Post-operative guidance
1. Regular follow-up visits
During the first year after surgery, at least three outpatient follow-up visits, as well as more follow-up visits by telephone or other means, should be conducted. The main contents of the follow-up visits include blood glucose, glycosylated hemoglobin, insulin, C-peptide, as well as weight, nutritional status, mental status and so on. After that, it will be once a year.
2.Vitamin supplementation
Long-term post-operative supplementation of Sinclair tablets and vitamin B complex to prevent hair loss, osteoporosis and anemia.
3.Prevent anastomotic ulcers
Take oral proton pump inhibitor for 4 weeks after surgery.
4.Postoperative dietary guidance
I. Dietary principles.
(A) Dietary progress and eating speed.
1. Dietary progression should be in progressive stages, in the following order.
Clear flow → liquid → soft → solid food
2.Eating speed should be slowed down, each meal eating time for half an hour.
3. Eat small amounts of food, chew slowly (at least 25 times) to prevent gastric outlet obstruction and vomiting.
(B) The appropriate intake of food and supplements.
1, three meals a day should be consumed small size food, and then take two snacks.
2. Drink at least 6-8 cups (1500-2000cc) of water daily to prevent dehydration and constipation.
3.Take a daily multivitamin and mineral supplement, and follow the doctor’s instructions to take it regularly.
(iii) Food that should not be consumed.
1.Avoid concentrated sweets (e.g. sugar, cola, cakes, ices, etc.), which may cause “dumping syndrome”.
2.Avoid foods high in oil, which can prevent vomiting and weight gain.
3.When eating, avoid drinking water and soup, and take in water between meals or 30-45 minutes after meals.
4.Ice water, coffee, tea, alcohol and other stimulants should not be consumed within three months after surgery.
(D) Other precautions.
1.After surgery, the initial stomach can only hold a small amount of capacity, and finally it can only hold half a cup to a cup (120cc-240cc) of capacity. If the stomach feels uncomfortable and vomiting occurs, you should avoid eating again.
2.If maladjustment occurs in the food you eat, you can temporarily return to the food you ate in the previous stage, such as clear liquid or fluid or soft food. The period is about one week.
II. Principles of dietary progress.
(i) Clear liquid diet: Description.
1, food choices: plain water, filtered clear soup, sports drink (add water 1:1 dilution), filtered unsweetened juice (add water 1:1 dilution), honey water, after the third day you can drink de-oiled chicken soup, fish soup.
2.Water intake: Try to drink water and clear food in small sips, about 120cc per hour. prohibit gulping to avoid flatulence and vomiting.
(B) Liquid diet.
1, food selection: choose low-fat, low-sugar, low-fiber grated and filtered food. You can choose oil-free soup, rice soup, rice syrup, barley syrup, soy milk, milk
2.Calorie intake: about 800-1200 calories and 50-70 grams of protein.
3, water intake: about 120-180cc per hour, at least 6-8 cups per day (1500-2000cc)
4.Other considerations.
(1) the choice of food and drink will affect the weight loss situation, although the amount of liquid food eaten, but if the high-calorie food, weight loss is still not ideal, on the contrary, if the intake of very low-calorie liquid food, and protein food intake is not enough, it is easy to affect the health, reduce immunity, easy to have hair loss and other phenomena occur. Therefore, the intake of liquid diet should include 240-480cc of milk daily to ensure sufficient protein.
(2) If you are lactose intolerant to milk, you can consume commercial formulas that do not contain lactose. For example: Tonicin, Yapexin, Novartis Aizucon.
(3) Soft diet.
1.Calorie intake: about 800-1200 calories and 50-70 grams of protein.
2, water intake: about 120-180cc per hour, at least 6-8 cups (1500-2000cc) of water per day.
3, food choice: low sugar, low fat, high protein food. As shown in Table 1.
The different ingredients used in the preparation should be handled according to their properties as follows.
1.When using yams or red grapes, steam them first and then cut them into small dice.
2. When using fresh eggs, boil them and peel off the shells, press them into a puree or prepare them by steaming or stewing.
3.When using lean meat, it should be finely chopped and cooked first.
If you cannot prepare it yourself, you can use commercially available baby food, such as meat, vegetable or fruit puree and other canned food.
(4) Low-calorie balanced diet
The calorie intake can be gradually increased to the recommended daily calorie requirement, and the protein intake should be 50-70 grams.