Diet after gastrectomy

The article is expertly consulted by Master, Doctor Duong Xuan Loc - Gastroenterologist - General Surgery Department - Vinmec Danang International General Hospital.

After a gastrectomy, the way a person eats and digests food will change as the stomach may be smaller or the stomach may be completely removed. For example, you will feel full faster, there is no bowel movement moving from the stomach to the intestines leading to faster digestion of food and a reduced ability to absorb nutrients compared to before surgery.

After gastric bypass surgery, your stomach won't be able to hold as much food as it used to, so you'll need to break down 3 large meals into 6 or more smaller meals. This will help you to eat the right amount of food according to the capacity of your stomach or the absence of a stomach.
Dietary Guidelines: Start with 6 or more 6 small meals daily. When you first start eating, you can start eating with portion sizes from 120 ml/meal to 240 ml/meal, after a few months you can eat larger portions and eat fewer meals. However, there are other patients who may still need to follow a small/fast diet because everyone's condition is different. Chew food thoroughly to help the digestive system easily absorb food. Eat slowly. This way, you will stop eating before you feel too full. Sit up straight while eating. The last meal of the day should be done at least 2 hours before bedtime. Do not drink more than 120ml of liquid with each meal. This will allow you to eat enough solid foods without feeling too full and keep food from moving into the small intestine too quickly. Note that soups and protein drinks still count as liquids. You should eat enough and varied protein in each meal such as eggs, meat, poultry, fish, nuts, milk, yogurt, cheese, peanut butter and tofu. Avoid spicy and peppery foods immediately after surgery. Avoid fatty and sugary foods if you feel uncomfortable after eating these foods. Drinking guidelines: Try to drink about 8 to 10 glasses of water a day. Avoid carbonated drinks as they cause a feeling of fullness. Drink water before and after at least 1 hour after eating to avoid feeling too full and prevent dehydration. Do not drink more than 120 ml of liquid with each meal. Vitamin B12: Because the stomach plays a very important role in helping the body absorb vitamin B12, if part of the stomach is removed, it will make the patient deficient in vitamin B12. You'll need to take extra vitamin B12 in the form of an oral supplement or a monthly injection.

You should keep a record of the foods you eat, drinks, and the symptoms or problems you experience after eating these foods to make it easier for you and your doctor to identify the cause and take action. Avoid these foods or drinks.
The following are common problems that patients often experience after gastrectomy and how to deal with them:
Nausea management tips: Avoid foods that are high in energy, spicy or greasy. Do not eat or drink too quickly. Do not eat or drink too much at once. Do not lie down after meals. Wait 2 to 3 hours after eating before lying down. Tips for managing overeating: Don't eat or drink too much at once. Do not drink too much water with each meal. Do not eat or drink too quickly. If you're having trouble breaking down 3 large meals into 6 small meals, create a schedule with fixed times for eating and drinking. Avoid carbonated drinks like soda and sparkling water. Avoid vegetables that can make you bloated like broccoli, cauliflower, cabbage, onions, brussels sprouts, and beans.

Tip for Diarrhea Management: Try reducing your intake first, then, try reducing dairy and finally, reducing your fat intake. Watch to see if the diarrhea gets worse when you cut back on these nutrients. Avoid sugar alcohols such as sorbitol and mannitol. These substances are commonly found in chewing gum, hard candies, cough drops, dairy desserts, cakes and cookies. You can see the ingredients on the product's label. You should eat foods with soluble fiber, like canned fruit, bananas, peanut butter, and oatmeal. Ensure good food storage at home: Store leftovers in the refrigerator or freezer immediately. Remove leftovers from the refrigerator after 2 days. Discard frozen foods after 6 months. It is best to defrost food in the refrigerator or microwave, not on the stove.

Reference source: Mskcc.org