”People are food-oriented”, but for patients who have just undergone gastric surgery, there will be more or less a series of discomfort such as inability to eat, lack of appetite, easy acid reflux, vomiting, abdominal distension, etc. after the session, eating is really a problem, how to gradually return to a normal diet?
Due to the removal of most of the stomach or even the whole stomach, a series of complications caused by poor food digestion or impaired nutrient absorption can occur. After the removal of a large part of the stomach or the whole stomach, attention should be paid to nutritional supplementation, but also must be combined with the patient’s own tolerance to diet, depending on the stomach capacity to adjust the amount and type of food as appropriate. Reasonable diet can enhance the whole body nutrition of postoperative gastric cancer patients, improve immunity and quality of life.
After all, after surgery, it is impossible to continue to eat and drink as much as before surgery. In order to minimize the discomfort after gastric surgery, the following principles should be followed to gradually transition back to normal or personally adapted eating habits
Eat less and eat more
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. Except for individual cases, drink as regularly as possible. Smaller and more frequent meals not only facilitate digestion and absorption, but also increase the total caloric intake and prevent weight loss. If you eat every two hours, you can prevent the occurrence of hypoglycemic syndrome. Small and frequent meals are an important dietary management for gastric surgery patients.
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 soup or beverage, they should pay attention to separate dry and thin, and try to eat soup 30 minutes before or after meal to prevent the food from being discharged too quickly to affect digestion and absorption; when eating, patients can adopt a semi-recumbent position or rest on their side after eating to prolong the time of food emptying so that it can be completely digested and absorbed.
Separate dry and thin food
In the early postoperative period, patients should eat according to the order of water, clear liquid, liquid food, semi-fluid, soft food and general food. The liquid diet should be rice soup, egg soup, vegetable soup and lotus root powder, 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. It is better not to have soup with rice for meals in the late postoperative recovery period, because the liquid beverage passes through the stomach and intestines too quickly and is easily brought down quickly along with the dry food piece. It should be appropriate to extend the residence time of food in the stomach and pass slowly through the small intestine to promote further digestion and absorption of food.
Expand the range of available foods
After the patient has recovered, the diet can be adjusted according to the recommendations of the Chinese Nutrition Society: 250-300 grams of cereals, 400-500 grams and 100-200 grams of vegetables and fruits respectively, 125-200 grams of animal foods such as fish, poultry, meat and eggs (50 grams of fish and shrimp, 50-100 grams of animal and poultry meat, 25-50 grams of eggs), 100 grams and 50 grams of milk and bean foods respectively, 25 grams of fats and oils The number and proportion of the above varieties do not need to be strictly evenly divided by day, but can be adjusted within a week. After entering the general diet, we should eat more vegetables, fruits and other foods with high fiber content to keep the stool open.
After gastric surgery, fecal excretion of carbohydrates, fats and proteins increases. After surgery, a high-calorie, high-protein diet should be supplemented, choosing foods that are easy to digest and have a full range of essential amino acids (such as eggs, fish, shrimp, lean meat, soy products, etc.), and protein supply should account for 15% to 20% of total energy, or be given at a standard of 1 to 2 g 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. Therefore, it is important to pay attention to the increase of foods with high iron content in the postoperative daily diet in appropriate amounts, such as spinach, eggplant, black beans, enoki mushrooms, black fungus, hairy vegetables, mulberries, grapes, peaches and red dates, as well as liver, red meat and seafood. 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 in the cells of the stomach lining. Patients with postoperative gastric cancer have impaired absorption of vitamin B12 and folic acid due to reduced secretion of endokines. 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.
Food taboos
1, avoid eating raw and 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, but we need to consider the amount and personal tolerance of these foods.
The above points are the basic principles of postoperative dietary adjustment for gastric cancer patients, and other aspects do not need to be too taboo. If there are symptoms such as fullness, bloating, diarrhea, dizziness, palpitations, etc., the patient should stop eating to prevent complications and start eating again after the symptoms disappear and improve.
Note: (Acid-producing foods: such as groundnuts, potatoes, overly sweet snacks and sweet and sour foods; gas-producing foods: such as raw onions, raw garlic, raw radishes, garlic cloves, onions, etc.; raw and cold foods: such as a lot of cold drinks, cold dishes, etc.; hard foods: such as bacon, ham, sausages, mussels, etc.; strong condiments: such as pepper, curry powder, mustard, chili oil, etc.)