How to eat after gastric cancer surgery? What to eat? Gastric cancer is one of the common malignant tumors in China, accounting for about 95% of all malignant tumors in the stomach. At present, the treatment plan of gastric cancer is mainly radical surgical resection, supplemented by chemotherapy, radiotherapy and biological immunotherapy.
Patients with gastric cancer can suffer from a series of complications caused by poor food digestion or impaired nutrient absorption due to the removal of most of the stomach or the whole stomach. Due to trauma or inability to eat normally, protein and fat are consumed in the body, resulting in weight loss, and some vitamin deficiency diseases and post-gastrectomy complications may occur. Therefore, it is very important for patients to have a good diet after surgery.
After major or total gastrectomy, attention should be paid to nutritional supplementation, and at the same time, the amount and type of food should be adjusted according to the stomach capacity as appropriate, taking into account the patient’s own tolerance of diet. A reasonable diet can enhance the whole body nutrition of postoperative gastric cancer patients, improve immunity, reduce postoperative complications and improve the quality of life.
Eat less and more meals
Because only a small part of stomach or inter-jejunal substitute stomach remains after radical resection of gastric cancer or total gastrectomy, the feeding capacity is obviously reduced compared with the original one, and only by increasing the number of meals can make up for the lack of food quantity and meet the body’s demand for nutrients. Therefore, patients should develop good eating habits, eat at regular times, eat regularly and quantitatively, and insist on eating less and more meals, with 5-6 meals per day being appropriate. The main food and side dishes should be soft and easy to digest. Do not overeat.
Chew and swallow slowly
After gastric cancer surgery, the grinding function of stomach is lacking, so the chewing function of teeth should play a more important role. When patients eat coarse and indigestible food, they should chew and swallow slowly; if they want to eat soups or drinks, they should pay attention to separate dry and thin ones, and try to eat soups 30 minutes before or after meals to prevent food from being discharged too quickly and affecting digestion and absorption; when eating, patients can adopt a semi-recumbent position or rest on their sides after meals to prolong the time of food emptying so that it can be completely digested and absorbed.
Eat more fish and meat
In the early postoperative period, the patient should eat in the order of water, clear liquid, liquid food, semi-fluid, soft food and general food. A liquid diet of rice soup, egg soup, vegetable soup and lotus root powder is appropriate, and foods that will induce intestinal flatulence should be avoided. The semi-liquid diet should be high in protein, high in calories, high in vitamins, low in fat, and fresh and easy to digest.
The best source of animal protein is fish, because fish is not only rich in protein, the composition of amino acids and the ratio between each other are similar to the human body, the utilization rate of fish protein can reach 96%, the fat of fish contains high unsaturated fatty acids, and easy for the body to digest and absorb, so we encourage more fish, such as yellow croaker, carp, etc. After entering the general diet should eat more vegetables, fruits and other foods containing high fiber, in order to keep the bowels open and promote the excretion of toxins.
Adequate nutrition
The fecal excretion of carbohydrates, fats and proteins increases after gastric surgery. This is due to the loss of pylorus and vagus nerve-mediated accommodative relaxation and regulation can accelerate gastric emptying; loss of pancreatic and biliary vagus nerve function causes a significant decrease in the amount of pancreatic juice and changes in the movement of the biliary tract, so that chyme fails to mix adequately with pancreatic juice and bile, and these reasons can lead to impaired absorption of the three major nutrients.
Therefore, a high-calorie and high-protein diet should be supplemented after gastric cancer surgery, choosing foods that are easy to digest and have a complete variety of essential amino acids (such as eggs, fish, shrimp, lean meat, soybean products, etc.), and protein supply should account for 15%-20% of total energy, or be given at the standard of 1~2g per kg of body weight.
For patients with dumping syndrome, measures such as increasing the number of meals appropriately, reducing the amount of each meal, avoiding high concentration of carbohydrates, drinking liquids after 30 min of eating, and adding snacks appropriately between meals can be used.
Prevention of anemia
Anemia due to iron deficiency is common after gastrectomy. Iron in food is mainly trivalent iron, which must be converted into divalent iron after interaction with gastric acid in order to be effectively absorbed. After gastrectomy, on the one hand, the production of divalent iron is reduced due to the decrease of gastric acid secretion; on the other hand, the absorption of divalent iron is mainly carried out in the upper part of duodenum and jejunum, and after gastrectomy, the B II type reconstruction makes the chyme cross the most effective iron absorption area, so that the absorption of iron is reduced.
Therefore, the daily postoperative diet should pay attention to increase the amount of iron-rich foods, such as spinach, eggplant, black beans, enoki mushrooms, black fungus, hairy vegetables, mulberries, grapes, peaches, red dates, as well as liver, red meat, seafood, etc.
Pay attention to the supplementation of two vitamins: vitamin B12 deficiency is often combined with megaloblastic anemia, and patients will develop neurological symptoms and pernicious anemia. The absorption of vitamin B12 depends on the endokines of the cells in the stomach lining. Patients after gastric cancer surgery have impaired absorption of vitamin B12 and folic acid due to the reduced secretion of endokines. In addition, post-gastric resection is often accompanied by vitamin D deficiency, which in turn affects calcium absorption. Patients after gastric cancer surgery should pay attention to supplementing various vitamins in their daily diet.
The main food sources of vitamin B12 are meat, animal offal, fish, poultry, shellfish and eggs; peanuts, spinach, beans and animal offal contain high content of folic acid, which can be actively supplemented to prevent pernicious anemia. Vitamin D in food is mainly found in yeast and mushrooms, animal liver
The main sources of vitamin D in food are yeast and mushrooms, animal foods such as animal liver, egg yolk, cream, cheese, and fish and fish eggs that contain a lot of fat. Vitamin D supplements can also be taken orally under the guidance of a physician if necessary.
Calcium supplementation
Osteochondrosis develops in 15% of patients after gastrectomy. The etiology of osteochondrosis is unknown and may be related to increased bone decalcification and insufficient calcium intake after gastrectomy.
Therefore, patients after gastric cancer surgery should pay attention to calcium supplementation in the diet. Foods with high calcium content include various kinds of soy products, dairy products, oatmeal, cabbage, cabbage, carrot, celery, pumpkin, radish, spinach, gourd, leek, dandelion, winter melon, etc. Certain nuts and seeds are also high in calcium content, such as dried almonds, walnuts, hazelnuts, sunflower seeds, etc., and fruits such as orange, etc.
Some vegetables such as spinach, amaranth, water spinach, etc. contain oxalic acid will affect the absorption of calcium, the vegetables containing high oxalic acid can be blanched in boiling water first, so that part of the oxalic acid first dissolved in water, filter the water and then fried.
Food taboos
1, avoid eating cold, too hot, coarse and hard food;
2, avoid eating spicy and stimulating condiments, such as pepper, mustard, etc.;
3, strictly forbidden to drink strong wine, strong tea and other stimulating food;
4, avoid excessive oil and too coarse food, such as fried chicken, doughnuts and other fried food;
5, should not eat coarse grains, dried beans, hard fruits, vegetables with high crude fiber content (bamboo shoots, celery, etc.), spicy and stimulating and gas-producing foods (such as radish, garlic, white potatoes, etc.). These foods are not completely inadmissible.
It is just a matter of considering the amount and personal tolerance of these foods.
These are the basic principles of postoperative diet for gastric cancer patients, and there is no need to be too taboo in other aspects. After patients are discharged from the hospital, they can resume eating with their family members. The amount of food they eat is generally based on their own feelings, and if they feel full, bloating, diarrhea, dizziness, palpitations and other symptoms, they should stop eating to prevent complications.