As a dietitian, I am always concerned about how the patients who come back for follow-up after gastric cancer surgery eat: Dietitian: How many meals a day? Patient: Three meals a day, I am not hungry. Dietitian: Do you eat dry rice or thin rice? Patient: Most of the time it’s thin rice, dry rice is too dry, the stalk can’t go down. Dietitian: How much do you eat each meal? Patient: Small half bowl, don’t dare to eat too much, eat too much stomach bloating, after eating to pull hiccups. Nutritionist: Do you eat a lot of meat every day? Patient: at most two or three lumps, the main soup, eat more indigestion to diarrhea Look at these thin circle of patients, and then turn over aha their test indicators: anemia, hypoproteinemia, electrolyte disorders, etc., really worrying and anxious. According to a survey, the top 10 symptoms related to nutrition and quality of life in postoperative gastric cancer follow-up patients are insomnia, numbness or tingling in hands/feet, feeling bloated, weight loss, nausea, diarrhea, loss of appetite, dry mouth, lack of energy, hair loss, and the patients after partial gastrectomy or total gastrectomy are always experiencing one or more of these symptoms, which leads to the patients don’t want to eat or even dare not to eat. How to solve the problem of “not daring to eat” during the recovery period of postoperative gastric cancer patients? Dietary points in the early stage after gastric cancer surgery: generally fasting for a certain period of time after surgery (the specific length of time is subject to the doctor’s arrangement); starting to eat (small amount of sweetened saline or warm boiled water) under the guidance of the doctor or dietitian; if there is no symptom of gastrointestinal intolerance, small amount of clear liquid can be eaten; and gradually transitioning to semi-fluid, semi-liquid, soft rice and general food with little dregs. Diet follows the principle of “gradual progress, small and frequent meals”, and observe whether there is abdominal pain, bloating, diarrhea and other gastrointestinal symptoms. The transition process varies according to different conditions and time needed, generally the transition time is 10-15 days. Next, dietitians popularize the common nutrition-related complications and ways to cope with them during the postoperative rehabilitation period of gastric cancer: 1. Dumping Syndrome Dumping syndrome is a common complication after partial or total gastrectomy. In the early stage, it appears 10-30 minutes after meals, and patients experience abdominal fullness and nausea; in the middle stage, it appears 20 minutes to 1 hour after meals, abdominal distension, enhanced gastric flatulence, abdominal cramping pain, and violent diarrhea; in the late stage, it realizes 1-3 hours after meals, and patients experience reactive hypoglycemia (symptoms such as facial redness, accelerated heartbeat, dizziness, and sweating, and the desire to sit down or lie down, and patients Feeling anxious, weak, shaky or hungry), the patient may not necessarily experience all the typical symptoms, as long as one or more of these symptoms occur, then it is very likely that dumping syndrome has occurred, please make dietary adjustments according to the following methods: small amount of meals and large number of meals (3 main meals a day, 2-3 additional meals) Gradual progression from small to large amount of meals and from dilute to thicker meals, shorten the stage of fluids, and change to semi-liquid or soft meals as early as possible; limit the total amount of liquid in the diet, and limit the amount of liquid in two meals; and limit the amount of liquid in the diet to two meals. Limit the total amount of fluids in the diet, and replenish fluids between meals (soup, fruit juice or milk). Reduce the intake of simple sugars: drink less or no glucose water, honey water or beverages containing more sugar. Increase the amount of soluble dietary fibers (pectin and gum, etc.) Increase the amount of fats in the diet. After partial or total gastrectomy, the absorption of iron and vitamin B12 decreases, resulting in a much higher probability of anemia. Patients recovering from gastric cancer should pay attention to: increase iron-rich foods in diet, such as animal liver or blood clots, it is recommended to eat twice a week, 50-100 grams each time. Regular regular testing is needed, oral iron supplements and vitamin B complex should be taken when needed, and supplementation should be made by parenteral route when the effect of oral supplementation is unsatisfactory. 3. Osteoporosis: Gastric acid is able to reduce calcium and keep it in soluble and absorbable state. After gastric cancer surgery, gastric acid secretion decreases, calcium is not well absorbed, and the risk of osteoporosis increases. Dietary attention should be paid to: Supplement dairy products, oral calcium and vitamin D supplements if necessary. 4. Lactose intolerance Many patients will have diarrhea after drinking milk, which is due to lactose intolerance. There are many cases of lactose intolerance after gastric cancer surgery. Suggestion: Replace milk with unsweetened yogurt or cheese Split a carton of milk into two drinks (100-125 ml/times) because a small amount of lactose intake at one time (e.g., 6 g or less per meal) is still tolerable (the lactose content of milk is about 4.2%-5%, and 250 ml of milk contains 10.5-12.5 g of lactose). 5, steatorrhea Due to surgery on the normal gastrointestinal tract structure changes, will indirectly affect the production of pancreatic fluid, fat digestion depends on the participation of pancreatic lipase, will cause postprandial fat maldigestion and malabsorption. Fat malabsorption will lead to some other secondary problems: abdominal cramps and abnormal sensation in the limbs (numbness and tingling), which are the manifestation of hypocalcemia and hypomagnesemia; prolonged steatorrhea will also affect the absorption of fat-soluble vitamins. Suggestion: Reduce fat intake, take pancreatic enzyme enteric-coated capsule or multi-enzyme tablets with meals if necessary, or replace part of dietary fat with medium-chain fat. Summarize: Patients in postoperative rehabilitation period of gastric cancer should not only dare to eat, but also know how to eat, not only eat softly, but also eat dryly, not only eat frequently, but also eat balanced and reasonable.