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.

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:

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)

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