Diet After Esophagectomy

Transcription

1 Diet After Esophagectomy Diet for: Dietitian:, RD Telephone: Date: By following these guidelines you will help to manage symptoms that may occur following an esophagectomy (stomach pull-up). Modified Texture Diet After surgery, you may have swelling in your esophagus at the surgical site. At your follow up appointment, talk to your surgeon about when you can increase the texture of the foods you eat. 1. Choose only moist, very soft or minced foods for the first 3 weeks after your surgery (at least until your follow up appointment with your surgeon). 2. Chew your food very well. 3. Eat slowly and concentrate on chewing and swallowing at mealtimes. To Prevent Weight Loss 1. Eat often (every 2 hours). 2. Eat at least a few mouthfuls, even if you do not feel hungry. 3. Plan regular snacks and try not to skip them.

2 Type of Food Foods to Choose Foods to Avoid Milk and Milk Products Breads and Cereals Meats, Fish Poultry and Alternates Fruits and Vegetables Desserts and Sweets Other Whole milk, milkshakes Yogurt Cottage cheese Melted cheese, grated cheese, cheese sauce, cheese added to soups, casseroles and vegetables Cooked cereals, or cold cereal with plenty of milk to soften Soft pasta Crackers crumbled into soup to soften Cookies dipped in warm beverage to soften Ground meat or poultry or soft fish Use gravy or sauces to moisten Any soft, moist cooked, cut up meat or poultry Soft boiled, poached or scrambled eggs Soft tofu Soft cooked, moist beans and lentils Bananas Canned or soft fruits such as applesauce, fruit cocktail, canned peaches and pears, soft, peeled, cut up melon, ripe peaches or ripe pears Stewed or cooked fruits Avocado Canned or soft cooked vegetables Mashed, scalloped, and baked potatoes (without the skin) Custard, puddings, ice cream, mousses (Be cautious with all sweets, see You may have diarrhea or dumping syndrome below) Macaroni and cheese Cut up spaghetti with sauce Shepard s pie Lasagna Meat or chicken stew Meatloaf with gravy Soups (canned or homemade) Hard cheeses that have not been grated or melted Bread/toast All baked goods such as muffins, pita bread, pastries, scones, bagels, tortillas, croissants, etc. Granola Rice Dry and/or chunky meat fish or poultry Deep fried or breaded meat, fish or poultry Raw vegetables (except avocado) Raw fruit with the skins Cakes Hard cookies Pastries, tarts, pies Nuts, seeds, popcorn, chips 2

3 Snack Suggestions: Macaroni or potato salad made with mayonnaise Smoothies or milkshakes Custard or pudding Cream soup Fruit with yogurt Cottage cheese Peanut butter spread on a banana A scoop of tuna salad, egg salad or chicken salad Commercial nutritional supplements (for example, Boost, Ensure ). Discuss these products with the dietitian/nutritionist (may cause dumping syndrome). 4. Eat your biggest meal when your appetite is best. 5. Choose foods that have a lot of energy ( calories ) and protein. If you can only eat a small amount of food, make every bite count! (See list of high calorie, high protein food on page 5.) For example: choose whole milk. Add calories and protein to naturally low calorie foods like fruit and vegetables. Try yogurt, creamo, ice cream, sour cream, and whipped cream on fruit. Try cheese sauce, white sauce, gravy, and butter or margarine on vegetables. 6. Be creative. You do not need to eat breakfast foods only at breakfast or supper foods only at supper. 7. Make a list of foods you enjoy and tolerate well. Keep this list handy so you do not need to think up new ideas for snacks or meals. 8. If only a few foods appeal to you, eat these foods as often as you like. 3

4 To Control Early Satiety 1. Eat small amounts of food, about ml (1-2 cups) six times a day. 2. Eat and drink often (every one to two hours). Your smaller stomach will not allow you to eat enough at meals alone. 3. Eat solid food on its own, without drinking liquids. Drink liquids 30 minutes before or after meals, rather than with meals. You May Have Diarrhea or Dumping Syndrome 1 2 hours after high sugar foods you may feel: Cramps Shakes Sweats Rapid heart beat To control this: 1. Find out your tolerance to sugar (the amount of sugary food you can handle without getting dumping symptoms). Start with small amounts of simple sugars (white sugar, brown sugar, syrup, honey, jelly, jam, liqueurs, wine) at first. 2. Eat only until you feel full. 3. Eat smaller amounts of food and eat more often (six times daily). 4. Separate solids and liquids at mealtimes. 5. Avoid foods that are natural laxatives, such as prunes, figs, flax and licorice. 6. Chew your food well. Relax while you eat. Eat slowly. diarrhea does not stop, contact your doctor or dietitian/nutritionist. 4

5 To Control Reflux 1. The most important tip is to not bend over at the waist especially after meals. Bend at the knees to pick up objects or to tie your shoes. 2. Do not lie down for at least one hour after eating or drinking. 3. Do not eat or drink two hours before bedtime. 4. When resting or sleeping, do not lie flat. You may need to raise the head of your bed cms (6-8 inches) with blocks. 5. Eat small amounts of food and eat more often to avoid over filling your stomach. If reflux continues to be a problem you can try the following tips: 1. Avoid spicy foods, especially those made with black, red or chili peppers. 2. Avoid acidic foods such as citrus fruits or juices, if you do not tolerate them. 3. Avoid alcohol and smoking. 4. Avoid any other foods that cause reflux for you. Notes 1. Weigh yourself once a week. If you are losing weight you need to eat more food or you need to eat more often. 2. If you continue to lose weight, contact the Dietitian/nutritionist or your doctor. 3. Take a multivitamin with minerals daily for six months, then several times a week (if you are eating well). 4. Have your family doctor check your vitamin B12 and iron levels in blood yearly. 5

6 High Energy (Calorie) Foods (for Weight Gain) Food Item Butter/Margarine Sour Cream Mayonnaise Cream (Half & Half) Whipping Cream Cream Cheese Ice Cream Vegetable Oil Use In/On Hot cereal, soup, cooked vegetables, potatoes Potatoes, cooked vegetables, soup, meat salads, sauces, dips Salads, devilled egg, dips Hot chocolate, soup, pudding, cereals, coffee, tea Puddings, hot chocolate, coffee, fruit, gelatin, other desserts Vegetables, fruit Eggnogs, milkshakes, fruit nog (see recipe section), gelatin, soft drinks Sautéed meats or vegetables Protein Boosters (for Tissue Repair) Food Item Milk Skim Milk Powder Meat, Fish, Poultry Eggs Cheese grated Cottage Cheese Peanut Butter Use In/On Cereal, gravy, soup, sauces, milkshakes, custard, pudding, creamed entrees or vegetables Cooked cereal, hot chocolate, soup, pudding, eggnogs, milkshakes, gravy, sauces, creamed entrees and vegetables Casseroles, soup, salads, crackers Eggnogs, fruitnogs (see recipe section), custard, puddings Finely chopped and blended into sauce, gravy, meat or vegetable salads Clear broth Cream sauce, egg dishes, casseroles, noodles, cooked vegetables Fruit, dips Sauces, spread on bananas, soft pears Adapted from The Manual of Nutritional Care, by BCDNA. 6

7 For more copies, go online at or and quote Catalogue No. FK.300.D566 Vancouver Coastal Health, November 2013 The information in this document is intended solely for the person to whom it was given by the health care team.