Stomach Sugery Diet

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Diet following Stomach Surgery

| Phase 1- Nutritional Guidelines | Phase 2- Nutritional Guidelines | Phase 3- Nutritional Guidelines | Gastric Bypass Diet (Phase 3) |

This diet is used primarily after a stomach resection when solid food is tolerated. This diet can help prevent dumping syndrome or uncomfortable side effects such as dizziness, abdominal fullness, nausea, and diarrhea that may occur after eating.

Dumping syndrome occurs when the lower end of the small intestine (jejunum) fills too quickly with undigested food from the stomach. The partially digested food draws excess fluid from the bloodstream into the intestine to dilute the undigested food

"Early" dumping begins during or right after a meal. Symptoms of early dumping include nausea, vomiting, bloating, diarrhea, and shortness of breath.

"Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness.

Many people have both types. 

It is used for persons who have undergone surgical procedures that accelerate the normal emptying time of the stomach such as vagotomy, pyloroplasty, hemigastrectomy involving Billroth I and II anastomosis, esophagogastrectomy, total gastrectomy, Bariatric surgery, Whipple's procedure, gastrojejunostomy, Roux-en-y procedure, gastric resection or gastroenterostomy.

This diet is not indicated in laparotomy, pancreatectomy, cholecystectomy, or appendectomy.

Dietary Guidelines

You will progress through three different phases.  After the surgery the diet is divided into 3 phases to allow for gradual tolerance.

Phase 1

High Protein-Liquid Diet

1 week after surgery

Phase 2

High Protein-Soft Diet

2-5 weeks after surgery

Phase 3

Transition to Regular Diet

6-8 weeks after surgery

Phase 1- Nutritional Guidelines

  • Consume liquids six times daily at set times (i.e. 7am, 9am, 11am, 1pm, 4pm, 7pm)

  • Sip your liquid meals very slowly. Each small meal should take you 30 minutes or more. Eating too fast may lead to nausea or vomiting.

  • Drink small amounts.  Learn to sip. Try not to fill your entire mouth with fluid. Use a 1-ounce medicine cup to help determine a safe amount.

  • Mix in liquid of your choice. If you choose milk, it would be best to use skim milk or lactaid milk as lactose intolerance can occur the first few weeks after surgery.

  • Avoid carbonated drinks for 2 weeks

  • Stop drinking immediately when you are full. One more sip may lead to some very unpleasant side effects (nausea, vomiting, pain, retching, cramping)

  • Avoid beverages high in sugar and fat. Foods high in sugar and fat may cause diarrhea and abdominal discomfort. This is called dumping syndrome. After gastric bypass surgery, some people feel light-heated, sweaty or faint soon after consuming sugar.

  • Take 2 chewable multivitamins with iron each day for the first month after surgery.  Vitamin and mineral supplements may be necessary because the RDA for thiamin, riboflavin, niacin, iron, zinc and total calories may be low.

Examples of full and clear liquid foods are as follows:

  • Broths

  • Blenderized or pureed soups without chunks

  • Tomato soup made with skim milk

  • Carnation Instant Breakfast (No sugar added, mixed with skim milk)

  • Protein Supplement Drinks

  • Boost®, Glucerna®

  • Skim milk or Lactaid milk

  • Light plain yogurt

  • Milkshakes made with skim milk, yogurt or light frozen yogurt and fruit

  • Sugar-free pudding

  • Sugar-free Jell-O

  • Sugar-free popsicle's or ice pops

  • Unsweetened applesauce

  • Sugar-free Kool-Aid / Crystal Light

  • Diet Snapple

  • Tea with artificial sweetener

  • Diluted fruit juices

  • Water

Protein powder can be mixed with yogurt, soups or fruit juice if blenderized

You can find protein supplements at health food stores from GNC, Isopure, Pure Pro Powder or any protein powder supplement containing 20 grams of whey protein and 6 grams of carbohydrates per serving. Sample packets need to be divided in half before mixing.

Phase 2- Nutritional Guidelines 

You will slowly begin adding soft, easily tolerated solid foods to your diet. Please do not begin this phase until your physician or dietitian tells you it is OK. This phase consists of foods that are soft and moist (which can be mashed, pureed, blended or chewed to a puree) and full liquids

  • Foods should be blended to a smooth consistency (like applesauce) in order to minimize stress on your new stomach pouch.

  • You should eat small and frequent meals at regular times. You should plan to eat 6 times a day (3 small meals plus 3 small snacks).  Avoid grazing, i.e. eating small amounts of foods throughout the day, with high total caloric intake.

  • Drink only between meals.  Consume at least 6 cups of fluid between meals over the course of the whole day. Do not drink for 15 minutes before meals, and wait 30-60 minutes after meals to drink. Drinking fluids immediately before or during meals may cause bloating, nausea or vomiting.  This is called dumping syndrome.

  • Avoid foods & beverages high in sugar. Foods high in sugar may cause diarrhea, abdominal discomfort or dumping syndrome.

  • Avoid extremes in the temperature of your foods and beverages. You may experience spasms or cramps with very hot or cold food/beverages.

  • Eat slowly and stop eating when you feel full. Eating too quickly and too much may cause you to overfill your new pouch and cause you discomfort (i.e. nausea and vomiting). A good rule to follow is to drink approximately 4 ounces of fluid over 30 minutes.

  • At mealtime, start with protein-rich foods first. This is necessary to promote adequate healing and to help you maintain your lean body mass.

  • If you are unable to tolerate milk, it's important to add other calcium and protein rich foods such as cottage cheese. Dry milk, protein powder, or soy powder can be added to foods for added protein (such as yogurt, soups or fruit juice if blenderized)

  • Read food labels; avoid desserts and foods with sugar, sucrose, or high fructose corn syrup as one of the first three ingredients.

  • Eat small portions of fruit and combine fruit with high a protein food such as cottage cheese, yogurt, or crackers

  • Try a slow cooking method to make your meat tender, such as a crock-pot, boiling or cooking at a low temperature over a long period of time.

  • Continue taking a chewable multi-vitamin supplement.  Vitamin and mineral supplements may be necessary because the RDA for thiamin, riboflavin, niacin, iron, zinc and total calories may be low.

  • To blend food: Cut foods into small pieces and place into blender or food processor.  Add liquid such as juice, milk, broth, or water and blend or puree until smooth.  Strain foods that do not blend into a completely smooth consistency.

Soft foods from the list below can now gradually be added to your diet:

SOFT FOODS ALLOWED AS TOLERATED

FOODS TO LIMIT OR AVOID

Clear Beverages: 

Broths 

Sugar-free Kool-Aid  

Crystal Light 

Diet Snapple  

Tea with artificial sweetener 

Diluted fruit juices 

Sugar-free Jell-O 

Sugar-free popsicle's or ice pops 

Water 

Full Beverages:   

Skim milk or Lactaid milk   

Carnation Instant Breakfast (Sugar-free, mixed with skim milk)  

Protein Supplement Drinks

Boost®, Glucerna®

Dry milk 

Milkshakes made with skim milk, yogurt or light frozen yogurt and fruit 

Blenderized or pureed soups without chunks 

Tomato soup made with skim milk 

Light plain yogurt, low fat or non-fat

Sugar-free pudding

Soft and moist foods (which can be mashed, pureed, blended or chewed to a puree) such as follows: 

Cottage cheese, low fat or non-fat

Mashed potatoes

Oatmeal, grits, or cream of wheat (thinned with skim milk as tolerated)

Tender or stewed meats:  

Fish, seafood 

Tofu 

Eggs, scrambled eggs 

Tuna salad, egg salad 

Soft fruits and vegetables:  

Banana, melon, strawberries 

Unsweetened applesauce

Cooked, mushy vegetables, except corn

Soft pasta (well chewed)

Toast or crackers

Artificial sweeteners

 

Beverages:

Carbonated drinks

Alcohol

Tonic water

Sweetened fruit drinks and beverages

Presweetened iced tea

Sticky foods:

Bread (may tolerate if toasted)

Sticky rice

Pasta (especially overcooked or large noodles)

Grits

Macaroni and cheese

Peanut butter

Crunchy foods:

Raw vegetables, corn, iceberg lettuce

The seeds and/or skins of all fruits and vegetables (oranges and grapefruits may not be tolerated unless the membrane is removed before eating)

Dried fruit

Corn, sweet potatoes

Nuts

Olives and pickles

Popcorn

Chips

Coconut

Tough or rubbery foods:

Tough meat (ex: steak, pork chops, ham, hot dogs)

High fat foods:  

Whole milk

Butter, margarine, oils

Sour cream

Cream cheese

Mayonnaise

Gravy

Fat back, bacon

Salad dressing

Hard cheeses

Fried foods

Bologna, salami, sausage

Desserts

Ice cream

Certain spices:   

Cinnamon, pepper, onion or garlic salt

Phase 3 - Nutritional Guidelines

You will slowly begin transitioning to a regular diet. Please do not begin this phase until your physician or dietitian tells you it is OK.  

  • You should continue to eat small and frequent meals at regular times. You should plan to eat 5 times a day (3 small meals plus 2 small snacks).  Avoid grazing, i.e. eating small amounts of foods throughout the day, with high total caloric intake.

  • Drink only between meals.  Consume at least 6 cups of fluid between meals over the course of the whole day. Do not drink for 15 minutes before meals, and wait 30-60 minutes after meals to drink. Drinking fluids immediately before or during meals may cause bloating, nausea or vomiting.  This is called dumping syndrome.

  • Walk or exercise daily. Start slowly after you get home from the hospital. Gradually work up to at least 30 minutes of non-stop exercise. Avoid heavy lifting until at least 6 weeks after your surgery.

  • Discontinue protein supplements drinks

  • Stop eating immediately when you are full. One more bite may lead to some very unpleasant side-effects (nausea, vomiting, pain, retching, cramping)

Gastric Bypass Diet (Phase 3)

FOOD GROUPS

FOODS ALLOWED AS TOLERATED

FOODS TO LIMIT

MILK & DAIRY 2-3 servings each day

Milk and dairy are the body's main source of calcium; protein, riboflavin, phosphorus, zinc, vitamins B12 and D. Foods in this group are good for growth and strong bones

Milk as tolerated, nonfat or 1%

Shredded or soft low fat cheeses (avoid melted cheese)

Cottage cheese, nonfat or low fat

Yogurt, light, unsweetened or plain

Chocolate milk, milkshakes, and frappes

Fruited or flavored yogurt

Sweetened cocoa mixes

Whole milk and 2% milk

Hard cheeses

BREADS & GRAINS 6-11 servings each day  

Foods in this group are a major source of thiamin, niacin, iron, fiber and zinc; and also a vital part of a healthy, balanced diet.

 

Whole-grain or enriched breads and cereals, rice, barley, and pastas

English muffins, bagels, low fat muffins

Dry or cooked unsweetened cereals

Crackers and pretzels chewed well

Breads made with dried fruits, nuts, and seeds

Pastries, doughnuts, muffins, croissants, fruit cake

Sugar-coated dry cereals, coarse cereals such as bran

VEGETABLES 3-5 servings each day  

Vegetables are high in certain nutrients, such as potassium, vitamins A and C and folic acid.

All canned, frozen or cooked vegetables

Fresh vegetables as tolerated

Vegetable juice

Raw vegetables or vegetables prepared with candied sauces or glazes with honey, syrup, sugar, jelly, marmalade, or jam.

FRUIT 2-4 servings each day

Fruit are major sources of vitamins A and C, potassium, folic acid, and soluble and insoluble fiber.

Fresh or frozen fruits processed without sugar

Applesauce, unsweetened

Water-packed canned fruits

Fruit juices, unsweetened

Dried fruits, figs, prunes

Canned, fresh or frozen fruit with sugar added; fruits packed in syrup.

Sweetened fruit juice and fruit flavored drinks

MEAT & MEAT SUBSTITUTES  

Meat is a major source of protein, iron, niacin, thiamin, vitamins B6 and B12, folic acid, magnesium, potassium, phosphorus and zinc.

Lean tender meats

Chicken (cooked so it is tender and cut into small pieces)

Low fat luncheon meats (turkey, roast beef-sliced thin)

Soft fish and shellfish (baked, boiled, grilled), Baby shrimp, scallops, crab

Tuna fish (fat-free mayo is OK)

Cooked dry beans and peas

Bean and lentil dishes and soups

Fat-free refried beans

Peanut butter

Tofu (soy) mixed in soup or vegetables

Eggs (cooked with minimal fat)

Fried meats, poultry, and fish

Fried eggs

Nuts

High fat deli meats (sausage, hot dogs, salami)

FATS  (use sparingly)  

A small amount of fat is essential in your diet.

Dietary fats give you energy and help you absorb vitamins from foods, such as Vitamins A, D, E, and K.  

 

Salad dressings, non fat or low fat

Butter or margarine, in small quantities

Mayonnaise, non fat or low fat

Sour cream, non fat or low fat

Vegetable oils (olive, corn, flaxseed, canola)  

Regular sweetened salad dressings 

Whipped cream 

Regular sour cream 

Lard or vegetable shortenings 

Gravies  

SNACKS

Foods in this group add flavor and pleasure to eating but provide mostly calories with few or no nutrients. Include moderate amounts occasionally.

Sugar free products such as pudding, gelatin, frozen yogurt, and carbonated beverages

Plain cakes, sugar free cookies

Custard, prepared without added sugar

Artificial sweeteners

Low-calorie jelly

Sweetened desserts (frosted cakes, cupcakes, pie, puddings, fried pastries)

Sugar, syrup, honey, jelly, jam, molasses, caramel, marshmallows, licorice and candy

Ice cream, sorbet, sherbet

MISCELLANEOUS

 

 

Coffee, tea, unsweetened or diluted fruit drinks

Spices and seasonings, as tolerated

Highly seasoned foods

Alcohol

Tonic water

Sweetened fruit drinks such as Kool-Aid and HI-C  

Carbonated beverages


The above opinionated views and information serves to educated and informed consumer. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. It should not replaced professional advise and consultation. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions

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