Diet after removal of the stomach for cancer: what is prohibited and allowed to eat. The essence and principles of diet after gastrectomy

As a rule, to surgical treatment stomach diseases such as cancer or peptic ulcers are resorted to only if methods are ineffective therapeutic effects. After resection, the anatomical shape of the stomach changes, and new conditions for food digestion are created. Therefore, nutrition after removal of the stomach (part of it) plays a major role in the further process of the body’s adaptation to new conditions of food intake and the speedy rehabilitation of the patient, especially in postoperative period.

What can you eat after surgery?

Typically, the early postoperative period is characterized by the inability to eat orally. In this regard, the operated person is prescribed infusions nutrients intravenously, including protein-amino acid solutions (enpits). For the first 2 days after surgery, doctors recommend following just such a diet with parallel aspiration (examination of the stomach contents). The patient is not allowed to drink for the first few days, but he can wet his lips with water using a sponge or cotton wool.

If the attending physician has determined the positive dynamics of the postoperative period and the absence of stagnant processes in the stomach cavity, then, starting from the 3rd day, the patient can take a decoction of rose hips, weak tea, as well as mineral water (still) in the amount of 30 g during the day 6 times. The same diet should be followed if the patient has undergone.

On the 4th day, the patient can be given a small amount of pureed buckwheat porridge, as well as fish and meat purees. The next day it is allowed to be taken boiled egg(soft-boiled), pureed rice porrige, soufflé and mashed cottage cheese. Then, until the end of the first postoperative week, it is recommended to eat pureed vegetable soup. From the 2nd week you are allowed to eat boiled potatoes (mashed potatoes) and steamed meat cutlets.

What are the features of eating after surgery?

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Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for independent treatment. Be sure to consult your doctor!

Some dangerous diseases lead to gastric resection; diet therapy in this situation is an integral component of the patient’s rehabilitation, and a specific diet after gastric resection is an integral component daily nutrition, in most cases forever.

The postoperative period requires serious attention. In the early postoperative period, patients cannot eat naturally. As a rule, parenteral nutrition is prescribed, including albumin. Nutrient requirements are determined based on a blood test.

During this period, the patient is prescribed fasting for 2 days, and active aspiration of gastric contents is carried out. From the third day, if gastric peristalsis is restored, give weak tea, rosehip decoction, a slightly sweet compote without berries in small portions - 20-30 ml, 5-6 times a day. To introduce protein products from the first days, it is recommended to use protein enpit (40 g per glass of water). Usually, in the first few days, 30–50 g of this solution is given through a probe, and later, after removing the probe, naturally. Gradually, as peristalsis is restored and postoperative healing occurs, the load on the gastrointestinal tract is increased and the amount of protein is increased to a sufficient level. A specific diet should be recommended by a doctor. The use of enpits allows you to increase the amount of animal protein in the diet to physiological norm, provide the body essential vitamins and mineral salts.

From the third or fourth day after the operation, the diet is expanded and mucous soups, meat, fish and curd purees and soufflés, soft-boiled eggs are prescribed, and on the fifth or sixth day - steamed omelettes, mashed porridges and vegetable purees in small quantities (50 g per serving). From the fifth day, if such nutrition is well tolerated, every meal should include protein products. Gradually, portions of food taken at a time are increased (from 50 ml on the 3rd day to 200 - 250 ml on the 7th day and to 300 - 400 ml on the 10th day). Thus, in the early postoperative period, patients will receive a sufficient amount of complete protein in an easily digestible form.

A gentle diet is prescribed 1 – 2 weeks after surgery for 4 months. In the presence of gastritis of the gastric stump, inflammation of the anastomosis, peptic ulcer, patients should follow a diet of more than long time. The main purpose of the diet is to prevent or reduce inflammatory process, prevention of dumping syndrome .

This is a physiologically complete diet with high content protein (meat, fish), normal content complex carbohydrates(grain products, cereals, vegetables, unsweetened fruits) and a sharp limitation of easily digestible carbohydrates (sugar, sweets, confectionery, fruit waters, canned juices), with normal fat content, limitation of mechanical and chemical irritants of the mucous membrane and receptor apparatus gastrointestinal tract, with maximum limitation of nitrogenous extractives (especially purines), refractory fats (lamb), fat breakdown products obtained during frying (aldehydes, acroleins), with the exception of strong stimulants of bile secretion and secretion of the pancreas and intestinal glands, products and dishes that cause dumping -syndrome (sweet liquid milk porridges, for example, semolina, sweet milk, sweet tea, hot fatty soup, etc.).

The meat is given in minced form, and the side dishes are not pureed (mash porridge, crushed potatoes). Salads, fresh fruits and vegetables, black bread are excluded. All dishes are boiled, pureed or steamed. The third course for lunch is unsweetened (without sugar) or with the addition of xylitol (10–15 g per serving). The patient is given a strictly limited amount of sugar,

Complex therapy aimed at compensating for impaired functions various systems body, begins after 2 weeks. after surgery and lasts 2–4 months. Diet is important integral part complex treatment in this period. This is a physiologically complete diet with a high protein content (140 g), a normal content of fats (110–115 g) and carbohydrates (380 g) with a limitation of mechanical and chemical irritants of the mucous membrane and the receptor apparatus of the gastrointestinal tract. Refractory fats, extractives, easily digestible carbohydrates, and fresh milk are excluded. Patients must adhere to the regimen fractional meals. It is necessary to strictly limit the intake of easily digestible carbohydrates to avoid the development of hypoglycemic and dumping syndrome. At the same time, prescribing only a protein diet without a sufficient amount of carbohydrates is inappropriate, because under conditions of carbohydrate restriction, proteins may not be used sparingly to cover energy costs, which leads to an increase in protein deficiency in the body. However, given the loss of peptic factor in such patients, preference should be given to protein products that are easily “attacked” by trypsin - fish and dairy. Eating foods with coarse fiber and plenty of connective tissue must be limited or they are subjected to heat treatment.

Sample diet menu after gastrectomy - mashed version

• 1st breakfast: soft-boiled egg, buckwheat, rice or rolled oats porridge, coffee with milk.
• 2nd breakfast: baked apple, rosehip decoction.
• Lunch: vegetarian potato soup, meat
• steam cutlets with milk sauce, pureed fresh fruit compote or jelly.
• Dinner: boiled fish, boiled potatoes.
• At night: kefir or weak tea with milk.
• List of recommended dishes and products:
• soups: vegetable broth with various cereals, vegetables, pasta, beetroot soups, milk soups with cereals, fruit soups with rice. Low-fat allowed meat soup 1-2 times a week, subject to good tolerance;
• meat and fish dishes: from lean meat, poultry, fish - boiled, baked (pre-boiled), stewed (with juice removed);
• vegetable dishes: fresh vegetables (tomatoes, cucumbers, carrots), boiled and stewed (carrots, potatoes, beets, zucchini, pumpkin, cauliflower). Non-acidic sauerkraut, fresh herbs (parsley, dill) are allowed;
• cereals and from pasta: various cereals- rice, buckwheat, oatmeal, millet. You can prepare crumbly porridges, cereals, puddings, rice pilaf with fruits; vermicelli, pasta;
• egg: soft-boiled egg, omelet;
• milk and dairy products: whole milk (if well tolerated); milk with tea and composition various dishes; kefir, curdled milk, acidophilus; sour cream mainly as a seasoning; freshly prepared cottage cheese. They also prepare cottage cheese, various puddings, soufflés, and dumplings;
• fruit and berries: ripe, raw and baked fruits (apples). Plum, cherry, currant, strawberry, etc.; √ sauces: milk, sour cream, fruit;
• snacks: “Doctorskoy” type sausage, lean ham, jellied fish, cheese, boiled tongue, salads from raw and boiled vegetables, soaked herring;
• sweets: jam, honey, marshmallows, marshmallows, jams (in very limited quantities);
• drinks: tea, weak coffee with and without milk, compotes of fresh fruits, berries and dried fruits (not very sweet);
• Jelly and juices: fruit, berry (not very sweet), vegetable. Rosehip decoction;
• fats: butter and vegetable oil (added to ready-made dishes);
• bread and bread products: wheat, rye, preferably slightly dried, crackers, savory cookies, savory dough products.

Baked goods, pickles, smoked meats, marinades, canned snack foods, radishes, rutabaga, and hot spices are excluded from the diet.

Diet menu after gastric resection - not pureed version

• 1st breakfast: tomato salad or vegetable vinaigrette, boiled meat, buckwheat crumbly, tea with milk.
• 2nd breakfast: fresh or baked apple or raw grated carrots.
• Lunch: salad, vegetarian borscht, boiled fish (cod, hake, iced) with boiled potatoes, sauerkraut, compote
• Afternoon snack: fresh fruit.
• Dinner: omelet, buckwheat cereal, tea.
• At night: kefir or yogurt.

5-6 months after partial or complete removal of the stomach, the attending physician, depending on the state of health, the presence or absence of complications from various organs digestive system(liver, gallbladder, pancreas, intestines) may recommend that the patient adhere to a diet such as dietary table No. 5 or No. 15.

IN long term after consultation with the attending physician, if there are no complications and severe concomitant diseases, fried foods, more fresh vegetables and fruits, meat and fish broths are introduced into the menu after gastric resection, of course, with good tolerance.

For some gastrointestinal diseases, an operation such as gastric resection is performed. For a long time experts could not decide which is better: this surgery or gastroenterostomy. Today, preference is still given to gastric resection.

Indications for use

This type of surgery has the following indications: peptic ulcer, tumors, dangerous stomach diseases, ulcers duodenum, polyps. Doctors say that often when detected malignant neoplasms This operation is the only option that can, if not completely get rid of the problem, then at least prolong life. Another area where gastric resection is used is the treatment of severe stages of obesity. With such surgical operation Up to 2/3 of the organ is removed. The first person to perform this manipulation was the German doctor Theodor Billroth. It was he who, after 1881, developed a technique for performing resection. In the early 2000s, other truncation methods became known, such as longitudinal or vertical.

Methods for performing gastric resection

There are several options for performing the operation.

1. Subtotal. It is carried out if the patient is diagnosed with malignant tumors or an ulcer that can no longer be treated.
2. Removal of 2/3 parts of the stomach.
3. Gastrectomy. With this type of surgery, the organ is completely removed.
4. Antrumectomy. The pyloric region of the stomach is removed.
5. Longitudinal. The lateral part of the organ is trimmed.

Billroth I, Billroth II

Option Billroth I is as follows. 2/3 of the stomach is removed. The central stump is partially sutured. The lumen that remains is the same size as the diameter of the duodenum. The peculiarity of this type is that after resection of the stomach, the physiological movement of food along with bile is preserved.

When performing the operation according to the second option, the stumps are sutured tightly (stomach and duodenum). The functions of the gastrointestinal tract are restored as follows: an anastomosis is created. That is, the overlap in this case occurs as an “end to side” type. This method has several modifications. One of them is gastric resection using the Hoffmeister-Finsterer method. The duodenal stump is sutured using a continuous continuous suture. The edges of the intestine are sutured to the stomach with several sutures. This procedure involves the gradual release of the contents of the latter. The best results are obtained by gastric resection in the Finsterer modification. In every special case the motor activity of the digestive organ changes significantly, the tone weakens.

How does the operation take place?

Surgical intervention involves several stages. The first of them is mobilization. At the same time, an examination of the organs is carried out. The left gastric artery is isolated and ligated with silk threads. The right one is also identified, crossed with clamps and bandaged. Separate small and big oil seal. Then a part of the stomach is directly cut off. After these manipulations, an anastomosis is formed. When performing an operation using the Billroth II method, the duodenal stump is sutured. It is then combined with a short rectal loop.

What is longitudinal gastrectomy?

Key indicators for surgical intervention - high degree obesity, body mass index exceeds values ​​such as 35 kg/m2. This type of surgery is used to reduce the volume of the stomach. At the first stage, a narrow tube is formed, which has a slight curvature. Feature this method is that the area that is responsible for the production of the hunger hormone is removed. The formed stomach is not stretched; the food in it moves quite slowly and has time to break down. In the second stage, the walls are stitched together to form a tube. At the same time, the main functions of the organ are preserved; this operation is quite simple to use. Nutrition after gastrectomy of this type is of considerable importance.

Contraindications for longitudinal resection

This surgical intervention has a number of contraindications. First of all, longitudinal resection is not performed during pregnancy. Also pathologies of cardio-vascular system and peptic ulcer will become obstacles to operations of this kind. Pancreatitis, reception hormonal drugs or steroids, other diseases digestive tract- all this is a contraindication for performing such an intervention as gastric resection. In addition, alcoholism, which has chronic form, and mental illnesses will not contribute to truncation.

Subtotal resection

Subtotal gastrectomy is performed when it is detected malignant tumors. Another option for use is incurable peptic ulcer disease. This removes top part digestive organ. First of all, the organ is inspected and mobilized, the stomach is pulled down. Through an incision made in the area of ​​the lesser curvature, a clamp is inserted and the lesser omentum and left gastric artery are separated. A loop of the small intestine is prepared, suturing and anastomosis are performed.

Complete resection

In case of extensive damage to the organ, a complete resection of the stomach can be performed. Moreover, from fabrics small intestine a new digestive organ is formed. According to reviews, this method is the most effective in the treatment of malignant tumors and is widely used in many countries. But such a surgical intervention makes its own adjustments to the patient’s future life. Nutrition after gastric resection, in which the entire organ is removed, requires special diet and special methods of eating.

Possible complications

Complications often arise after gastrectomy has been performed. After surgery, the state of anastomotic obstruction is one of them. Often occurs from improper application or swelling. Bleeding into the peritoneal area is dangerous because anemia quickly develops. Intestinal obstruction also occurs. Extremely dangerous condition- postoperative peritonitis. Subsequently, a fistula may form due to incorrectly applied sutures. All these complications arise when the surgical technique is violated. They are extremely rare among experienced specialists. Doctors say that only about 5% of all surgeries require revision surgery. Rehabilitation period includes the following points: the first six months must be limited physical exercise and wear a special bandage; specialists also prescribe a special diet.

Nutritional Features

The diet after gastrectomy has some restrictions and features. First of all, the amount of food that the patient can eat at one time changes significantly. The disease that led to the operation is also taken into account. For ulcers, 2/3 of the stomach is usually removed. Therefore, the portion is reduced proportionally, and a person can afford 1/3 of the usual amount of food. At malignant tumors Most of the organ is truncated. The amount of food is 50-100 ml. Therefore, the patient eats quite often: 5-6 times a day. Later certain time The amount of food can be increased slightly. It is also important that food processing changes. Doctors say that in the first weeks, liquid or pureed food is recommended (that is, it must undergo mechanical processing). It is better if the dishes are boiled or steamed. Experts note that after gastric resection, protein absorption deteriorates. Doctors recommend enriching your diet with protein foods, preferably of animal origin.

Dumping syndrome

Due to the fact that food now enters the rectum much faster, patients often experience dumping syndrome, in which irritation is observed in this area. Dizziness occurs, heart rate increases, and sweating also increases. Against this background, the person complains of general weakness. Some patients note that after eating they experience attacks of nausea and vomiting. They usually go away if you lie down for 20-30 minutes. Most often, this condition is provoked by carbohydrate-rich foods, baked goods, and potatoes. Therefore, it is better to limit them, or even eliminate them altogether.

Sample menu after gastrectomy

1 breakfast. At this meal you can eat an omelet, milk porridge (but it is better to dilute the milk), and some fruit. For second breakfast, minced meat products or meat balls are recommended. You can also add an apple. During your lunch meal, you can eat vegetarian soup or borscht, mashed potatoes with steamed cutlets. For an afternoon snack, experts recommend tea, fruit, a sandwich with cheese or biscuits. The dinner menu may include the following dishes: buckwheat porridge, meatballs, fish. The last meal is limited to kefir or jelly.

Prohibited Products

Gastric resection means that the future diet will be somewhat limited. First of all, in the first months you need to reduce the amount of salt you consume. The second prohibition concerns confectionery, flour, sugar, jam. Proteins are especially necessary after this operation, but fatty broths and fried meat will only do harm. Canned food, sausages, and pickles are also prohibited. You should avoid products that contain preservatives, dyes and other chemical additives. Alcohol is also excluded. It is very important to understand that such restrictions are imposed not only for the first year after surgery. These principles should be adhered to throughout the rest of your life.

Nutrition after longitudinal resection

In the postoperative period, proper nutrition is of great importance. The first week has a particularly strict diet, which includes only liquid food. Basically it is water, broth (but not fatty), milk. The liquid can be drunk in small sips at intervals of 5 minutes. In the second week, the diet expands somewhat. You can eat food that has the consistency of puree. Fermented milk products, pureed vegetables and lean meat (mainly poultry) make up the diet for a month. In the second month, you can introduce fish and other types of meat. Then regular food is allowed, but the portions should be small. It is better to avoid fresh baked goods. Longitudinal gastrectomy receives the following reviews: in 100% of cases, weight loss is observed, mostly the body mass index reaches normal levels.

Professor G. F. Markova

THIS ARTICLE is a kind of response to the letters that I received after my article “If the stomach is operated on” was published in the magazine “Health” No. 4 for 1966.

Advice about the regimen that must be followed immediately after surgery did not satisfy everyone. Many people ask to know how to behave if the operation was done a long time ago.

Let us recall that the removal of part of the stomach (its resection) is performed quite often due to peptic ulcer of the stomach or duodenum. This operation is performed in cases where the disease cannot be treated conservative treatment. Often the reason for gastrectomy is a benign tumor.

Having removed part of the stomach, the surgeon connects (stitches) the remaining part directly to the small intestine.

If healthy people food from the stomach rhythmically enters the duodenum and only then into the small intestine, then after resection from the remaining part of the stomach - immediately into the small intestine.

And the second feature has to be taken into account: after surgery, as a rule, free hydrochloric acid is not produced in the stomach.

Is this good or bad? It’s bad because it makes digestion difficult to a certain extent. And at the same time, it’s good, because with zero acidity, a relapse of the ulcer can no longer occur.

It is widely known that the human body has amazing ability devices. And some time after gastrectomy, despite the exclusion of the duodenum and part of the stomach itself from digestion, the digestion process is essentially not disturbed.

The small intestine and pancreas produce the enzymes necessary to break down all nutrients(proteins, fats, carbohydrates). Digestion occurs in approximately the same way in those non-operated patients who suffer from a lack of hydrochloric acid and pepsin in the gastric juice.

Usually, after gastric resection, immediately and many years later, stool remains normal and regular - once a day. Some patients, after eating, especially in the morning, experience a feeling of heaviness, fullness in the epigastric region, heart rate increases.

Sometimes there is pain in the heart area, general weakness, lightheadedness, and a desire to lie down. Then people think that the stomach disease is also accompanied by heart disease. However, these fears are unfounded.

The listed symptoms are due to the fact that food enters the small intestine and the cardiovascular system reacts violently to this.

Some patients are concerned about significant weight loss after surgery and especially that their weight, despite good food, and after a few years it does not increase. Meanwhile weight loss cannot be considered as alarming symptom and fear that the condition will worsen.

What should you take care of several years after gastrectomy? First of all, periodically donate blood for analysis. Then it is possible to detect anemia in time, which sometimes occurs in some patients.

Currently, it is successfully treated with iron supplements and vitamin B12. This vitamin, by the way, not only improves blood composition, but also the absorption of food proteins.

Therefore, it is often recommended to such patients from time to time intramuscular injection vitamin B 12 (once a week for a year or courses once or twice a year). Of course, only a doctor can make such important appointments.

Doctors often prescribe a solution of hydrochloric acid or gastric juice. This is advisable in the first months after surgery to stimulate the activity of the pancreas.

In the future, digestion usually improves, and if hydrochloric acid or gastric juice continues to be taken, they may cause discomfort in the esophagus.

A year or more after surgery, pancreatin is useful - a drug prepared from the pancreas of livestock, as well as abomas (from abomasums, calves and lambs). These drugs help better absorption food.

Vitamins are constantly needed, especially group B. They can be taken in tablets or powders after meals (vitamins B 1 and B 2 - 0.015 grams each and vitamin B 6 - 0.05 grams each).

If a person is concerned about bowel movements, a combination of pancreatin with chalk, bismuth nitrate and tannalbin can help.

One should not think that relaxation is a sign intestinal infection, and in no case should you take it yourself sulfa drugs or antibiotics.

You should not go on a starvation diet, for crackers and strong tea, congee: Not good nutrition may damage.

And nutritious nutrition for people with a resected stomach is necessary every day, throughout their lives. Let us remind you: it should be varied and, above all, rich in animal protein, which is found in meat, fish, poultry, and dairy products; There is especially a lot of it in cheese, cottage cheese, and eggs. Plant proteins found in bread and cereals.

Proteins in the human body perform a so-called plastic function: they are used to build cells of various organs and tissues, including blood. Therefore in daily ration a person at any time after gastrectomy should have at least 120-150 grams of protein.

This means that two or three times a day you need to eat dishes made from lean meat, poultry and fish, 1-2 soft-boiled eggs or an omelette, 50 grams of cheese (mild varieties). It is better to cut the sausage (doctor’s sausage) thinly and boil it, then it is more fully digestible.

Nutrition after gastrectomy

Gastric resection is performed for peptic ulcers that have not responded to therapeutic treatment, or for cancer and gastric polyposis. Nutrition immediately after surgery is outlined in the section “Therapeutic nutrition for surgical patients - nutrition before and after operations.” During recovery (after about 12-14 days), the patient is transferred to diet No. 1. However, there are some changes to this diet. First of all, limit the amount of food eaten at one time: no more than 250 g of soup or 1 glass of liquid, and only 2 dishes for lunch. Frequent, at least 5-6 times a day, meals are required.

It is recommended to add fat mainly to dishes. And that's why. Some patients do not tolerate butter, sour cream and even cream. If you add them to porridge or boiled vegetables, and cottage cheese, for example, can be used to prepare cottage cheese and cereal puddings; they are better tolerated.

Sour cream and cream should not be eaten in large quantities, so as not to overload the body with fats.

Carbohydrate intake has to be somewhat limited especially if after eating a person’s temperature rises, increased sweating and palpitations appear.

It has been established that sugar, honey, and jam enhance these phenomena, even in those people who have had surgery a long time ago.

Bread, cereals, vegetables and fruits also contain a lot of carbohydrates, but the body accepts these foods better. In addition, vegetables and fruits contain vitamins and mineral salts, promoting the separation of bile and regular bowel movements.

We remind you: Carbohydrate consumption should be reduced, but not eliminated from the diet. Both carbohydrates and fats are necessary for the body.

Pork, fatty lamb, lard, cream pies, ice cream, and alcoholic beverages are contraindicated for the patient.

Some patients ask: is it possible to drink grape wines to stimulate appetite? Absolutely not! And in those who have been operated on for a long time, even from the weak alcoholic drinks significant intoxication immediately occurs, because alcohol is quickly absorbed through the mucous membrane of the small intestine and enters the blood. And even in small quantities it harms the liver.

The volume of the stomach after surgery, thanks to training, although it increases somewhat over time, still does not reach normal values. That's why food should be taken in small portions, without overeating, four to five times a day.

Most patients can eat unprocessed food within a few months after surgery.

Soon after the operation, When patients switch to an extended diet, they eat almost the same as healthy people.

No matter how much time passes after the operation, you should be under the systematic supervision of a therapist and strictly follow his advice.

We give great importance restorative treatment: periodic courses of strychnine injections, intravenous injections glucose with ascorbic acid, ingestion vitamin preparations, injections of vitamin B 12.

Good action provides transfusion donated blood and various protein preparations. But all this is done only as prescribed by a doctor and often in a hospital setting. And when the doctor suggests such treatment, You should not refuse hospitalization even if you feel satisfactory.

It is useful to spend your next vacation in a sanatorium, in a familiar climate zone, where the patient lives permanently.

Drink mineral waters is assigned strictly individually. Sunbathing is strictly contraindicated.

I would like to emphasize that in sanatorium conditions the most powerful healing factors are dietary nutrition, restorative treatment, and rest.

There is no need to expect that the patient will definitely gain weight in the sanatorium. And if he gets better, but then loses weight again, it doesn’t matter. The main thing is different: sanatorium treatment helps improve overall well-being.

For those who have had their stomach resected, It is necessary to systematically treat teeth and provide them with prosthetics on time. Good chewing facilitates stomach function.

Short, leisurely walking and skiing trips, with breaks for rest, are useful. All this increases the body's resistance, strengthens the nervous system, and improves mood.

Some people suffer from increased suspiciousness after gastric resection; even a slight deterioration in their well-being causes them to have anxious thoughts.

This condition in itself causes harm. A person should know that sometimes his health will worsen, and the appearance of some painful signs is inevitable. We specifically talked about them so that their occurrence does not cause unnecessary concern.

SAMPLE MENU

The basic principles of the diet after gastrectomy and completion of a course of intravenous nutrition can be formulated in three words: “less”, “smaller” and “more often”. That is, the portion should be minimal, thoroughly pureed, the number of such portions per day increases to at least six. Only after two to three months can you move on to unprocessed food, which should still remain gentle.

Dietary nutrition after gastric resection surgery

Resection - surgical removal parts of the stomach produced for peptic ulcers that have not responded to therapeutic treatment, for perforation of the ulcer, for long-term gastrointestinal bleeding, severe pyloric stenosis and others. Nutrition immediately after gastrectomy is carried out in the hospital (intravenously initially) and is therefore not given here.

How to eat after gastrectomy as the stump heals?

After about 7-10 days, the patient is transferred to a gentle pureed diet:

1. At the same time, limit the amount of food eaten at one time: no more than 250 grams of soup or 1 glass of liquid, only 2 dishes for lunch.

2. Frequent, at least 5-6 times a day, meals are required.

3. In the diet therapeutic nutrition after gastrectomy, the content is increased to 90-100 grams and the amount of easily digestible foods (sugar, jam, sweet drinks, honey) is limited to 300-350 grams.

4. In some cases, it is necessary to completely eliminate sugar-containing foods and dishes (sugar substitutes can be used).

What can you eat after gastrectomy as a source of protein? For this purpose, dishes made from boiled minced meat, boiled fish, omelets made from egg whites, fresh pureed or calcined cottage cheese. With poor fat tolerance (regurgitation, bitterness in the mouth, diarrhea), especially in pure form, they are limited to 60-70 grams per day. If whole milk is intolerant in the diet after gastric resection surgery, it should be replaced fermented milk products or used in dishes.

Be sure to include in your diet medications containing multivitamins, iron and other minerals.

The following are excluded from nutrition after gastric resection surgery: meat, fish and mushroom broths, fatty varieties meat, poultry and fish; products made from butter and puff pastry, very fresh bread, all fried foods, smoked foods, canned food (except canned food for baby and diet food), salted fish and vegetables, savory snacks, raw unprocessed vegetables and fruits.

2-4 months after surgery with feeling good You can gradually switch to unprocessed gentle nutrition, that is, without mechanical sparing.

5-6 months after the operation, sometimes earlier, with satisfactory gastrointestinal function, a transition to normal nutrition is possible, taking into account the noted features of the composition of the diet and diet. At the same time, self-monitoring of nutrition is extremely important, that is, determining those foods and dishes that are well or poorly tolerated.

Postoperative nutrition for patients who have undergone gastrectomy

After gastric resection, a complication is possible, accompanied by deterioration of digestion and absorption of food, metabolic disorders, cardiovascular and nervous systems, called dumping syndrome, or simply dumping (from the English dumping - “dumping”, “ejection”).

Dumping is caused by the rapid transition of food from the stump of the stomach to the small intestine, which causes: weakness, sweating, dizziness, palpitations, sensations of heat, chills, less often fainting, abdominal pain and bloating, rumbling, diarrhea, belching.

Most often, dumping occurs after eating sugar-containing foods, honey, sweet drinks, ice cream, as well as fresh flour products, potatoes, bananas, milk, cottage cheese, fatty hot soups. Cold and hot food and its a large number of for 1 dose often provoke dumping.

Therefore, strict accounting of all intolerable dishes and individual selection of menus is important.

At the same time, nutrition for patients who have undergone gastrectomy should not significantly limit the amount of food consumed, as this leads to exhaustion, hypovitaminosis, anemia and other disorders.

To prevent dumping postoperative nutrition after gastric resection it should be gentle, with increased content protein up to 110-120 grams (men), 100-110 grams (women), limiting carbohydrates to 350 and 300 grams, respectively, mainly due to sugar (no more than 30 grams up to complete exclusion) and bakery products made from 1st wheat flour and top quality.

Along with diet, it is advisable to use medications that normalize motor function upper sections digestive tract, as well as enzyme preparations(festal, digestal, creon, mezim) to improve digestion processes.

Be sure to supplement your diet with multivitamin and mineral preparations.

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