Diet after gastrectomy. Necessary diet after stomach removal for cancer

According to statistics, it is one of the most dangerous and common diseases. To date, the most effective and in an effective way The treatment of the disease is surgery. Stomach surgery is very difficult, so for her successful implementation You must very strictly follow all medical instructions, especially those related to nutrition. During the preoperative period, food should be rich in proteins, have a certain liquid content and be rich in vitamins, and in some cases this food must be pureed. But the quality, volume, and quantity of food intake after surgery still has higher value for the patient's health and even life.

Since during this period the patient is completely unable to eat through the mouth, his nutrition is produced by intravenous administration various nutrients containing proteins and amino acids. The composition of the mixtures, as well as their volumes during this period, are determined by the doctor, based on the results of a blood test. Naturally, this cannot continue for long. Usually starvation diet lasts two days after the operation, and on the third day, if there is no congestion in the stomach, the doctor gives the go-ahead for a weak “gull”. As a rule, this is a decoction made from rose hips or a not very sweet compote, but not containing berries. The diet allows you to take this drink in small portions; it is permissible to take 20-30 milliliters at a time five or six times throughout the day. At the same moment, doctors prescribe protein enpit. Immediately over two to three days, 30-50 milliliters of enpite solution are administered per day. While the probe is installed, enpit is administered through it; after the probe is removed, enpit is administered through the mouth. Gradually, the amount of protein enpit increases and is brought to the physiological norm.

Extended postoperative diet

This period begins 3-4 days after a successful operation. First, meat soups are gradually introduced into the food, as well as pureed curd soufflé, boiled egg or a little fish. On days 5-6, omelettes, pureed porridges and even vegetable purees. True, portions should be very small, 50 grams, no more. If such nutrition does not cause problems, foods containing proteins are included in the diet. The volume of food gradually increases. If at first it is 50 milliliters, on the third day the portion can be increased to 200-250 milliliters. By the seventh day, the volume increases to 300-400 milliliters.

Gentle diet

After two weeks after the operation, the patient who has had his stomach removed for cancer is transferred to a gentle diet, which can last up to four months of his life. However, if the patient has gastritis of the gastric stump, anastomositis or peptic ulcer, the diet can last much longer. During this very important period, the most important task is prevention. possible formation a patient with dumping syndrome. Nutrition during this period has a number of features. First, the patient must receive food with a high protein content and adequate (meets normal) content complex carbohydrates. At the same time, easily digestible carbohydrates (sugar, sweets, canned juices, cookies and cakes, sweet drinks). Secondly, the food should not contain excess fat, and fat breakdown products that are obtained during frying (most often acrolein and various types of aldehydes) are completely undesirable. In addition, dishes that can stimulate increased bile secretion or increased secretion of the pancreas are completely contraindicated in the menu. Dishes that can cause dumping syndrome are strictly contraindicated. These are milk porridges, including semolina, tea with added sugar, sweets warm milk, hot and containing increased amount fat soup You can give meat, but it must be very chopped. At the same time, side dishes should not be wiped. Smeared porridge or well-mashed potatoes are recommended as a side dish. All of these dishes listed must be steamed. All salads should be completely removed from the diet. fresh vegetables and black bread, beloved by many. Third meals for the patient are prepared without the use of traditional sugar. To sweeten third courses in the nutrition menu, you can use xylitol, but its amount should not exceed 10-15 grams per serving.

List of products that are allowed on the patient’s menu :

• Bread. This product can be bread baked yesterday, crackers obtained by drying wheat bread, or unsweetened, completely sugar-free cookies. Fresh bread can be included in the diet no earlier than a month after surgery.
• Soup. As a rule, vegetable with cereal. Products that should not be included in soup white cabbage and millet.
• Meat. Boiled or steamed lean chicken, beef, rabbit or turkey meat, as well as pike, bream, carp, hake.
• Egg. The most popular is the soft-boiled egg, but you should remember that you can include no more than one egg in your diet in one day.
• Dairy products and milk. This can be milk with tea or milk as part of other dishes. If there are no problems with tolerance, then you can drink whole milk. Sour cream is included in the diet solely as an additive, nothing more. Kefir can be included in the menu no earlier than two months after a successful operation. You can also include pureed, fresh, non-sour cottage cheese.
• Greens and vegetables are included only in pureed form. Food can only be included in the menu cauliflower(boiled), zucchini and pumpkin (stewed), carrots, beets and mashed potatoes.
• Fruits and berries are fresh, but in limited quantities to prevent unwanted consequences.

Long term diet

In the future, even though there are no signs of the disease, the patient is recommended to adhere to a fairly strict diet for 2-5 years, that is, for a long time. During this long period of time after removal of the stomach for cancer meals should be specific, fractional (at least 4-5 times a day) and not contain easily digestible carbohydrates. However, the menu should be very varied and complete, and also selected taking into account the individual tolerance of certain food products. Doctors say that in most cases, if the diet is followed, patients do not need drug treatment. If problems arise, depending on the situation, the attending physician may decide on conservative or surgical method solving the problem through surgery. When choosing conservative treatment, diet therapy is key point. The food the patient receives must be varied, contain the necessary proteins and vitamins, and contain normal fats and carbohydrates. For patients during this period, the menu includes low-fat sausage, cutlets, soups with meat or fish broth, vegetables, salads and vinaigrettes, tea, compote, and fermented milk products. It is very undesirable to include sweet compotes, tea or coffee in the diet; baked goods, fresh baked goods, and liquid milk sweet porridges are also not suitable. If you have dumping syndrome, you should start eating with hearty meals, and it is advisable to be in bed or reclining in a chair for 30 minutes. It should be remembered that this diet should contain 138 grams of protein, 110-115 grams of fat and 390 grams of carbohydrates. In this case, the total energy value should be 3,000 kcal. If you follow such a diet, surgery is not necessary and the patient can enjoy a full life.

List of foods that are allowed in a long-term diet after removal of the stomach for cancer:

• Bread, gray wheat, yesterday's pastries, unsweetened and not rich buns. Rye seeded bread.
• Vegetarian soups made with vegetable broths. Low-fat meat soup once a week
• Fish and meat dishes. Should be baked, stewed or boiled in small pieces
• Eggs and various dishes made from them, but it should be remembered that there should not be more than one egg in the diet per day
• Cereals and pasta should be included in the diet in the form of crumbly and viscous porridges or puddings; it is possible to include casseroles in food. The recommended cereals are rolled oats, buckwheat or rice; semolina should be avoided.
• Greens and vegetables can be included in the menu raw, baked, stewed, or boiled. In any of these types, these products are welcome. Non-acidic acid is also allowed sauerkraut, zucchini, pumpkin, salads, green peas and tomatoes with vegetable oil.
• Fruits and berries should be included in food in the form of compotes, jelly and mousses. Honey, jam, sugar should be consumed as rarely as possible.
• Snacks in the form of mild cheese, herring, doctor's sausage or sausages, meat pate, as well as ham without lard, jellied fish in gelatin or leg jelly can also be included in the meal.
• Various sauces based on vegetable broth, sour cream and other large quantities butter can also make the patient's food more varied
• Drinks and juice, but not sweet ones, are welcome.

Contents of the article:

Diet after removal of the stomach for cancer is a mandatory part of treatment, since the operation disrupts the function of the gastrointestinal tract. If earlier in small intestine digested food mass has entered, now it does not undergo the necessary processing, therefore necessary for the body substances are absorbed much worse.

About the operation

Removal of the stomach is a difficult surgical operation, which is prescribed when there are no other ways to save a person’s life. It's called a gastrectomy. In this case, this organ is completely removed. Even if the operation was successful, there was no serious complications, the patient needs to prepare for long-term rehabilitation. At complete removal stomach it is important to take vitamins in the form medicines, especially vitamin B12, since it is absorbed in the stomach, and without additional treatment Pernicious anemia may develop.

However, the prognosis is favorable if the patient underwent surgery on time, and then underwent rehabilitation and followed all the doctor’s recommendations. You can easily adapt to new digestive conditions. But with oncology, everything is much more complicated, since much depends on the stage of cancer, general condition sick.

Gastric resection is a similar operation, however, the patient does not have the entire organ removed, but only part of it: from a quarter to 2/3. Then the stump of the stomach is connected to the duodenum. It is too major surgery, as well as removal of the stomach. To recover from it, you need to strictly follow the doctor’s recommendations, it is especially important to eat right.

Nutrition in the first days

Immediately after gastric surgery, the patient cannot eat, so there is no need to bring anything to the hospital. For the first 2 days he fasts, and on the third day the doctor may allow him to drink a little compote or rosehip decoction, or sweet tea. The patient is given water every 15 minutes, giving him 1 tsp. liquids.
Something there are doctors right after surgical intervention do not recommend, organize feeding of the patient medical staff clinics. To ensure that the body receives all the necessary nutrients, special mixtures of proteins and amino acids can be administered intravenously. The doctor may also prescribe protein enpit. The patient receives 30-50 ml of this solution. First, it is administered through a probe, then, when it is removed, through the mouth. The patient eats in this peculiar way for about 2 or 3 days. Gradually the amount of protein enpitite obtained is increased.

Nutrition after surgery

After 4 or 5 days, the doctor will switch the patient to a normal diet, provided that he has no bloating and normal peristalsis. But this does not mean that now he will be able to eat dumplings with sour cream or pies. The diet after surgery is very strict, but you cannot break it, because proper nutrition- This an important part rehabilitation of the patient.

After gastrectomy, the patient must eat according to a special diet. There are several types of diet that are prescribed to the patient. You need to adhere to each of them for about 2-4 days, but the doctor can increase or shorten this period, it depends on the patient’s well-being.

Diet No. 0A

Diet No. 0A is prescribed on days 4 or 5. Features of this diet: little salt (no more than 1 or 2 g) and a lot of water (1.8 -2.2 l). The patient should eat at least 7 or 8 times a day, eating no more than 250 g of food. As an addition to the diet, you are allowed to eat 1 or 2 soft-boiled eggs.

What you can eat:

• mucous decoctions to which cream is added;
• easy meat broth, no fat;
• fruit or berry jelly;
• juices from vegetables or fruits;
• sweetened drink made from rose hips.

For now, you cannot eat dense foods, even if they are pureed, or drink milk.

Diet No. 0B

This diet is needed on the 6th or 8th day after surgery due to stomach cancer. The patient should take up to 2 liters of liquid, and the amount of salt is slightly increased, to 4 or 5 g. The patient can eat up to 6 times a day, servings - 400 g. What is possible? The menu is the same as for diet No. 0A, but the list of allowed products is longer:

• soups with cereals;
• the patient can already eat pureed porridges made from rice or buckwheat, but only if they are liquid;
• soft-boiled eggs or white omelet are allowed;
• The patient’s menu also includes meat and fish (puree), but only dietary ones.

Diet No. 0B

This diet is usually prescribed for days 9-11. This is a special diet after surgery, when the patient switches to a full diet. The patient should drink up to 1.5 liters of water or other liquid, the amount of salt allowed is 6 or 7 g. The patient eats about 5 or 6 times a day, the following dishes are added to his menu:

• cream soup;
• white crackers, but not more than 75 g;
• pureed vegetables or fruits;
• apples, but not fresh, but baked;
• chopped meat or fish;
• cottage cheese, you can add a little cream;
• various fermented milk drinks.

Dumping syndrome

In approximately 10-30% of patients after surgery on the stomach, dumping syndrome is observed, when food is quickly dumped from the stomach into the intestines and is disrupted. carbohydrate metabolism, balance of gastrointestinal hormones and so on. Such patients complain of weakness, severe dizziness after meal, headache. They feel hot, sweat profusely, and the patient may faint.

To prevent these and other unpleasant symptoms from appearing, especially if a person has stomach cancer, you need to follow a number of simple rules:

1. The patient's menu should contain a lot of proteins and the required amount of complex carbohydrates.
2. The amount of easily digestible carbohydrates is limited, that is, you will have to forget about sweets, sugar, cakes, drinks, and canned juices for a while.
3. The amount of fat is reduced, fried foods are also not allowed.
4. Patients should not eat foods that increase bile secretion or that increase pancreatic secretion.

If unpleasant symptoms nevertheless appear, you must report them to the attending physician, who should monitor the patient after gastrectomy or resection. He will choose the right treatment.

Diet 10 days after surgery

What can patients without a stomach eat or those who have had part of their stomach cut off? 9-12 days after surgical intervention the patient is transferred to dietary table No. 1, but the pureed option is chosen. The patient should eat frequently, eating about 5 or 6 times a day. Portions should be small, about 250 g; if it is liquid, then no more than one glass.

The diet should contain a lot of protein, so patients need to eat chopped meat or boiled fish, prepare omelettes from proteins, do not give up fresh cottage cheese. Fats are also necessary, but in moderation. If the patient feels bad from such food, the amount of fat is reduced. The patient should eat little carbohydrates, especially if they are easily digestible, it is better to reduce their content.
During this period, the patient should not eat strong broths, as well as fatty poultry, meat, all kinds of sausages, ham, smoked products and canned food. Everything fried, bread, flour products, pickles. All vegetables and fruits must be ground before consumption.

Nutrition several months after surgery

If the patient feels well, there is no point in eating only pureed foods. After 3 or 4 months the patient can begin to eat regular food, however, some restrictions still remain. How to eat right? You still need to stick to diet number 1, but not the pureed version. The patient's diet becomes more varied: he can eat meat soups, eating them with dried white bread, fish and meat, chicken. Allowed are boiled vegetables, herbs from the garden, potatoes, buckwheat, rice, fresh fruits, fermented milk drinks and so on.

You can stick to this diet for about 2 or 3 months. If the patient has no complications, he has no problems with the intestines, the functioning of the gastrointestinal tract, then six months after the operation you can eat like everyone else. However, the diet cannot be canceled; it is also important to monitor the chemical composition of the diet.

Allowed

If a patient has stomach cancer, due to which part of the stomach or the entire organ was removed, the menu can still be varied. Here is a list of dishes and foods that can be eaten with this disease:

• slimy soups, to which oatmeal, buckwheat, rice were added, a little butter or cream was added;
• you can cook meat dishes, for example, veal, chicken, turkey;
• white bread croutons;
• you need to prepare fish dishes, and these are pollock, hake, cod and pike;
• Porridges are allowed: oatmeal, rice, buckwheat, you can put a piece of meat in them;
• soft-boiled eggs or omelet;
• if there is no intolerance, milk, cream, cottage cheese are allowed;
• Jelly or jelly made from berries are useful.

Prohibited Products

To avoid pain in the abdomen and other unpleasant symptoms, after the tumor has been removed, it is better to exclude some foods from the diet or at least limit their quantity:

• strong broths;
• can't eat fresh bread, various confectionery and flour products;
• Sausages, canned food and all kinds of smoked meats, fatty meat or poultry are not allowed;
• It is worth giving up some cereals: barley, corn, pearl barley and millet;
• pasta;
• You can’t eat fried foods or pickles;
• mushrooms;
• raw vegetables, especially legumes, cabbage, rutabaga, onions, radishes and so on;
• cottage cheese or sour cream, if they are fatty;
• Sauces and spices, all kinds of seasonings are contraindicated;
• you cannot drink soda, coffee, strong tea, alcohol, or juices from the store;
• sweets and jam are also not allowed, as are ice cream, cakes, and chocolates.

Nutrition after removal of the stomach for cancer is an important part of treatment; you must follow a diet, otherwise the body will not be able to recover quickly. Sticking to it is not so difficult, since the basis of nutrition is soups and cereals. If you create a menu correctly, the patient will quickly recover, and over time will be able to expand his diet.

We are faced with an operation such as Gastric resection (this is an operation in which part of the stomach is removed)?! Now to get it working again gastrointestinal tract, it is necessary to follow all the doctors’ instructions, tune your thoughts only to the good, and most importantly, Special attention pay attention to a balanced and nutritious diet.

• Nutrition after gastrectomy should be designed taking into account high content it contains protein food (at least one hundred and forty grams per day), as well as one hundred and ten grams of fats and carbohydrates.
• It is necessary to eat, especially in the first time after surgery, only pureed, steamed or boiled food.
• It is advisable to lie down for about half an hour after eating.
• Try to replace sugar with sorbitol and reduce the amount of carbohydrates.
• Carbonated, cold, hot, oily and spicy food, as well as foods rich in carbohydrates.
• Eating after gastrectomy should be frequent, but you need to eat little by little.
• The menu after gastrectomy must be drawn up by the attending physician. Do not forget that for any questions, you also need to contact qualified specialists.

Allowed products after gastrectomy

• After such an operation allowed to consume : omelet, soft-boiled eggs, lean animal and poultry meats, lean beef, veal, turkey, low-fat chicken. Homemade pates, pureed meat, boiled low-fat sausages, lean sausage - all of this is acceptable food.
• In addition, it is imperative to include in the patient’s diet lean fish, best boiled or steamed.
• If there are no diseases of the liver, biliary tract, or diseases of the pancreas, then it is allowed to eat lightly fried varieties lean meat or fish.
• It is recommended to introduce into the diet vegetable oils rich in Omega 3, 6, 9, which are found in flaxseed, vegetable, olive, sunflower and other oils.
• IN The menu, after gastrectomy, may include low-fat dairy products (dairy products containing bifidobacteria are also considered healthy), except milk. It's better to take low-fat kefir, yoghurts, low-fat cottage cheese, whey, fermented baked milk, sour cream, with reduced content fat, hard cheeses. You can add a little butter to your food. But it would be better to forget about margarine.
• Vegetables such as beets, potatoes, carrots, zucchini, tomatoes, pumpkin, cabbage (with caution, in case of pancreatitis it would be better to wait with it) are allowed after surgery.
• Porridges, casseroles from buckwheat, oatmeal, rice and other cereals (except semolina), cooked in water, not milk.
• Soups prepared in vegetable broths are allowed; cooking soups in meat broth is allowed extremely rarely and only on the condition that the patient who has undergone gastrectomy no longer has any serious illnesses internal organs(such as diseases of the liver, gall bladder, pancreas, spleen).
• Sweet apples, ripe peaches, apricots, sweet plums, and berry jelly.
• You can drink teas with mint, tea with milk, dried fruit compote, rosehip decoction, apple, orange and tomato juices.
• During an exacerbation after gastrectomy, it is advisable to only consume pureed or steamed low-fat foods.

What foods are contraindicated after gastric resection?

To the products worth it limit after gastrectomy, relate: sweets, jam, honey, jelly, whole milk, cocoa and coffee.

Here is a list of products you need exclude from diet. These products include: pork, lamb, fatty legs, fatty duck, goose, all fats except vegetable and butter, spicy foods, carbonated drinks, pies, pancakes, pancakes, pasties, donuts and other fried foods, as well as other flour products products. It is also necessary to exclude cold foods, such as ice cream.

Sample menu for gastric resection

First breakfast . Hercules porridge with small pieces of apples, cooked in water. Apple juice.

Lunch . Berry jelly made from sweet fruits. Rose hip decoction.

Dinner. Buckwheat soup cooked in vegetable broth (potatoes, carrots, onions). Boiled potatoes with vegetable oil and steamed meatballs made from lean beef. Dried fruits compote.

Afternoon snack. Cottage cheese with sour cream and pieces of fruit.

Dinner . Boiled chicken meat. Tomato juice.

Thus, using the above products that are recommended for consumption after gastrectomy, you can create an approximate menu.

Attention! Be sure to coordinate the menu with your doctor. And to questions like can I eat? cookies after gastric resection or whether caviar is acceptable during gastric resection, we can answer that it all depends on the condition of the patient who underwent the operation, the complications present, as well as on the physiology of the patient himself.

If, in addition to gastric resection, the patient has no other health complaints, then he can eat unsweetened cookies, such as “croquettes,” only soaked in water or warm tea. And, as for caviar, herring and other salted fish, the amount of salt after gastrectomy will need to be kept to a minimum. Caviar and herring can be eaten, but preferably as steamed seafood or as an independent boiled dish.

If, after a gastric resection, you begin to experience complications, and doctors have diagnosed dumping syndrome, then a diet and nutritional therapy will help you cope with this disease. It is very important to remember that if you have dumping syndrome, you need to eat often and in small portions, and after eating you can lie down or relax in a chair.

And the last thing! If doctors have prescribed gastric resection for you, do not put it off until later; you should also not resort to “grandmother’s” methods and hope for chance. And those who decide to undergo such an operation do not have to go abroad. Lots of good ones qualified specialists is also with us. For example, gastrectomy in Minsk, where highly qualified specialists work, almost always goes well and without any complications. But, in any case, it's up to you to decide. Good luck!

Lyudmila D. was with you.

Gastrectomy is a serious surgical intervention digestive system the body when part of the stomach or the entire organ is removed. Postoperative recovery healing process- it's not only drug treatment. Diet after gastrectomy is important integral part this process. This operation is performed according to certain indications:

• stomach cancer;
• complication of a stomach ulcer in the form of perforation;
• polyps that are precancerous in nature;
• pyloric stenosis;
• obesity.

After gastrectomy begins recovery period, which has long time and takes months. This is very important point in the rehabilitation of the patient, which determines the further quality of his life.

Why do you need a diet after gastric resection?

Removing part or all of the stomach radically changes the digestion process. In order to restore this process, it takes time and a special strict diet that will spare the sore stomach. The slightest error in food will immediately give rise to pathological symptoms in the form of abdominal pain, heaviness in the stomach, and belching. Often after surgery a complication develops in the form of dumping syndrome.

Due to the reduction in the volume of the stomach, food immediately passes in large quantities from the esophagus into the “small” stomach and small intestine. For successful absorption of nutrients, this area of ​​​​digestion begins to be intensively supplied with blood. Pathological condition develops quickly and is accompanied by headache, dizziness, decreased blood pressure, tachycardia, which leads to fainting.

To avoid complications and restore normal function digestion, diet plays a paramount role in the recovery period.

Basic principles of nutrition

In order for the rehabilitation of patients after gastrectomy to proceed normally, it is necessary to follow certain principles in the diet:

• food and drinks must be warm, no higher than 24 degrees;
• split meals are required - up to seven times a day;
• the volume of a single serving of food or liquid should be from 30-50 to 200 grams;
• cooking food only by steaming, stewing or baking;
• use food products only in crushed form;
• food should be rich in proteins;
• it is necessary to chew food thoroughly;
• follow a daily routine and try to eat at the same time;
• After eating, it is recommended to rest for half an hour.

Important! Strict adherence to the basic principles of nutrition after gastric resection is the key to speedy recovery functioning of the body's digestive system.

Authorized Products

After the operation, the patient in the hospital immediately begins to receive dietary food. Before discharge, a consultation with a dietitian is required, followed by a recommendation on how to follow a diet. The products that can be eaten and those that must be excluded from consumption must be indicated.

Read also Foods that increase stomach acidity

• chicken eggs soft-boiled;
• steamed omelette;
• low fat dairy products;
• yesterday's dried white bread;
• “light” poultry, lean beef;
• crackers, biscuits;
• semi-liquid porridges from rice, buckwheat, oatmeal;
• low-fat varieties of fish;
• vegetables - pumpkin, zucchini, potatoes, eggplants, bell peppers;
• weak black or green tea;
• compotes with a small amount of sugar from dried fruits.

Prohibited Products

In order for the recovery period after removal of the stomach to proceed smoothly, it is necessary to exclude the following foods from the diet:

• fatty meats;
• confectionery;
• smoked and canned products;
• salted and pickled vegetables;
• fresh pastries and soft wheat bread;
• carbonated drinks;
• coffee and strong black and green tea;
• peas, beans.

It is necessary to be especially careful when choosing foods and strictly adhering to a diet during oncology surgery.

Nutrition during stomach cancer removal has its own characteristics. In the first two days after surgery, nutrition is provided parenterally. The patient should not consume any food or drink by mouth. After 48-72 hours, you are allowed to drink 20 grams of weak meat or vegetable broth . The menu is gradually starting to expand. After a week, you can eat pureed soups with pureed vegetables.

After two weeks, the diet expands even further, and dishes are added in the form of slimy crushed porridges cooked in water, pureed boiled vegetables, chopped meat in a blender, steamed, and pasta.

Gradually, the patient gets used to eating certain foods after cancer surgery. The most difficult period of recovery occurs within two months, when the patient adapts to the “new” life. During this period, the patient, except therapeutic nutrition under the supervision of a nutritionist, undergoing drug treatment recommended by a gastroenterologist.

Correction of the diet is carried out by a nutritionist taking into account the general condition of the patient, the nature and extent of the surgical intervention. Often, when asked how long it is necessary to follow a diet after surgery, doctors say that for a long time, perhaps more than one year.

Resection of the stomach or part of it in a number of cases is the only possible method treatment and preservation of the patient's life. Stomach surgery is radical method treatment of extensive malignant neoplasms (stomach cancer ), not amenable conservative treatment, polyps, stomach bleeding. Despite the progress of medicine, gastric removal remains one of the most difficult surgical operations and even if it is successful and there are no significant complications, rehabilitation takes a long period of time, and nutrition after gastric surgery is the most important component of this process.

Diet after gastrectomy or after removal of part of the stomach

Parenteral nutrition after gastrectomy begins with sequentially prescribed Diet No. 0A , 0B , 0V ( , 1B surgical). Their purpose is to provide the patient’s body with a minimum amount of basic food nutrients, unload and spare the stomach, prevent intestinal bloating, etc. The diet contains easily digestible foods containing complete proteins, fats, carbohydrates, vitamins and macro/microelements and an increased amount of free fluid. Salt consumption is sharply limited.

On the first postoperative day, the patient is shown to be hungry; on day 2 - the diet includes 250 ml of warm sweet tea and rosehip infusion (50 ml), which are given after 15-20 minutes per teaspoon; on days 4-5 in the absence of abdominal bloating and normal peristalsis, prescribe Diet No. 0A and 2 soft-boiled eggs; for 6-8 days Diet No. 0B ; on days 9-11 - Diet No. 0B .

• Diet No. 0A . Contains 5-10 g of proteins, 15-20 g of fats and 180-200 g of carbohydrates. The volume of free liquid is 1.8-2.2 l, sodium chloride is no more than 1-2 g. Energy value The daily diet varies between 760-1020 Kcal. Food is served in liquid form. Fractional diet - up to 7-8 times a day and the amount of food per meal is no more than 250 g. The diet includes mucous decoctions with cream, light low-fat meat broth, fruit and berry jelly/jelly, sweet rosehip decoction, fruit and berry juices . Dishes with a pureed and dense consistency, drinks containing carbon dioxide, and whole milk are completely prohibited.
• Diet No. 0B . Contains 40-50 g of protein, 50 g of fat and 250 g of carbohydrates. The volume of free liquid is up to 2 l/day, sodium chloride is no more than 4-5 g. The energy value of the daily diet is 1580-1650 Kcal. Food is prepared in liquid/puree form. Diet - up to 6 times a day, portion size should not exceed 400 g. In addition to permitted products Diets No. 0A the diet is expanded by adding mucous cereal soups cooked with vegetable broth, soft-boiled eggs, liquid pureed rice and buckwheat porridges, protein steamed omelettes, pureed dietary meat and fish, and sweet berry jelly.
• Diet 0B . Is a diet of a transitional stage to the next physiologically good nutrition. Contains 80-90 g of protein, 70 g of fat and 320 g of carbohydrates. The volume of free fluid is 1.5 l/day. Sodium chloride no more than 6-7 g. The energy value of the daily diet is 2100-2400 Kcal. Food is served in puree form. Diet: 5-6 times a day. The diet additionally includes cream/puree soups, pureed steamed meat and fish, cottage cheese pureed with cream, fermented milk drinks, baked apples, pureed fruit/vegetable puree and 50-75 g of white crackers.

The duration of each surgical diet is 2-4 days, but, if necessary, the time spent on them can be lengthened or shortened. That is, approximately 9-12 days later, the surgical diet after the operation ends, and the patient is transferred to the standard Pevzner diet (mashed version), which limits the amount of food consumed at one time: no more than 250 g of the first pureed dish or a glass of liquid ( 250 g), and for lunch - only two dishes. Meals are fractional, 5-6 times a day.

The diet contains an increased amount of protein (100-110 g), which includes dishes from boiled minced meat, boiled fish, fresh mashed/calcined cottage cheese, and egg white omelettes. The amount of fat in the diet is at the level of physiological norms or several times higher (80-90 g). If the patient does not tolerate fats well (and pure form too), which is manifested by bitterness in the mouth, regurgitation, diarrhea, their quantity is limited to 60-70 g. The carbohydrate content is reduced to 300-320 g due to easily digestible carbohydrates.

In some cases, in particular when dumping syndrome manifested by weakness, heartbeat , chills, a feeling of heat, abdominal pain and bloating that appear after eating, it is necessary to completely eliminate foods containing sugar, since the consumption of easily digestible carbohydrates is one of the reasons for its appearance.

To slow down the evacuation of food from the gastric stump, it is recommended to consume viscous and jelly-like foods. You can practice separate meals of dense and liquid consistency, starting with a dense one, as well as eating in a lying position. Eat food in even small portions 6-7 times a day. After eating, you need to lie/recline in bed for 30-40 minutes. You can also practice eating butter before eating carbohydrate foods, which inhibits the removal of food from the gastric stump. If whole milk is poorly tolerated, it is excluded from the diet and replaced with other products.

Strong broths based on meat, mushrooms and fish, fatty red meat and fish, some types of birds (duck, goose) and products based on them (sausages, canned food, ham, smoked meats), fried foods, dough products are completely excluded from the diet. , fresh bread, savory snacks, salty fish and vegetables, solid animal fats, unprocessed raw vegetables and fruits.

At feeling good 3-4 months after the operation, the patient is gradually transferred to the non-rubbed version Diets No. 1 . The diet is physiologically complete, contains an increased amount of proteins and is practically normal amount fats and complex carbohydrates. The limitation concerns simple carbohydrates, in order to prevent the development of dumping syndrome. Culinary methods of processing products are preserved: the products are boiled or steamed, and after boiling, baked or stewed. In terms of the range of products, the diet of this diet option is more extensive, but the rules and restrictions are the same.

Allowed to consume low-fat meat soups, borscht, cabbage soup (once a week), dried wheat bread, not fatty varieties fish and beef, chicken dishes, savory cookies. It is allowed to eat boiled and raw vegetables, garden herbs, fermented milk products, dishes based on buckwheat and rice, potatoes, mild low-fat cheese, dietary sausages, fresh fruits and berries.

In the absence of complications and satisfactory gastrointestinal function, 6 months after surgery, the patient can switch to a normal diet, but taking into account the diet and characteristics chemical composition diet. Possible self-correction a set of food products in the diet, taking into account individually intolerable foods. With pronounced loss of body weight (10-15%) after gastric resection, especially for cancer, the calorie content of the daily diet should be increased compared to physiological norm by increasing the content of essential food nutrients recommended for the diet.

If complications such as inflammation of the anastomosis or gastric stump occur, peptic ulcer prescribe the pureed option Diets No. 1 , and during exacerbation - sequentially No. 1A And 1B with modifications to them taking into account intolerance to certain products. In general, the nutrition of patients with diseases of the operated stomach must be individualized.

It is advisable to include specially designed dietary supplements in the diet after gastric surgery. nutritional mixtures - « Nutrizon », « Nutridrink », « Berlamin Modular ", which should be administered in small portions, can be diluted with water, with continuous evaluation their tolerability.

Dietary nutrition must necessarily include taking vitamin-mineral complex tablets and medications that normalize motor-evacuation function various departments Gastrointestinal tract and preparations containing enzymes to improve digestion processes ( Creon , Mezim-forte ). Complete rehabilitation in patients is long-term and usually occurs by the end of the first year after surgery.

Indications

Gastric resection and complications of the operated stomach.

Authorized Products

Diet after gastric resection when transferring the patient to Diet No. 1 (A , B ) includes slimy cereal soups from rice, buckwheat, oatmeal with the addition of ready dish butter, low-fat cream or egg-milk mixture, cream. For second courses, lean types of red meat are used (veal, beef), chicken or turkey, well boiled and minced.

Dishes of white fish (cod, pollock, pike, hake) in the form of steamed or boiled are allowed. Cereal dishes are prepared with milk/water in the form of liquid porridge from buckwheat, oatmeal, and rice, to which butter is added.

If tolerated well, the diet includes milk and dishes based on it, low-fat cream, calcined cottage cheese, milk jelly, chicken eggs in the form of a steam omelet or soft-boiled.

Among fats, preference is given to butter and vegetable oils, added immediately before use to the finished dish. Jelly and jelly made from sweet berries are useful. From drinks - juices from fresh berries, weak tea with cream, rosehip infusion.

Table of permitted products

Fully or partially limited products

In the patient's diet after surgical intervention On the stomach, bakery and confectionery products, fresh bread, pastries, and products made from any type of dough are excluded. Strong broths based on meat or fish, dishes made from fatty meats and fish, as well as products based on them (canned food, sausages, smoked meats), solid animal and cooking fats, fried foods, pickles, mushrooms, various snacks, vegetables and raw fruits, full-fat cottage cheese, cheese, sour cream, fermented milk products.

You cannot include various sauces, seasonings, and spices in your diet. The consumption of carbonated drinks, strong tea, coffee, concentrated vegetable and fruit juices, and any alcohol-containing drinks is prohibited.

Table of prohibited products

* data is per 100 g of product

Nutrition menu after gastrectomy (Diet)

The menu for a week after gastrectomy should provide alternation of various protein and cereal dishes in order to avoid its monotony, with strict adherence permitted methods of culinary processing of products and, most importantly, compliance with portion sizes. It must be remembered that meat/fish dishes can be consumed in the form of puree or soufflé once a day. If you are intolerant to milk, it must be replaced with other products or consumed in small portions, as well as diluted with weak tea.