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"Liver Shrinking"- the pre-op diet?

I'm aware that the pre-op diet is typically in place to shrink your liver- does anyone know why this is so important? Is the liver typically "in the way" during surgery?

What is it about the diet that causes the liver to "shrink"? My surgeon is having me do a pre-op diet that consists of 2 small Protein shakes and a green salad with "clear" dressing (Italian, balsamic etc.) I know for certain, this will have me very very hungry all week. I intend to do my absolute best and follow all instructions, but going from eating (I'm not a huge eater actually) to a diet that's roughly 600 calories a day is intimidating.

I worry a bit, because though I am stopping drinking now (surgery is November 8th) I drink fairly regularly (4-5 drinks a week). I wonder if I have some giant liver! I have had my liver checked, and my function is healthy- but I am a bit fearful.

I am "low" BMI (32) so my surgeon only requires this diet for a week.

How did you deal with the pre-op diet?

  • Replies 30
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  • Author

I was drinking pretty regularly until 3 weeks ago, so I just figure my liver is this black inflamed sad thing (LOL!), I'm sure it's not so bad, and all I ca do is my best. I have no way of knowing how small or large it is right now, and I doubt it's so huge it's going to interfere with surgery.

Hi There -

I'm on the lovely liquid diet too and boy oh boy does it suck! It's really weird because some docs do it and some don't. I"m wondering if it would be a huge crime to have a least a little bite of something.

I feel all of your pain too. My surgery is set for November 7th and I'm scared yet excited!

Mommyx3

  • Author

It is interesting, I was consulting heavily with one (reputable) surgeon who required I do no pre-op diet and just 48 hours of full liquids.

My chosen surgeon has me doing 7 days of a strict Protein shake diet, and 3 full days of a clear fluids.

I'm sure people do "cheat" and eat despite being instructed otherwise, we are mostly in this position because of not being able to control our eating- lets get real! That said, I have been good and not cheated, and I try to remind myself that this is the hungriest I will feel for the rest of my life!

I think for some Dr.'s who don't have the ability to do post-op care in the long term (surgeons in Mexico, surgeons who work in facilities that people often fly in to etc.) it's a precaution thing to assure the surgery is as easy as possible, and your recovery is predictable. I could be wrong.

I see my MD's strict guidelines as being a sign that he truly takes as many precautions as possible and wants to assure he will get the best possible leak rate and recovery. Surgeons know that we go on here and rant or rave about our experience, and I imagine that in the decision making process, a huge portion of their business is from people who have viewed this forum and others like it.

  • 3 weeks later...

My diet was 3 protien drinks and 2 yogurts for two weeks preop. I was so mad about it. I literally cried at one point. I almost backed out.

I questioned why they would force such a restrictive diet on a person that obviously could not diet.

I had one slip up that I ended up vomitting up. Besides that, I lost 19lbs during that period and had a perfect surgery.

I was on that same diet for 6 week after surgery as well. I looked forward to eating other things but now, at 9 weeks, I am totally used to the changes and dont' really think about food.

Hang in there!

I'm aware that the pre-op diet is typically in place to shrink your liver- does anyone know why this is so important? Is the liver typically "in the way" during surgery?

What is it about the diet that causes the liver to "shrink"? My surgeon is having me do a pre-op diet that consists of 2 small Protein shakes and a green salad with "clear" dressing (Italian, balsamic etc.) I know for certain, this will have me very very hungry all week. I intend to do my absolute best and follow all instructions, but going from eating (I'm not a huge eater actually) to a diet that's roughly 600 calories a day is intimidating.

I worry a bit, because though I am stopping drinking now (surgery is November 8th) I drink fairly regularly (4-5 drinks a week). I wonder if I have some giant liver! I have had my liver checked, and my function is healthy- but I am a bit fearful.

I am "low" BMI (32) so my surgeon only requires this diet for a week.

How did you deal with the pre-op diet?

1. Well. 600 calories a day sounds way too low. The diet I was requested to do had 1,440 calories a day for 3 weeks, and included low fat meat and dairy products, vegetables and a lot of Water. The emphasis was on high protein intake and low carb intake. Something about the diet you're on strikes me as odd, but I'm not a doctor or a specialist. I'd get a second opinion if I were you.

2. Almost everyone who is heavily overweight has a larger liver. isThe purpose of the low-carb diet is to reduce liver size. An augmented, brittle liver poses a higher risk because the surgeon is more likely to nick it inadvertently, and cause hemorrhage. This is why those diets are so strict. They are difficult to adhere to, but knowing that it's a matter of life and death helped me refrain from pastas.

3. If your BMI is only 32, how come you're going for a bariatric surgery? I thought the minimum requirement was 40 or 35 with related diseases.

  • Author

Fortunately my surgery went fine, and my surgeon confirmed my liver was nice and small. Yay!

I am down to a 30 BMI. I do not have health insurance, so I made the informed decision to go with Dr. Kelly who is based out of Mexico (though also is a MD in the USA). Most USA insurance will not cover surgery on a person at a 32 BMI, which is a shame, as 30+ is technically obese. I felt thin at my 32 BMI, but it was still a big struggle to maintain it and I had many health issues present related to my weight.

I would be careful my Dr. said it was fine I didnt have to fast just not eat after midnight of the surgery well everything was fine then 2 days after surgery my liver numbers went bad I was in 4 days trying to regulate them my liver was pretty big I guess the shock of it all so I would just be careful of whatyou eat and if there is anything you can do do it!

But I am feeling marvelous so glad i did it I am 13 post op and I feel wonderful!

  • 2 years later...

I start my Pre Op diet in the morning.. My Doctor has me on 3 protein shakes day and 2 frozen dinners with less than 30 calories and less than 30 Carbs.. I had 3 choices to choose from but decided to go this route..

I hope my Liver shrinks in the 2 weeks so I do not have complication on the 16th of April when I have my surgery..

  • 1 month later...

great to know all this. it prompted me to watch a few videos of the actual surgery. very interesting.

  • 3 weeks later...

I have a question.

I have been on preop diet since may 8th and lost forty pound in less than a month. When I went back to the dr recently he said my liver was still pretty big. Is it possible that a persons liver will stay larger if they have been big their whole lives. I'm worried this liver of mine is not going to shrink enough.

I have a question.

I have been on preop diet since may 8th and lost forty pound in less than a month. When I went back to the dr recently he said my liver was still pretty big. Is it possible that a persons liver will stay larger if they have been big their whole lives. I'm worried this liver of mine is not going to shrink enough.

I don't know the answer to your question...it is so strange how different surgeons require different diets...I was just approved by insurance...I got a call on Monday (9th) saying my dr had a cancellation and I would have surgery June 16th.....was told he normally requires a ten day clear liquid diet but I would be doing 7 days...so difficult! Good luck with your surgery!

I have a question.

I have been on preop diet since may 8th and lost forty pound in less than a month. When I went back to the dr recently he said my liver was still pretty big. Is it possible that a persons liver will stay larger if they have been big their whole lives. I'm worried this liver of mine is not going to shrink enough.

What kind of pre-op diet are you on?

I hope everything works out well for you!!

Sheena:-)

  • 3 weeks later...

Does anyone know if it is possible to EAT at least half of the required protein for the preop diet and do the rest in peotein shakes? My shakes has 27g per shake and 150 cals each. I would love to be able to eat hard boiled eggs and baked salmon. Any thoughts?

Does anyone know if it is possible to EAT at least half of the required protein for the preop diet and do the rest in peotein shakes? My shakes has 27g per shake and 150 cals each. I would love to be able to eat hard boiled eggs and baked salmon. Any thoughts?

Physiologically there is no reason that you can't get your protein from regular food for the typical pre-op diet as long as the carbs are on the low side (assuming that the point of the diet is to improve liver conditions prior to surgery.) As docs have as many reasons for the diets that they impose as there are diets, it's best to go with what your doc wants, or at least discuss deviations with him or his staff (I still have no idea what the purpose of an all-liquid pre-op diet is,)

My surgeon wants it to shrink the liver so she can get to the stomach easier. She also wants me to lose 5to 10% of my weight. 11 to 23 pounds. I'm not a sugar addict and the shakes are sweet. I just want to be able to eat eggs or fish once a day. Don't even want carbs just to eat the protein and still be around 600cals. Thanks for replying.

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