and eating little in the previous weeks. For many people, digestive surgery can look like this: the procedure is necessary, the team is prepared, but the body arrives without enough reserves to face the effort of the operation.
The problem that many people don’t realize before surgery
When we think about the risks of digestive surgery, we usually only imagine the complexity of the procedure or the severity of the disease. But there is an often silent factor that can go unnoticed: the patient’s nutritional and muscular status before surgery.
Two problems deserve special attention: malnutrition – common in patients with cancer, chronic diseases or candidates for major surgery – and sarcopenia, which corresponds to the progressive loss of muscle mass and strength. A person can have an apparently normal weight and still have little muscle reserve to face an operation.
Why does this increase post-operative risk?
During surgery, the body goes through great stress: the inflammatory response and metabolic expenditure increase, accelerating the loss of the body’s reserves. Muscle is not just for walking or carrying weight – it is essential for healing, fighting infections, breathing better and getting out of bed. When the patient arrives fragile, the risk increases. Studies in patients undergoing digestive surgery show that sarcopenia is associated with a greater risk of serious complications, prolonged hospital stay, greater chance of hospital readmission and worse overall outcomes.
What can be done before the procedure
The good news is that some of this risk can be identified – and reduced – before the procedure. Preoperative evaluation should include aspects such as recent weight loss, reduced appetite and signs of muscle loss. In patients with malnutrition or greater nutritional risk, optimization before surgery makes an important difference.
The concept of prehabilitation is also growing: preparing the patient before surgery, combining
nutritional guidance, physical exercises and psychological support. Studies show that this preparation can reduce complications and promote better functional recovery after surgery.
The message is simple: arriving at surgery safely is part of the treatment. It’s worth asking your doctor: “How is my nutritional status? Have I lost muscle? Should I prepare myself with diet or exercise?”; A better nourished and stronger body is better able to face surgery and return home safely.
Dr. Andrea Furlan – CRM 97345 | RQE:115611
Surgeon of the digestive system, bariatric and metabolic surgery, and digestive endoscopy at the Hospital das Clínicas of FMUSP.
Postgraduate in Nutrology from the Faculty of Medicine of Ribeirão Preto – USP.
