Dietary principles for patients after gastrectomy surgery
Stomach is an important digestive organ of human body, which not only has the function of storing food, but also can secrete gastric acid to help digestion and absorption of food. The lack of stomach will have a great impact on the digestive function of the body, and the adoption of reasonable dietary principles and measures can improve the nutritional status of patients, reduce postoperative complications and improve the quality of life of patients.
(1) Postoperative nutrition should be increased by the principle of “gradual, small and multiple meals” under the guidance of doctors. After resumption of feeding, only water or rice soup should be drunk at first, and at least 6-7 meals per day, and gradually change to semi-liquid and soft food after tolerance. The quantity of each meal starts from 30-40ml and gradually increases to 150-200ml.
(2) Within six months after surgery, food should be fine and soft and well digested. If the return to normal diet is slow, the deficiency can be supplemented by oral enteral nutrition preparation. Poor appetite can be supplemented with multi-enzyme tablets and lactase to help digestion, and pay attention to increase some activities
(3) Post-gastroduodenectomy can lead to a decrease in gastric acid and pancreatic juice secretion of patients, which affects the absorption of fat, certain vitamins and trace elements, such as iron, calcium, vitamin B12, folic acid, etc. It can be corrected by supplementing multivitamin tablets such as Sun Cun, Jin Shi Er Kang.
Dietary steps after major gastric resection surgery.
The first step (about 5 days after surgery)
Clear liquid food: water, rice soup, light juice
Step 2 (about 1 week after surgery)
Liquid food: low-fat broth, lotus root powder, etc., rice dessert, sour milk, fruit and vegetable juice, total nutrition solution
Step 3 (about 2 weeks after surgery)
Semi-liquid food: rice porridge, lump soup, dragon’s beard noodles, egg custard, meat puree, fruit and vegetable puree Step 4 (about 1 month after surgery)
Soft food: noodles, steamed buns, lean meatballs, stewed meat, fish and shrimp, rolls, boiled eggs, less residual vegetables, fruits, etc. Coarse grains, nuts, dried beans and vegetables with much coarse fiber (such as bamboo shoots, celery, garlic seedlings), gas-producing foods (such as radish, white potato, onion, etc.) and irritating foods are not recommended within 6 months.
Dietary principles for stomach tumor patients to prevent common comorbidities
Patients with gastric tumor should first eliminate the cause of the disease and treat it symptomatically. For patients with gastric tumor combined with gastritis and gastric ulcer, they should avoid physical and chemical stimulation of diet, quit smoking and alcohol, and eat less overheated, cold, greasy and hard food.
Patients with gastric ulcer should reduce dietary stimulation of stomach, including foods that easily stimulate gastric acid secretion, such as fried foods, thick broth, strong tea, coffee, glutinous rice cake, corn, brown rice, strawberries, hawthorn, pineapple, chili, pepper, mustard, etc.; vegetables with more crude fiber, such as leek, celery, kale, bamboo shoots, etc.; a small amount of milk can neutralize acid, but a large amount of food can enhance the acid secretion reaction.
To reduce the burden on the stomach and intestines, you can eat a small number of meals, light, soft and digestible food, such as soft rice, noodles, dumplings, lotus root powder, yogurt, egg custard, meat stew, steamed fish, boiled dumplings, etc.. Cooking can be done by steaming, boiling, boiling, braising, stewing and other methods. For patients with incomplete obstruction caused by tumor and other patients who need liquid food, oral enteral nutrition preparation should be given to supplement nutrition.
Due to the reduction of gastric volume, post-gastrectomy patients sometimes have some adverse reactions after eating, such as dumping syndrome and hypoglycemia. Dumping syndrome mainly manifests as abdominal distension, abdominal pain, vomiting and sweating after eating, which often occurs 15-30 minutes after eating and is related to the rapid entry of large amount of food into the jejunum after the reduction of gastric volume and the loss of control of the pylorus; hypoglycemia often occurs about 2 hours after meals and manifests as palpitation, dizziness and cold sweat, which is caused by the rapid increase of insulin due to the rapid absorption of sugar and the secondary decrease of blood sugar.
Adjustment of dietary habits can greatly reduce the occurrence of these two comorbidities, and the main preventive measures are as follows:
1, less food and more meals: patients with major gastric resection are affected by the gastric capacity and digestive function, so it is advisable to start eating less and more meals, 6-7 times a day, to ensure the number of staple foods and caloric intake.
2, dry and thin food: eat only dry food during meals, drink water or liquid food 30 minutes before and 45 minutes after meals to slow down the speed of food entering the small intestine, thus reducing the occurrence of dumping syndrome and also promoting the digestion and absorption of food.
3, pay attention to the position: take a semi-recumbent position during meals, chew and swallow slowly, recline for 20-30 minutes after meals can reduce the discomfort symptoms.
4, low sugar diet: early postoperative ban refined sugar and sugar processed into sweet drinks such as sweet fruit juice, sweet snacks, cakes, etc., less than 2 taels of staple foods per day, it is advisable to use foods containing more soluble fiber such as millet porridge, konjac noodles, etc., to delay the absorption of sugar and reduce the occurrence of hypoglycemia.