Dietary Advice
following
Gastrectomy
Issue No 4
Date of Issue Feb 08
Review Date Feb 09
Devised by Emma Hughes, Specialist Dietitian
Working with you to make Highland the healthy place to be
Designed by Medical Illustration Dept.
Raigmore Hospital, Inverness. G5L July 2008
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Introduction
Further Contacts & Support:
The stomach acts as a reservoir where some digestion of food takes
place. The partially digested food is then passed gradually into the small
bowel where digestion continues.
Department of Nutrition and Dietetics
Tel : 01463 704325
Cancer Bacup Freephone 0808 001234
Macmillan Cancer Relief Freephone 0808 082020
Department of Nutrition & Dietetics
Raigmore Hospital
Old Perth Road
Inverness
IV2 3UJ
Tel: 04163 704325
Fax: 01463 704322
After your stomach operation the reservoir is much smaller, so less food
can be eaten at one time, and the food does not remain in the stomach
area for as long.
For this reason you will need to alter your eating pattern. Some ideas to
help you are given in this leaflet.
What can I eat?
Now that you have had your stomach surgery you will start with fluids
and then build up gradually to a normal diet. As your stomach is now
smaller you may find that you become full more quickly than before.
You may need to eat very small amounts but more often (ie every 2-3
hours) at first and then gradually increase the amounts and the time
between meals.
The exact quantity and frequency of food will depend on how you tolerate
it.
Here are some tips:
• Aim to eat little and often i.e. small meals with snacks in between.
• Avoid drinking directly before, during or immediately after a meal as this will fill you up.
• Avoid having soup before a main course as this can also fill you up.
• If you cannot manage a dessert, have it about an hour later.
• Eat slowly and chew your food well.
• Avoid fizzy drinks.
• Sit upright at meal times and for about half an hour afterwards.
Remember it is important to include a wide variety of foods to give
you all the nourishment you need.
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Important Vitamins and Minerals
Suggested Meal Plan
Vitamin B12
Deficiency of this vitamin can cause a type of anaemia. When part or
all of your stomach is removed you lose the ability to absorb vitamin
B12 from you diet. To prevent this you may need vitamin B12 injections.
Having a diet rich in vitamin B12 would include dietary sources such
as:
meat, liver, fish, dairy produce and some yeast extracts.
Magnesium
In some patients there is a reduced absorption of magnesium therefore it
is important to have an adequate intake of magnesium from your diet.
The best natural sources of magnesium include dairy products, fish,
meat, seafood, green leafy vegetables, bananas, broccoli, eggs, nuts,
potatoes, whole grains, apples, brown rice, soybeans and tofu.
If you are worried about your vitamin or mineral intake, then please let
the Dietitian know.
Nutritional Supplements
You may have been advised by your Dietitian to have some nutritional
supplement drinks. These should be taken in between meals.
The Dietitian will ask your GP to prescribe the following nutritional
supplements if they are required:
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Breakfast:
Porridge, Ready Brek or cereal with full fat milk and sugar
Toast with butter and jam/marmalade
Croissant/muffins/crumpets
Eggs – boiled or scrambled
Pancakes with sugar/honey/maple syrup/ chocolate sauce
Thick and creamy yoghurt
Light/snack meal:
Jacket potato with tuna mayonnaise/ cheese/beans
Soup and bread with extra cheese/cream
Sandwiches e.g. cheese and tomato/ham and pickle
/egg mayonnaise/tuna mayonnaise
Omelettes with ham and extra cheese
Beans/cheese/sardines on toast
Main meal:
Meat, fish or poultry with potatoes and vegetables
Pasta and sauce dishes with tuna/chicken/mince
Chilli con carne and rice
Cauliflower cheese with bread and butter/margarine
Fish Pie with mashed potato
Stirfried rice with chicken and vegetables
Desserts:
Milk puddings eg custard and rice with dried fruit
Sponge and custard
Thick and creamy yoghurt/fromage frais
Fruit with yoghurt, cream or ice cream and jelly
Trifle, mousse or instant whip
Snacks:
Milky drinks eg hot chocolate/Horlicks/Ovaltine
Cake or biscuits e.g. fruit cake/flapjack/sponge cake
Cheese and biscuits
Crisps and nuts
Chocolate
Scone, Jam and Cream
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What Can I Do If I Don’t Feel Hungry?
If you have a poor appetite or have lost some weight try the following:
Choose full cream milk and full fat foods instead of low
fat products.
Add sugar, evaporated milk and dried fruit to cereals,
puddings and drinks.
Grated cheese, cream or butter can be added to
potatoes, vegetables, soups, sauces and puddings.
Fortify milk by adding 2-4 tablespoons dried milk
powder to 1 pint milk and use this to make drinks,
soups, puddings and sauces.
Try a nourishing drink such as Complan, Build-Up
or supermarket own brand or make your own fruit
smoothie or milkshake.
Use ready prepared meals or tinned foods to reduce
preparation time.
Dumping Syndrome:
This is a problem that can occur after stomach surgery. It results from
the sudden movement of a meal from the stomach into the small bowel
and may cause diarrhoea, bloating, sweating or dizziness.
The effects of dumping syndrome can be reduced by:
Eating slowly.
Eating smaller more regular meals.
Reducing the amount of sugar in the diet.
Increasing the amount of fat in your foods to replace
the energy provided by sugar.
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Here are some tips:
Replace sweet snacks such as sweets, cake and
chocolates with high energy savoury snacks such as
crisps, scones or cheese and biscuits.
Have sugar free squashes and diet drinks instead of
regular drinks and squashes.
Choose low sugar milk puddings eg custard/rice or
make them with an artificial sweetener.
If your symptoms persist you should contact your GP, Specialist
Nurse or Dietitian for further advice.
If you do not experience these symptoms sugar may be included as
normal in your diet.
Feeling Sick:
Some tips to help reduce nausea and vomiting:
Cold foods and drinks usually have less smell than hot,
cooked foods. Try yogurt, tinned fruit or ice-cream.
Try to have plenty of drinks throughout the day. Aim for
8 drinks each day.
You may find cold drinks helpful.
Fruit sorbets, ice cream, jelly and sharp flavours such
as lemon and grapefruit can quell nausea.
Salty foods such as crisps, cheese biscuits, crackers
or peanuts can also dampen feelings of nausea.
Avoid greasy and fatty foods.
Plain biscuits, crackers and dry toast may help to settle
your stomach.
Ask your doctor to prescribe some anti-sickness medication (antiemetics) if the problem persists.
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