Dietary advice following Oesophagectomy, Oesophagogastrectomy or Gastrectomy

Transcription

1 University Teaching Trust Dietary advice following Oesophagectomy, Oesophagogastrectomy or Gastrectomy Ladywell Building Dietitian All Rights Reserved Document for issue as handout. Unique Identifier: CS 55 (16). Review date: November 2018.

2 Name: Types of surgery Partial/Distal Gastrectomy The removal of part of your stomach. Dietitian: Telephone number: Stomach Part of stomach removed Remaining stomach re-attached Your dietitian Good nutrition is an important part of your treatment and often patients can find it challenging getting the diet right. Total Gastrectomy The removal of all of your stomach. The dietitians will support you before your surgery, throughout your inpatient stay and afterwards in clinic to help you make changes to your diet. Please do not hesitate to contact us on the number above if you have any questions regarding your nutrition. Stomach All of stomach removed Oesophagus attached to small bowel 1 2

3 Oesophagectomy / Oesophagogastrectomy This operation involves the removal of all/part of the oesophagus (gullet) and in some cases it may involve the removal of part of your stomach. Oesophagus After your surgery It is important to maintain good nutritional intake at all stages of your treatment especially after surgery. This will help with your recovery, aid wound healing and will also help to minimise weight loss. Section of oesophagus removed Things to expect following your surgery/treatment l Reduced appetite and desire to eat l Feeling of fullness soon after eating l Smaller portion sizes l Taste changes l Tiredness l Changes in your weight. Stomach pulled up higher in chest Main principles We recommend a soft diet for 4-6 weeks post-surgery to protect the surgery site. l Foods should be easily mashed with a fork l Foods should not contain sharp edges, skins/pips or seeds l Foods can be moistened with gravy, sauces or butter l Chew foods well and avoid swallowing large, hard lumps. Follow a little and often meal pattern l Aim for 5-6 small meals per day, eating every 2 hours l Start with palm sized portions l Serve meals on a side plate to avoid being over faced. Avoid large volumes of fluids at meal times (for 30minutes before and after). Maintain good posture at meal times. If you suffer from reflux avoid eating late at night and ensure you are sleeping propped up. Making the most of your intake Choose high energy and high protein foods. Use full fat products where possible and avoid diet or sugar free options. Try to include some fruit and vegetables in your diet to provide important vitamins and minerals. l Ensure vegetables are well cooked and soft l Choose tinned, stewed or soft fruits with cream or ice cream or custard l Have a small glass of fruit juice. 3 4

4 Meal ideas Breakfast Main meals Puddings Snacks l Cereal or porridge with full fat milk and ground almonds l Full fat yoghurt with mashed banana l Omelette, poached or scrambled eggs (2 eggs) l ½ tin of spaghetti in tomato sauce. l Poached fish with mashed potato l Savoury mince (beef, lamb, poultry, soya) with mashed potato l Cottage/shepherd s pie l Pasta- spaghetti bolognese, lasagne l Corned beef hash l Stews, casseroles or curries made with tender meat and well cooked vegetables with mashed potato l Omelette, poached or scrambled eggs l Skinless sausages Can be eaten minutes after eating if you are feeling too full. l Milky puddings e.g. rice pudding, semolina, sago, tapioca, custard l Stewed fruit, soft tinned fruit or mashed banana with custard/double cream or ice cream l Full fat yoghurt, fromage frais, mousse, trifle, tiramisu, crème caramel or instant whip l Sponge and custard l Ice cream. l Cereal or porridge with full fat milk and ground almonds l Glass of fortified milk with 2 biscuits or piece of cake l Full fat yoghurt with mashed banana l Jelly and ice cream l Houmous l Smooth peanut butter l 2 Scrambled eggs with butter l Avocado with prawn cocktail. l Dahl l Jacket potato (without skin) with tuna mayonnaise or cheese. 5 6

5 Small meal ideas What does 300 calories and 10-15g protein look like? 1. 2 Scrambled eggs with butter and grated cheese. 2. ½ ripe avocado with 50g small cooked prawns and 1 ½ tablespoons of mayonnaise tablespoon full fat Greek yoghurt with ½ mashed ripe banana, 1 tsp ground almonds and drizzle with honey. 4. ½ tin Rice pudding with double cream and jam. 5. ½ jacket potato with ½ tin Tuna/salmon mayonnaise or grated cheese/cottage cheese and butter. 6. Mashed potato with butter, corned beef or cheese. Adding extra nourishment to your diet. l Use full fat milk. Aim for 1 pint of milk spread throughout day l Add 2-4 tablespoons of milk powder to 1 pint of full fat milk to increase calories and protein (Fortified milk) l Try adding double cream to porridge, soups, sauces or puddings and try pouring it on fruit, cakes and other desserts l Add extra butter, margarine, mayonnaise, salad cream to your food l Add extra cheese to sauces, vegetables, potato and pasta. l Add olive oil or butter to cooked pasta or rice l Add jam, honey or syrup to drinks, cereal and puddings l Choose thick/creamy yoghurts and other desserts. Avoid diet or low fat versions l Add ground nuts to porridge or milky puddings. Example meal plan Breakfast: Porridge with fortified full fat milk Mid am: Greek yoghurt and honey with mashed banana Lunch: Cottage pie and mashed swede/ carrots Mid pm: Sponge and custard Evening meal: Cheese omelette Supper: Glass of warm fortified milk and 2 biscuits 7 8

6 Dumping Syndrome Dumping syndrome describes a group of symptoms that you may experience after your surgery. It happens when food moves too quickly into your small intestine. Early dumping syndrome Occurs minutes after eating. Symptoms include: feeling full quickly, nausea, bloating, cramps, diarrhoea, dizziness, feeling tired, and rapid heart rate. How to avoid dumping syndrome Changing what you eat can decrease the symptoms of both early and late dumping syndrome. l Eat small regular meals l Avoid large volumes of fluids with meals l Limit simple, added sugars e.g. sugary/fizzy drinks, cakes/biscuits and sweets. Use artificial sweeteners if necessary l Take your time with eating, chew foods well. Foods to avoid 6 Sugar/glucose Sugary drinks Jam, marmalade, honey Sweets, cakes and biscuits Tinned fruit in syrup Notes Foods to choose 4 Artificial sweeteners Diet/low calorie drinks Low sugar jam, marmalade, smooth peanut butter Plain biscuits Tinned fruit in juice/water Late dumping syndrome Occurs one to four hours after eating. If you experience these symptoms you may feel better if you lie down for 30 minutes and eat a snack. Symptoms include: sweating, shakiness, having a hard time focusing and hunger. Symptoms of late dumping syndrome are from an imbalance in your blood glucose (sugar) levels. 9 10

7 G W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2016 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: CS 55 (16) Review Date: November 2018 University Teaching Trust For further information on this leaflet, it s references and sources used, please contact Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. InterpretationandTrans@srft.nhs.uk Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone If you would like to become a Foundation Trust Member please visit: for-members If you have any suggestions as to how this document could be improved in the future then please visit: for-patients