Essential Nutrition Tips for Stomach Cancer Patients: A Guide

Q: Essential Nutrition Tips for Stomach Cancer Patients: A Guide

Hello Evelyn： After a total gastrectomy, the diet does not necessarily require food to be pureed. <br>It can gradually transition from liquids to soft solids (such as eggs, rice, and minced meat) based on chewing ability. <br>It is important to chew thoroughly and eat small, freq

How should gastric cancer patients eat?

Your father is a 58-year-old patient with gastric adenocarcinoma.
He was hospitalized at Veterans General Hospital from July 1, 2002, and underwent a total gastrectomy on July 3, 2002.
He was discharged home for recovery on July 17, 2002.
I would like to ask the following questions:
1.
Currently, we are using a food processor at home to puree his food into a paste-like consistency.
Is it necessary to puree the food?
2.
My father eats six meals a day at regular intervals, with each meal approximately 240 grams.
When can we increase the portion size (whether for milk or rice)? Is weighing the food necessary?
3.
Are there any foods that my father should avoid?
4.
My father currently has normal swallowing, bowel movements, and gas passage, but he often experiences dizziness and has nearly fainted on occasion.
Could this indicate anemia? How should we supplement with relevant foods or medications?
5.
My father receives a monthly injection of 1cc of vitamin B12.
Can we supplement with oral vitamin B12 added to his meals?
Thank you for your response.

Evelyn, 20~29 year old female. Ask Date: 2002/08/20

Dr. Zhang Yujun reply Nutrition

Hello Evelyn: After a total gastrectomy, the diet does not necessarily require food to be pureed.
It can gradually transition from liquids to soft solids (such as eggs, rice, and minced meat) based on chewing ability.
It is important to chew thoroughly and eat small, frequent meals, gradually increasing portion sizes.
In fact, excessive liquid intake can lead to "dumping syndrome," which is a common discomfort occurring 20 to 30 minutes after meals, including symptoms such as upper abdominal fullness, facial flushing, and cold sweats.
Weighing meals is not essential; rather, changes in your father's weight post-surgery can serve as a nutritional indicator (but attention should be paid to changes in food intake).
Dietary considerations include avoiding greasy and high-sugar foods, while focusing on high-protein and soft-textured options.
It is advisable to limit coarse, high-fiber foods (such as hard bamboo shoots and roots), gas-producing foods (like bell peppers, onions, and legumes), and irritants (such as coffee, strong tea, and spicy foods).
Food temperature should be moderate, and it is best to lie down for 20 to 30 minutes after meals instead of standing.
Due to poor absorption of certain nutrients, anemia can easily occur; therefore, it is beneficial to include foods rich in iron (such as organ meats, red meats, and egg yolks), folate (fresh green leafy vegetables and lean meats), protein (dairy, meat, eggs, fish, and soy products), and vitamin C (dark green, yellow, and red vegetables, as well as citrus fruits).
This type of surgery can lead to a deficiency of "intrinsic factor," which affects the absorption of oral vitamin B12, necessitating supplementation through injections.
If your father's weight drops rapidly and he is unable to increase his food intake, it is important to consult a nutritionist for assessment as soon as possible.

Reply Date: 2002/08/20

More Info

When caring for a stomach cancer patient, especially one who has undergone a total gastrectomy, it is crucial to focus on nutrition to support recovery and maintain health. Here are some essential nutrition tips and answers to your specific questions regarding dietary management for your father, who is 58 years old and recovering from stomach cancer surgery.

1. Food Texture: After a total gastrectomy, patients often need to modify their diet to accommodate their new digestive capabilities. While it is common to start with pureed foods to ease swallowing and digestion, it is not always necessary to keep food in a completely mushy state. As your father’s swallowing ability improves, he can gradually transition to soft, well-cooked foods that are easy to chew, such as scrambled eggs, soft fruits, and well-cooked vegetables. The key is to ensure that he chews his food thoroughly and eats slowly to prevent discomfort.

2. Meal Frequency and Portion Size: Eating smaller, more frequent meals is beneficial for patients post-surgery. Your father is currently consuming six meals a day, which is excellent for maintaining energy levels and preventing feelings of fullness that can occur with larger meals. As he adjusts to his diet and if he feels comfortable, you can gradually increase the portion size of each meal. Monitoring his weight can serve as a good indicator of whether he is getting enough nutrition. If he is maintaining or gaining weight, it may be appropriate to increase meal sizes.

3. Foods to Avoid: After stomach surgery, certain foods can cause discomfort or digestive issues. It is advisable to avoid high-fiber foods that can be hard to digest, such as raw vegetables, whole grains, and tough meats. Additionally, spicy foods, caffeine, and carbonated beverages may irritate the digestive tract and should be limited. Instead, focus on high-protein, low-fiber foods that are easier to digest, such as lean meats, dairy products, and eggs.

4. Symptoms of Anemia: The dizziness and near-fainting episodes your father is experiencing could indeed be signs of anemia, which is common after gastric surgery due to potential deficiencies in iron, vitamin B12, and folate. It is essential to include iron-rich foods in his diet, such as red meat, poultry, fish, and fortified cereals. Foods high in vitamin C, like citrus fruits, can enhance iron absorption. If he continues to feel unwell, it would be prudent to consult with a healthcare provider for blood tests to assess his hemoglobin levels and determine if supplementation is necessary.

5. Vitamin B12 Supplementation: After a total gastrectomy, the body’s ability to absorb vitamin B12 is significantly impaired due to the loss of intrinsic factor, which is necessary for B12 absorption. While your father is receiving monthly B12 injections, oral supplements may not be effective due to absorption issues. It is best to continue with the injections as prescribed by his healthcare provider. If he prefers, he can discuss with his doctor the possibility of taking sublingual B12 supplements, which may be better absorbed.

In conclusion, managing the diet of a stomach cancer patient requires careful consideration of food texture, meal frequency, and nutritional content. It is essential to work closely with a registered dietitian or nutritionist who specializes in oncology to create a personalized nutrition plan that meets your father's specific needs. Regular follow-ups with healthcare providers will help monitor his recovery and nutritional status, ensuring he receives the best possible care during this challenging time.

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