Gastrectomy and GI reconstruction result in altered anatomic relationships in the GI tract and a range of physiological abnormalities. The result of partial or total gastrectomy is a significant reduction in food intake and partial or total loss of digestive function, combined with a reduction in secretion of some factors, making patients with gastric cancer very susceptible to poor nutrient absorption, anemia, weight loss, and obstruction, dumping syndrome, and postprandial hypoglycemia after gastrectomy. The first thing you need to do is to make a long-term diet plan and learn how to “eat”.
Cultivate good eating habits
- Eat smaller, more frequent meals and avoid satiety
After gastrectomy, stomach volume is significantly reduced, food is not easily digested, and nutrient absorption is low. Only by increasing the number of meals can we compensate for the insufficient amount of food each time and reduce the obstruction caused by eating too much, improve the absorption rate of nutrients, and thus obtain adequate nutrition. Usually 5 to 6 meals per day is appropriate.
- Chew and swallow slowly
After gastrectomy, the stomach loses some of its function as a digestive organ, resulting in inadequate food grinding. Therefore, it is important to chew and swallow slowly when eating to reduce the burden of processing food in the remnant stomach.
- Timing
Cultivating good dietary habits and eating regularly and quantitatively allows the gastrointestinal tract to move and rest regularly, increasing the rate of food digestion and absorption, helping to keep the gastrointestinal tract in good functional condition and reducing the occurrence of complications.
Choose foods appropriately
- Supplement a high-protein diet
Protein in food should supply 15% to 20% of the total energy. It is recommended to choose foods that are easy to digest and have a full range of essential amino acids, such as fish, eggs, shrimp, lean meat, and soy products. Fish, in particular, is rich in protein, has similar amino acids to the human body, is high in unsaturated fatty acids, and is easy to digest and absorb.
- Appropriate control of sugar intake
Sugar supply should be 50% to 60% of total calories. Even six months after gastrectomy, some patients still have symptoms such as panic, sweating, dizziness, nausea, upper abdominal discomfort, and walking Louis lopsided after eating sweets, i.e., late dumping syndrome. To prevent the above from happening, patients should eat less sweets, eat easy-to-digest salty foods in moderation, control the speed of eating, and eat a quantitative and moderate diet. Avoid overly sweet foods, and the sugar consumed should be mainly starchy foods, such as rice, pasta, sweet potatoes, corn, yams, etc.
- Eat more fiber-rich foods such as vegetables and fruits
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Control fat intake
Fats should supply no more than 35% of total energy, avoid animal fats, and choose fats that are easy to digest and absorb, such as vegetable oils, creams, egg yolks, etc.
Gastrectomy predisposes to iron deficiency anemia and megaloblastic anemia due to insufficient absorption of iron and vitamins. Patients can eat moderate amounts of animal liver, fresh vegetables, meat, fish, shrimp, animal blood, egg yolk, soy products (e.g., red soybeans), dates, cinnamon, wolfberries, and other foods rich in protein, vitamins, minerals, and iron.
- Refrain from eating spicy and stimulating, too cold and too hot foods.
Stimulating foods tend to damage the mucous membrane of the mouth and gastrointestinal tract, leading to dysfunction of the gastrointestinal tract, causing diarrhea and resulting in impaired nutrient absorption.
In general, it is important to choose the proper food combination and develop good eating habits after gastrectomy under the guidance of the doctor. The impact varies with the extent of resection. For total gastrectomy, the development of dietary habits is more rigorous than for major gastrectomy, with more frequent meals and smaller amounts per meal, more conservative dietary transitions, fluid, semi-liquid, and soft foods that will take longer or even a lifetime, more reasonable food combinations, and even selective supplementation with some vitamin and mineral preparations. (Contributed by Pengliang Wang, Department of Gastrointestinal Oncology, The First Hospital of China Medical University)