Dietary Guidelines After Early Stomach Cancer Surgery: What You Need to Know

Dietary Recommendations After Surgery for Early Gastric Cancer

Dear Doctor,
I would like to inquire about dietary recommendations after early-stage gastric cancer surgery for my father, who is 71 years old.
He maintains a regular daily routine and has a light diet.
In early April, he was diagnosed with gastric cancer and underwent a subtotal gastrectomy (2/3) on April 26.
After testing, it was confirmed to be early-stage gastric cancer.
On the sixth day post-surgery, he had his nasogastric tube removed after passing gas, and the following day he began drinking water, followed by a full liquid diet.
He was discharged on the tenth day, but the doctor did not provide specific dietary advice, only suggesting small, frequent meals.
At home, he first drinks bird's nest soup upon waking, has a cup of nutrient soup for breakfast, and if he feels hungry around 10:00 AM, he can have another cup of nutrient soup with blue-green algae.
For lunch, he has a thick rice porridge with small fish and steamed potatoes and pumpkin alongside the porridge and blue-green algae.
If he feels hungry around 3:00 PM, he can have another cup of nutrient soup, and dinner is similar to lunch.
I would like to ask the nutritionist the following questions:
1.
Is this dietary arrangement problematic? How long will it take before he can eat solid foods and vegetables like a normal person?
2.
Besides the basic principles of small, frequent meals and low sugar, what other recommendations and precautions should be considered?
Thank you for your assistance.
Arno

Arno, 40~49 year old female. Ask Date: 2005/05/10

Dr. Shi Guimei reply Nutrition

Hello! Your father underwent a gastrectomy about half a month ago.
From your description, the patient has been able to consume a low-fiber soft diet.
Currently, he can attempt soft foods for all three main meals (meaning all ingredients should be cooked until soft, while ensuring nutritional balance).
He can also try eating rice, but it should be cooked softer.
For vegetables, he may choose soft options like gourds or tender greens, and for fruits, he can try small amounts of softer varieties like melons.
If he experiences no discomfort, he can gradually increase the quantity; if there is any discomfort, he should revert to the original low-fiber soft diet (which is his current dietary pattern) and then try small amounts again after a few days (dietary progression should be based on the patient's adaptability, which can vary significantly among individuals).
For snacks, he can consume milk or balanced nutritional supplements.
Sincerely, Dietitian Shih Kuei-Mei, Director of the Nutrition Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2005/05/10

More Info

After undergoing surgery for early-stage stomach cancer, it is crucial to follow specific dietary guidelines to support recovery and overall health. Here are some recommendations and considerations for your father’s post-operative diet, particularly after a subtotal gastrectomy (removal of two-thirds of the stomach).

1. Initial Dietary Phases:
Post-surgery, patients typically progress through several dietary phases:
- Clear Liquids: Initially, clear liquids (water, broth, and clear juices) are introduced to ensure hydration and allow the stomach to heal.

- Full Liquids: Once the patient can tolerate clear liquids without discomfort, full liquids (including smoothies, yogurt, and protein shakes) can be introduced.

- Soft Foods: Gradually, soft foods such as mashed potatoes, well-cooked vegetables, and pureed fruits can be added. This phase usually begins around a week after surgery, depending on individual tolerance.

2. Nutritional Considerations:
- Small, Frequent Meals: As advised, eating small, frequent meals (5-6 times a day) is essential. This approach helps manage the reduced stomach capacity and aids digestion.

- Balanced Diet: Ensure that meals are balanced and include a variety of food groups: proteins (lean meats, fish, eggs, legumes), carbohydrates (whole grains, starchy vegetables), and healthy fats (avocado, olive oil). This balance is vital for healing and energy.

- Hydration: Encourage adequate fluid intake, but avoid drinking large amounts during meals to prevent discomfort. Instead, drink fluids between meals.

3. Foods to Avoid:
- High Sugar and Processed Foods: Limit sugary foods and beverages, as they can lead to dumping syndrome, which is common after gastric surgery. This syndrome can cause symptoms like nausea, diarrhea, and abdominal cramps.

- Spicy and Irritating Foods: Avoid spicy foods, caffeine, and alcohol, as they can irritate the stomach lining and cause discomfort.

- High-Fiber Foods: Initially, high-fiber foods (like raw fruits and vegetables) may be difficult to digest. Gradually introduce them as tolerated.

4. Reintroducing Solid Foods:
- After a few weeks, and once your father feels comfortable, he can start reintroducing solid foods. Start with soft, easily digestible options and gradually increase the variety and texture.

- It may take several weeks to months before he can comfortably eat a diet similar to what he consumed before surgery. Patience is key, and it’s essential to listen to his body’s signals.

5. Monitoring and Support:
- Nutritional Counseling: Consider consulting a registered dietitian who specializes in oncology nutrition. They can provide personalized dietary advice and help create a meal plan tailored to your father’s needs.

- Regular Follow-ups: Keep regular appointments with his healthcare team to monitor recovery and nutritional status. Blood tests may be necessary to check for deficiencies, especially in vitamins and minerals like B12, iron, and calcium, which can be affected by gastric surgery.

6. Psychological and Emotional Support:
- Recovery from cancer surgery can be emotionally challenging. Encourage open communication about feelings and concerns, and consider support groups or counseling if needed.

Conclusion:
In summary, after early-stage stomach cancer surgery, a gradual transition from liquids to soft foods, followed by solid foods, is essential. Emphasizing small, frequent meals, balanced nutrition, and hydration will support recovery. Avoiding irritants and high-sugar foods is crucial to prevent complications. Regular follow-ups with healthcare providers and possibly a nutritionist will ensure your father receives the best care during his recovery journey.

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