(1) You can have a full-flow diet for about 1~3 days after surgery (or after removal of the gastrostomy tube), which includes water, non-scummed rice and vegetable broths, and enteral nutritional fluids.
(2) 4~7 days after the operation (or after the removal of gastric tube), you can add semi-fluid food on the basis of full-fluid food in moderation: including porridge, flour, noodles, egg custard, yogurt, vegetable puree, fruit puree, puree of meat, etc.
(3) 1~2 weeks after the operation, you should focus on the above semi-fluid food;
(4) 2~4 weeks after the operation, you can add easy-to-digest soft food on the basis of semi-fluid food in moderation: including soft rice, steamed buns, meat stuffing (such as buns, wontons, meatballs), fish, whole eggs, fresh vegetables and fruits, etc.;
(5) One month after surgery, you can enter a normal diet, but it is still recommended to be light, easy to digest, and fully cooked as the main principle. If a small part of the stomach or gastric wall resection patients can speed up the above transition, generally about two weeks can enter the ordinary diet.
In addition, due to the weakening or loss of gastric grinding function, patients after gastrectomy should pay special attention to fully cooked food, chewing and swallowing slowly, and chewing 20~30 times for each mouthful of food, so as to replace the grinding function of the stomach with sufficient oral mastication.
After gastrectomy, the size of the remnant or replacement stomach is significantly smaller than the normal stomach, and the amount of food it can hold is significantly reduced, so patients who have had a major gastrectomy or total gastrectomy should follow the principle of eating fewer, more frequent meals. In the early postoperative period, the number of meals per day may need to be 6~10 times, each time 1/3~1/4 of the preoperative diet. After 3~6 months of recovery, the patient's remnant stomach (the remaining small part of the stomach) or pronephric stomach (the upper part of the small intestine enlarged to replace part of the function of the stomach) can be compensated for the increase in size, and then the patient's number of times of eating can be significantly reduced, but usually also need to eat 4~6 times a day.
In normal people, there is a structure called the pylorus between the stomach and the small intestine that controls the slow passage of food from the stomach into the small intestine. After gastrectomy, due to the absence of the pylorus and the decrease in stomach volume, a large amount of hypertonic chow may enter the small intestine rapidly after meals, resulting in increased blood glucose and decreased blood volume, and some patients may experience symptoms of fullness, nausea, sweating, and tachycardia, which is known as the "dumping syndrome". Carbohydrates (staple foods) and refined sugars (glucose, sucrose, maltose, etc.) are particularly prone to increase intestinal osmolality, so gastrectomy patients can appropriately reduce the intake of staple foods and minimize the intake of refined sugars. Eating smaller meals and lying down after meals can also help to improve or eliminate these symptoms, so it is recommended that gastrectomy patients lie down for about an hour after meals before engaging in activities.
For people with benign diseases diet can refer to the "Dietary Guidelines for Chinese Residents", whose main content includes: 1, food variety, grain-based; 2, eat a balanced diet, a healthy body weight; 3, eat more vegetables, dairy, soy; 4, moderate amount of fish, poultry, eggs, lean meat; 5, less salt, less oil, sugar control and alcohol.
Diets for cancer patients can be found in my other article, "Healthy Advice for Cancer Patients," which focuses on: 1) Being as thin as possible but avoiding underweight. 2) Exercising for at least 30 minutes a day. 3) Avoiding sugar-sweetened beverages and limiting high-calorie foods. 4) Eating a variety of different types of vegetables, fruits, whole grains, and legumes. 5) Limiting the intake of red meats, and avoiding processed meats. 6) If you have to, eat more vegetables, fruits, whole grains, and soybeans. If you have to drink alcohol, limit it to no more than two drinks per day for men and one drink per day for women.7 Limit your sodium intake.8 Do not rely on nutritional supplements to treat cancer. Special note: Do not smoke or chew tobacco.
But for patients after gastrectomy, the following points should also be noted: 1, completely prohibit alcohol, because ethanol can directly damage the gastric mucosa; 2, the lack of gastric acid after gastrectomy "disinfection" and the decline in the digestive ability, so it is recommended that food should be cooked, do not eat raw meat, including raw fish, not fully cooked steak, etc.; 3, the gastric resection food can be directly into the small intestine after the stomach. After gastrectomy, the food can directly enter the small intestine, so the temperature should be appropriate, and you should not eat too cold food. Note that the "too cold food" here usually refers to cold water or directly from the refrigerator out of the food; room temperature of the fruit is generally not very low temperature and chewing process can play a role in heating, so there is no need to heat after cooking.
Gastric acid production is reduced after gastrectomy, which affects the absorption of iron from food, and a reduction in endogenous factor (a substance produced by the gastric mucosa that aids in the absorption of vitamin B12) can lead to vitamin B12 deficiency after gastrectomy. Anemia can occur in both cases, so it is important to review blood counts regularly after gastrectomy in order to prevent and treat anemia in a timely manner.
Patients after gastrectomy can appropriately increase the number of iron-rich foods (egg yolk, animal liver, animal blood, red meat, beans, mushrooms, etc.) and vitamin B12-rich foods (red meat, animal offal, fish, poultry, shellfish and eggs, etc.). However, due to decreased absorption, iron and vitamin B12 supplementation through medication is sometimes necessary. ?
Gastrectomy is prone to inadequate nutritional intake and weight loss in the short term. However, in the long run, as long as you master the principle of reasonable diet and actively cooperate with the postoperative review, you have a chance to maintain good nutritional status. I wish all patients can eat happily and live healthily.
Associate Professor, Deputy Chief Physician, Doctor of Surgery, Master's Degree Supervisor
Deputy Director of the Department of Anal and Intestinal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University
Anal and Intestinal Leaning Jook-Group Leader
Young Member and Secretary of the Professional Committee on Colorectal and Anal Diseases of the Chinese Society of Integrative Medicine
Vice-Chairman of Physician Examination Branch of the Chinese Physicians Association's Committee on Anal and Intestinal Specialties Director
Council Member of the Third Council of the World Federation of China's Anal and Intestinal Diseases
Member of the Chinese Physicians Association's Anal and Intestinal Physicians Branch
Member of the First Transanal Endoscopic Minimally Invasive Surgery Committee of the Chinese Physicians Association's Colorectal Oncology Committee
Member of the Chinese Anti-cancer Association's Colorectal Cancer Committee's TEM (Trans-anal Rectal Minimally Invasive Surgery) Section
Member of the Chinese Anti-cancer Association's Colorectal Cancer Committee
Member of TEM (Transanal Rectal Minimally Invasive Surgery) Group, Chinese Cancer Association
Standing Committee Member of Anal and Intestinal Specialty Committee, Guangdong Society of Traditional Chinese Medicine
Member of Gastrointestinal Surgery Physicians' Working Committee, Guangdong Physicians' Association
Member of South China Famous Doctors' Union of Medical Specialists, Guangdong Society of Clinical Medicine
European Journal of Gastroenterology &. Hepatology
Techniques in coloproctology reviewer
Specializing in the diagnosis and treatment of benign and malignant diseases of the anus and intestines, he is good at the diagnosis and treatment of pelvic floor disorders, intractable constipation, complex anal fistulae, hemorrhoids, fissures, and benign and malignant tumors of the colorectum and rectum.