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Diet After Gastrectomy: Care Instructions

Overview

After surgery, you probably will feel full much sooner after eating than you did before surgery. This is because your stomach has less room for food.

This surgery also can make your stomach empty food into your small intestine more quickly than it did before. This can cause a problem called dumping syndrome. It can make you feel faint, shaky, and nauseated. And you may have diarrhea. It also can make it hard for your body to get enough nutrition. Dumping syndrome can happen within a half hour after you eat or 2 or 3 hours later.

You may be able to improve your symptoms of dumping syndrome and feeling too full by changing the way you eat. Try to eat more small meals rather than a few large ones. And drink fluids between meals, not with them. Eating smaller meals more regularly can help you to get enough nutrition including protein, calcium, and iron. A dietitian can help you plan menus to pack good nutrition into several small meals.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Eat 4 to 6 times a day. For example, try 3 small meals and 3 snacks. This may keep you from feeling too full after you eat. And it may reduce problems with diarrhea or dumping syndrome.
  • Eat slowly. Try to chew each bite very well, or until it is liquid. Allow 20 to 30 minutes for each meal.
  • Try to eat often. This helps you get enough calories and nutrition. You might not feel as hungry as you did before surgery, but it is important to not skip meals. Many people who have this surgery lose weight without meaning to because they eat much less than they did before. Keep healthy, high-calorie snacks around, such as peanut butter and crackers or cheese and crackers.
  • Try to eat a variety of foods to make sure you get all the nutrition you need.
  • Limit or avoid foods if they give you a lot of gas or diarrhea. These may include foods like milk (if you are lactose intolerant), beans and legumes, foods that are high in fat, and some vegetables such as brussel sprouts, garlic, and onions.
  • Eat meals that have protein. This is found in beef, poultry, fish, eggs, cheese and other dairy products, soy foods, peanut butter and other nut butters.
  • Limit foods that have a lot of added sugar. High-sugar foods increase the chance of dumping syndrome. These include desserts, soda pop, and fruit juices.
  • Try to limit food and fluids that have sugar substitutes, such as sugar alcohols, in them. These can give you gas, bloating, and diarrhea. Sugar substitutes are found in chewing gum, diet drinks, and sugar-free candies.
  • Drink fluids between, not during, meals. Do not drink liquids within a half hour before and after you eat. Fluids fill up your stomach quickly. They also move food even more quickly into the small intestine. Quick emptying of the stomach increases the chance of diarrhea, pain, gas, and bloating.
  • Unless fibre is making you painfully full, choose foods with fibre. Fibre can slow how quickly food moves from your stomach to your small intestine. Try small amounts of fibre-rich foods at meals and snacks, including oatmeal and other whole grains, fruits, and vegetables.
  • If fibre is causing you discomfort, reduce how many fibre rich foods you eat. Then slowly add them back in based on how your stomach feels.
  • Ask your doctor or dietitian if a fibre supplement is right for you.
  • Lie down for 20 minutes after a meal. This can help slow the movement of food through your stomach and intestine. If you have heartburn, do not lie down (stay sitting up).
  • Avoid drinks with bubbles or gas (carbonation). These may cause fullness, discomfort, heartburn, or nausea.
  • Limit caffeine to no more than 400 mg each day, or about 2 to 3 cups of coffee.
  • Talk to your doctor or dietitian about drinking alcohol. Surgery can change how alcohol affects you.
  • After a gastrectomy, you will need to take vitamin and mineral supplements even if you are eating well. Ask your doctor or dietitian which vitamin and mineral supplements are right for you.
  • If all of your stomach was removed, you need to have regular shots, or injections, of vitamin B12. Follow your doctor's directions on when to have them.
  • If milk gives you gas or diarrhea, try to eat yogurt and cheese.
  • Think about how your body feels when you are hungry and when you are full. Often people find their hunger and fullness feel different after surgery.
  • Consider recording what you eat and drink in a journal, like the bowel and symptom journal.

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