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Diet following Stomach Surgery
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.
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Phase 1 |
High Protein-Liquid Diet
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1 week after surgery
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Phase 2 |
High Protein-Soft Diet
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2-5 weeks after surgery
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Phase 3 |
Transition to Regular Diet
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6-8 weeks after surgery
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Consume liquids six times daily at
set times (i.e. 7am, 9am, 11am, 1pm, 4pm, 7pm)
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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.
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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.
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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.
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Avoid carbonated drinks for 2 weeks
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Stop drinking immediately when you
are full. One more sip may lead to some very unpleasant side effects (nausea,
vomiting, pain, retching, cramping)
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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.
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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:
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Broths
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Blenderized or pureed soups without
chunks
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Tomato soup made with skim milk
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Carnation Instant Breakfast (No
sugar added, mixed with skim milk)
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Protein Supplement Drinks
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Boost®, Glucerna®
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Skim milk or Lactaid milk
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Light plain yogurt
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Milkshakes made with skim milk,
yogurt or light frozen yogurt and fruit
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Sugar-free pudding
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Sugar-free Jell-O
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Sugar-free popsicle's or ice pops
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Unsweetened applesauce
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Sugar-free Kool-Aid / Crystal Light
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Diet Snapple
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Tea with artificial sweetener
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Diluted fruit juices
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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.
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
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Foods should be blended to a smooth
consistency (like applesauce) in order to minimize stress on your new stomach
pouch.
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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.
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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.
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Avoid foods & beverages high in
sugar. Foods high in sugar may cause diarrhea, abdominal discomfort or dumping
syndrome.
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Avoid extremes in the temperature
of your foods and beverages. You may experience spasms or cramps with very hot
or cold food/beverages.
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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.
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At mealtime, start with
protein-rich foods first. This is necessary to promote adequate healing and to
help you maintain your lean body mass.
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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)
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Read food labels; avoid desserts
and foods with sugar, sucrose, or high fructose corn syrup as one of the first
three ingredients.
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Eat small portions of fruit and
combine fruit with high a protein food such as cottage cheese, yogurt, or
crackers
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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.
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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.
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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:
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SOFT FOODS ALLOWED AS TOLERATED
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FOODS TO LIMIT OR AVOID
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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
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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 |
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.
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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.
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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.
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Discontinue protein
supplements drinks
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Stop eating immediately
when you are full. One more bite may lead to some very unpleasant side-effects
(nausea, vomiting, pain, retching, cramping)
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FOOD
GROUPS |
FOODS
ALLOWED AS TOLERATED |
FOODS TO LIMIT |
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MILK & DAIRY 2-3 servings each
day |
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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
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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
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BREADS & GRAINS 6-11 servings
each day |
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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.
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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
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Breads made with dried fruits,
nuts, and seeds
Pastries, doughnuts, muffins,
croissants, fruit cake
Sugar-coated dry cereals, coarse
cereals such as bran |
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VEGETABLES 3-5 servings each day
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Vegetables are high in certain
nutrients, such as potassium, vitamins A and C and folic acid.
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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. |
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FRUIT
2-4 servings each day |
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Fruit are major sources of
vitamins A and C, potassium, folic acid, and soluble and insoluble fiber.
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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 |
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MEAT & MEAT SUBSTITUTES
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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)
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Fried meats, poultry, and fish
Fried eggs
Nuts
High fat deli meats (sausage, hot
dogs, salami) |
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FATS (use sparingly)
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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.
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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
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SNACKS |
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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
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Sweetened desserts (frosted
cakes, cupcakes, pie, puddings, fried pastries)
Sugar, syrup, honey, jelly, jam,
molasses, caramel, marshmallows, licorice and candy
Ice cream, sorbet, sherbet
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MISCELLANEOUS |
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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
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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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