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This information will help you learn how to eat after your gastrectomy (surgery to remove part or all of your stomach). After your gastrectomy, the way you eat and digest (break down) food will change. Your stomach may be smaller, or it may have been removed. This means you will feel full faster than you did before your surgery. The valve that controls how food moves from your stomach to your intestines may have also been removed or changed during your surgery. This means you may digest your food too quickly and not absorb nutrients as well as before your surgery. If you have questions about your diet while you’re in the hospital, ask to see a clinical dietitian nutritionist. After you’re discharged from the hospital, you can call 212-639-7312 if you have questions or to make an appointment with an outpatient clinical dietitian nutritionist. General Diet Guidelines After Your GastrectomyAfter your surgery, your stomach won’t be able to hold as much as it did before surgery. You will need to have 6 or more small meals a day instead of 3 main meals. This will help you eat the right amount of food, even though your stomach is smaller or gone. Tell your doctor and clinical dietitian nutritionist if you’re losing weight without meaning to. Guidelines for eating
Guidelines for drinking
Vitamin B12If a large part of your stomach was removed during your surgery, you may need to take extra vitamin B12. You can get vitamin B12 as an oral supplement (such as a pill) or a monthly shot. You may also need other vitamin and mineral supplements. If you do, your doctor or clinical dietitian nutritionist will discuss this with you. Food Intolerances After SurgeryA food intolerance is when you have discomfort or unpleasant symptoms after having certain types of foods or drinks. After your surgery, you may have some food intolerances that you didn’t have before surgery. Sugar intoleranceSome people have cramping, stomach pain, or diarrhea (loose or watery bowel movements) within about 20 minutes of eating foods or drinks that are high in sugar. This is called dumping syndrome. Dumping syndrome can also be caused by eating too much at once. Some people feel weak, hungry, nauseous (like you’re going to throw up), anxious, shaky, or sweaty 1 to 2 hours after eating a sugary meal. This happens because your body releases extra insulin after you eat large amounts of sugar. Having too much insulin in your bloodstream causes low blood sugar. Dumping syndrome and low blood sugar can be controlled by changing your diet and watching what you eat. Try avoiding foods and drinks with lots of sugar, such as:
It’s okay to eat small amounts of cakes, cookies and candies sweetened with sugar alcohols (such as sorbitol and mannitol). Eating too much may cause loose bowel movements or diarrhea. Eating smaller meals, having a protein source with meals, and including foods with soluble fiber (such as canned fruits, bananas, peanut butter and oatmeal) may also help with symptoms. Fat intoleranceSome people have trouble digesting large amounts of fat. Try having small amounts at first, and then increase the amount of fat in your diet slowly. Foods high in fat include:
If your bowel movements (poop) smell worse than usual or are pale, greasy, or floating, you may not be digesting fats well. If you have any of these symptoms, talk with your doctor or outpatient clinical dietitian nutritionist. You may need a medication to help you digest fats. This is rare. Lactose (dairy) intoleranceLactose is a type of sugar found in dairy or milk products. Some people have trouble digesting lactose after having a gastrectomy. This is called lactose intolerance. Symptoms of lactose intolerance include gas, bloating, and diarrhea. These symptoms can happen 30 minutes to 2 hours after having dairy products. After surgery, slowly bring dairy products back into your diet. Milk, ice cream, and soft cheeses have high amounts of lactose. Hard cheeses, yogurt, and butter have smaller amounts of lactose. To test your tolerance to dairy foods, start by drinking a 4-ounce (½ cup) serving of milk.
If you think you may be lactose intolerant:
Sometimes, lactose intolerance that develops after surgery goes away with time. You may want to try dairy products again in a couple of months to see if you still have symptoms. Managing Common ProblemsThe following are common problems after a gastrectomy. Keeping a food log and writing down any symptoms or problems you have may help you realize why the problems are happening. You can use the blank daily food and drink log at the end of this resource. If the tips below don’t help, talk with your clinical dietitian nutritionist or doctor. Tips for managing nausea
Tips for managing fullness
Tips for managing diarrhea
Eating at Restaurants and Social EventsFood is the focus of many social events. Remember that portions served at events and restaurants tend to be large. It usually takes some time to get used to eating out at restaurants or attending events like weddings and dinner parties.
Tracking your Food and Liquid IntakeAfter your gastrectomy, you may feel full quickly or have other changes that affect your eating. Keeping a food and drink log will help you see what foods and portion sizes are easiest for you to eat. It will also help you make sure you’re getting enough calories. In your food and drink log:
See the example of a food and drink log below. There is also a blank log for you to use at the end of this resource.
Tracking your weightIt’s also important to track your weight. Weigh yourself about every 3 to 5 days. It’s best to weigh yourself around the same time of day each time. Make sure you’re wearing the same amount of clothing when you weigh yourself. If you find you’re losing weight, make a follow-up appointment with an outpatient clinical dietitian nutritionist. Measuring foodsTo accurately measure foods, use measuring spoons, measuring cups, or a food scale. You can also use the guidelines in Figure 1 to estimate amounts of some foods. Finding calorie informationYou can find the calorie information for packaged foods on the nutrition facts label (see Figure 2). If a food doesn’t have a nutrition facts label, you can look up the calorie information on a nutrition resource website, such as CalorieKing.com or MyFitnessPal.com. You can also download the MyFitnessPal application to your smartphone. ResourcesMSK support servicesIntegrative Medicine Service You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They will work with you to come up with a plan for creating a healthy lifestyle and managing side effects. To make an appointment, call 646-608-8550. Resources for Life After Cancer (RLAC) Program External resourcesAcademy of Nutrition and Dietetics (AND) American Institute for Cancer Research FDA Center for Food Safety and Applied Nutrition 6-Meal Diet Sample MenusThe sample menus below show a soft diet in 6 small meals. They include 4 ounces of liquid with each meal (to keep you from feeling too full during meals) and 8 ounces of liquid between meals (to keep you well-hydrated). Remember that soup and protein shakes also count as liquids.
Sample menu 1
Sample menu 2
Sample menu 3
Sample menu 4
Daily Food and Drink Log
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