Eating after a Gastrectomy

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1 Patient Education diet and nutrition It is important to reduce your intake of concentrated sweets following a gastrectomy. Eating after a Gastrectomy This information describes post-gastrectomy diet guidelines. After stomach surgery, some patients may have what is commonly known as dumping syndrome. This occurs within 30 minutes after eating. Signs may include: Nausea Vomiting Diarrhea Cramping Dizziness A cold sweat Dumping syndrome is caused by food passing from the stomach to the small intestine too quickly. To avoid dumping syndrome: Eat 3 small meals and 3 snacks daily Have a protein food with each meal and snack Reduce your intake of concentrated sweets Drink liquids before or after rather than with meals General Guidelines Eat at least 6 times per day, 3 small meals and 3 snacks. You may be able to tolerate larger portions over time, but keep servings small at first. Eat slowly and chew food well. Try to relax while eating. Lying down right after eating may lessen signs of dumping syndrome.

2 Drink liquids 30 minutes before or after meals, but not with your food. Remember that soup and milk are liquids. With time, you may be able to tolerate small amounts of liquid (about ½ cup) with meals. Avoid concentrated sweets, sugar and foods sweetened with sugar (see food lists). Limit fruit to 2 or 3 servings per day and avoid fruit juice due to its natural sugar content. Read labels on sugar-free products. They may contain other types of sugar such as syrups, honey, fruit juice concentrate, fructose, lactose, dextrose, maltose, sorbitol, xylitol or mannitol. Include a good protein source with each meal or snack. High protein foods include meat, poultry, fish, eggs, cheese, milk, yogurt, peanut butter, nuts and dried beans and peas. You may wish to take a multi-vitamin if you have diarrhea or do not tolerate many foods. Depending on the type of surgery, specific vitamins may be suggested; check with your doctor or dietitian first. Refer to the following charts to help with meal planning. If dumping syndrome persists, or if you cannot maintain a normal body weight, contact your doctor or registered dietitian. Dietitian Phone number

3 Food Group and Daily Amount Beverages Serving Size Food 8-12 servings 1 cup Water, milk, coffee, tea, soup, broth, artificially sweetened carbonated beverages, artificially sweetened and flavored drinks. Food Not Chocolate milk, milkshakes, all sugar-sweetened beverages, alcohol and regular soda. Breads/Starches 4 or more servings 1 slice bread, ½ roll or bagel, ½ cup cooked starches, 6 crackers, ¾ cup of dry cereal Protein Source Whole grain or enriched breads, bagels, English muffins, crackers, potatoes, enriched rice, barley, noodles, macaroni, spaghetti and other pastas, popcorn and unsweetened dry or cooked cereals. Sugar-sweetened breads such as sweet rolls, coffeecake, muffins, breakfast bars, donuts, sugarsweetened cereals, and any starches prepared with syrup or sweetened sauces. With each meal and snack 1-3 oz. meat, fish, poultry or cheese, ¼ - ½ cup tuna or cottage cheese, 1-2 eggs, 1 cup plain or artificially sweetened yogurt, 1-2 tsp. peanut butter All fresh, frozen, canned or cured lean meats, poultry, fish, and shellfish, eggs, cheese, yogurt, peanut butter, nuts, dried peas and beans, mixed dishes with gravy or unsweetened sauces, cottage cheese. Entrees with sweetened sauces.

4 Food Group and Daily Amount Serving Size Food Food Not Vegetables 2 or more servings 1 cup raw, ½ cup cooked, ½ cup juice Fruits 2 or 3 servings 1 medium piece, ½ cup cooked or canned, ½ cup juice Fats All fresh, frozen or canned vegetables. All fresh fruits, frozen or canned fruit in unsweetened fruit juice. All vegetables with added sugar or sweetened sauces. Dried fruit, fruit in sweetened syrup. 6 or more servings 1 tsp. Margarine, butter, mayonnaise, vegetable oils, cream, cream substitutes, sour cream, cream cheese, bacon, salad dressings. Sweetened cream cheese, honey butter, salad dressings made with honey. Food Food Not Desserts Sugar-free gelatin, plain or artificially sweetened yogurt, sugar-free pudding. Plain cake, cookies (no frosting or icing). Sweets Artificial sweetener (aspartame, saccharin), sugarless gum, artificially sweetened hard candy (limit to 3 pieces per day), diet syrup, all fruit preserves, low sugar jelly. Ice cream, pudding, custard, pastries, pies, cakes, frosting, cookies, fruit ices, sherbet and gelatin. Sugar, candy, honey, jam, jelly, molasses, marshmallows, syrup, low calorie syrup, sweetened toppings, chocolate. Condiments Salt, pepper, herbs, spices, unsweetened sauces, flavorings, 1 Tbsp ketchup. Sweet and sour sauce, honey glazes, other sweetened sauces.

5 Sample Menu/Schedule Food Fluids* Breakfast 8:00 a.m. 1 boiled egg ½ cup oatmeal with margarine or butter 8:30 a.m. 1 cup coffee with sugar substitute and 1 cup milk Snack 10:00 a.m. 1 oz. cheese and crackers 1 piece of fruit 10:30 a.m. 1 cup water Lunch Noon. 3 oz. beef patty on bun, lettuce, tomato, mayonnaise 12:30 p.m. 1 cup milk Snack 2:00 p.m. 1 small banana 1 cup plain yogurt 2:30 p.m. 1½ cups soup Dinner 6:00 p.m. 3 oz. baked chicken ½ cup broccoli ½ cup rice with margarine or butter Garden salad with French dressing 6:30 p.m. 1 cup water Snack 8:30 p.m. 4 graham crackers with 2 tsp peanut butter 9:00 p.m. 1½ cup tea (unsweetened or with sugar substitute) * Fluids may be taken 30 minutes before instead of 30 minutes after each meal.

6 Health Information Resources For more information, visit one of Northwestern Memorial Hospital s Health Learning Centers. These state-of-the-art health libraries are located on the third floor of the Galter Pavilion and on the first floor of the Prentice Women s Hospital. Health information professionals are available to help you find the information you need and provide you with personalized support at no charge. You may contact the Health Learning Centers by calling LINK (5465) or by sending an to For additional information about Northwestern Memorial Hospital, please visit our Web site at Developed by: Registered Dietitians, Nutrition Services October Northwestern Memorial Hospital (10/07) 6

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