Post-Gastrectomy Nutrition: Essential Guidelines for Recovery and Chemotherapy

Q: Post-Gastrectomy Nutrition: Essential Guidelines for Recovery and Chemotherapy

Hello： For patients who have undergone more than two-thirds of a gastrectomy, approximately 10-20% may experience discomfort symptoms such as abdominal distension, nausea, cramping, diarrhea, dizziness, weakness, increased pulse, and cold sweats about 10-15 minutes after consumin

Diet after gastric surgery?

I have a few questions for a nutritionist.
My mother is 53 years old and recently underwent surgery for stomach cancer, leaving her with only 1/4 of her stomach.
She is currently undergoing chemotherapy.

1.
What foods should my mother eat to better absorb nutrients? Are there any foods she should avoid?
2.
She cannot eat anything cooked with ginger after the surgery; when will she be able to eat it again?
3.
My mother finds fish soup tasteless and cannot drink it.
Can she consume miso soup, milk, yogurt, or Yakult?
4.
Some say she should not eat chicken because many chickens are injected with medications.
Is it safe for her to drink chicken essence?
5.
My mother experiences cramping in her intestines immediately after eating.
What should we do about this?
6.
During chemotherapy, she feels unwell, has a poor appetite, and experiences vomiting.
What foods can help her maintain her strength and nutrition?
Thank you very much for your assistance!

wers, 20~29 year old female. Ask Date: 2005/06/21

Dr. Shi Guimei reply Nutrition

Hello: For patients who have undergone more than two-thirds of a gastrectomy, approximately 10-20% may experience discomfort symptoms such as abdominal distension, nausea, cramping, diarrhea, dizziness, weakness, increased pulse, and cold sweats about 10-15 minutes after consuming a large amount of food when they start to take regular diets.
This condition is known as dumping syndrome.
To prevent the aforementioned symptoms, dietary management can follow these principles: 1.
Adopt a high-protein, low-carbohydrate, and moderate-fat diet.
2.
Avoid sugars, sweets, alcohol, and sugary beverages.
3.
Eat small, frequent meals, and avoid drinking soup or juice during meals; liquid foods can be consumed one hour before or after meals, or between meals, so it is best to drink chicken essence during these times.
4.
Maintain a semi-reclined position while eating, avoid eating too quickly, and lie on the left side for at least 30 minutes after meals to slow gastric emptying.
5.
Avoid foods that cause personal discomfort.
If the patient can tolerate the taste of ginger in cooked foods, a small amount can be used.
When experiencing discomfort, loss of appetite, and vomiting due to chemotherapy, the following principles can be followed: 1.
Avoid eating within 2 hours before chemotherapy to prevent vomiting.
2.
Eat small, frequent meals and avoid an empty stomach.
3.
Avoid consuming hot and cold foods simultaneously, as this may trigger vomiting.
4.
Vary cooking methods to stimulate appetite and choose foods with stronger flavors, such as mushrooms and onions.
5.
Avoid selecting foods with strong bitter flavors, as they may increase sensitivity to bitterness.
6.
If nutritional intake is poor, consider supplementing with balanced nutritional formulas between meals.
Sincerely, Dietitian Shih Kuei-Mei, Director of Nutrition, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2005/06/21

More Info

Post-gastrectomy nutrition is crucial for recovery, especially for patients undergoing chemotherapy. After a significant surgical procedure like a gastrectomy, the body undergoes various changes that affect digestion and nutrient absorption. Here are some essential guidelines and recommendations for your mother’s nutritional care:
1. Nutrient-Dense Foods: After a gastrectomy, it’s vital to focus on easily digestible, nutrient-dense foods. High-protein options such as eggs, lean meats (like turkey or fish), dairy products (like yogurt and cheese), and plant-based proteins (like tofu and legumes) are excellent choices. These foods help in muscle repair and recovery. Additionally, incorporating healthy fats from sources like avocados, nuts, and olive oil can provide essential calories without overwhelming the digestive system.

Foods to Avoid: It’s generally advisable to avoid high-fiber foods initially, as they can be difficult to digest. This includes whole grains, raw vegetables, and tough cuts of meat. Spicy foods, caffeine, and alcohol should also be limited, as they can irritate the stomach lining and exacerbate discomfort.

2. Ginger and Other Spices: Post-surgery, some patients are advised to avoid ginger due to its potential to stimulate gastric activity. However, this restriction may be temporary. It’s best to consult with a healthcare provider about when it might be appropriate to reintroduce ginger or other spices into her diet.

3. Soups and Broths: If your mother finds fish broth or miso soup unpalatable, she can try other broths or soups that are less intense in flavor. Dairy products like yogurt, milk, and probiotic drinks (like Yakult) can be beneficial, as they provide protein and probiotics that support gut health. However, if she experiences discomfort after consuming these, it may be wise to limit them and explore alternatives.

4. Chicken and Broths: Concerns about chicken and the use of chicken essence (chicken extract) are common. While some people worry about antibiotics and hormones in poultry, choosing organic or free-range chicken can mitigate these concerns. Chicken essence can be a good source of protein and may be consumed unless it causes discomfort.

5. Post-Meal Discomfort: Experiencing abdominal pain after eating can be a sign of "dumping syndrome," which is common after gastric surgery. This occurs when food moves too quickly from the stomach to the small intestine. To manage this, encourage smaller, more frequent meals rather than large portions. Eating slowly and chewing food thoroughly can also help reduce discomfort.

6. Chemotherapy and Nutrition: Chemotherapy can significantly impact appetite and cause nausea. To maintain energy and nutrition during this time, consider nutrient-rich smoothies made with fruits, vegetables, and protein powders. Soft foods like mashed potatoes, oatmeal, and smoothies can be easier to consume. Hydration is also crucial; encourage her to sip on clear fluids throughout the day.

If nausea persists, anti-nausea medications prescribed by her oncologist can help. Additionally, ginger tea or peppermint tea may provide some relief from nausea.

In summary, after a gastrectomy and during chemotherapy, it’s essential to focus on nutrient-dense, easily digestible foods while avoiding those that may cause discomfort. Regular consultations with a registered dietitian or nutritionist specializing in oncology can provide personalized guidance and support throughout her recovery. Always consult with her healthcare team before making significant dietary changes, especially during chemotherapy.

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