Features of dietary nutrition after removal of the stomach. Gastric resection: reviews from patients and doctors. Nutrition after gastrectomy

Surgeons remove the fourth, third, or second part of the stomach; less commonly, a complete gastrectomy is performed. The segment of the organ remaining after the operation takes on all functions, but there is no talk of full digestion. Dietary nutrition after gastric resection for cancer helps to quickly adapt to the new condition.

Nutrition in the first days

Immediately after the operation, the patient cannot eat or drink. All the necessary substances must be injected into his veins in the form of complex solutions (they contain amino acids, glucose, and various salts). On the third day, if everything goes without complications, the attending doctor allows you to drink warm sweet tea in small portions (literally a teaspoon). At the same time, a special liquid diet is introduced into the diet - a protein mixture that is easily digestible and does not irritate the stomach.

Both the process of feeding the patient and the menu in the first days after gastric surgery is a concern medical personnel. First, food is introduced into digestive tract through the tube, after its removal - in the usual way. In order for recovery after gastric resection for oncology to proceed without complications, in matters of nutrition for the patient, it is necessary to strictly follow the instructions of the surgeons.

Diet after surgery

On days 4-6 (everything is determined by the characteristics of the course postoperative period) the patient is transferred to normal nutrition. However, the word “usual” does not mean a return to the usual diet, but only a transition to eating diet food. The first stage of this transition period is diet No. 0 (A, B, C), which is indicated after any gastric resection: regardless of whether it was oncology or an ulcer.

№0A

The operated patient should eat frequently (at least 8 times a day), in portions not exceeding 200 ml. All food should be warm, liquid and practically unsalted. The duration of adherence to this diet is determined by the doctor depending on the patient’s well-being. However, in most cases it is 3 days.

The patient is allowed:

• slimy decoction of oatmeal or rice;
• low-fat meat broth;
• jelly;
• rosehip infusion slightly sweetened.

№0B

Diet No. 0B after gastric surgery for oncology resembles the previous version, but there are changes in it:

• the frequency of meals can be reduced to 6-7;
• the size of one serving increases to 250 ml;
• the slimy decoction can be mixed with ground porridge;
• You can add a little grated dietary meat or chopped egg yolk to the broth.

It is advisable to eat according to these principles for 2-3 days or longer if indicated.

№0В

This The final stage transition of the operated patient to a complete diet. There should be 5-6 meals during the day. The menu can include:

• egg white omelet;
• puree soup (vegetable or meat);
• low-fat cottage cheese with cream;
• fermented milk drinks;
• baked apples(non-acidic varieties);
• crackers or biscuits (50-75 g).

Dumping syndrome

This syndrome is a common complication after surgery to eliminate stomach cancer. It occurs due to the ingestion of undigested carbohydrate foods into the intestines and an excessive rush of blood to the duodenum.

Main manifestations: feeling of fullness in the abdomen, seizures severe weakness and heat after eating, even loss of consciousness is possible. If a patient does not follow a diet after surgery for stomach cancer, the risk of developing dumping syndrome increases significantly.

To prevent this complication from occurring, you must:

• eat more protein foods and complex carbohydrates;
• It is advisable to limit light carbohydrates to a minimum;
• do not eat foods that strongly stimulate the secretion of bile and pancreatic juice (fatty, smoked, spicy, etc.).

Diet after 10 days

10-14 days after surgery on the esophagus and stomach, patients begin to feel much better, but this does not mean that they can not follow the diet. At this stage recovery period Diet No. 1 is shown. Food should continue to be pureed or pureed, you need to eat 5-6 times a day, 250 g each. You can drink no more than a glass of liquid at a time.

It is very important that the patient receives enough protein. To do this, your diet should include protein omelettes, lean fish, dietary meat, low-fat cottage cheese. Vegetables and fruits should be steamed or boiled and chopped so as not to irritate the gastrointestinal tract.

Nutrition after a few months

During gastric resection for cancer, restoration of the functioning of the gastrointestinal tract takes a long time, so nutrition should remain dietary even several months after the operation. The patient must continue to follow the principles of diet No. 1, but can already eat food in pieces. It is preferable to prepare dishes by boiling, stewing and baking.

6-8 months after gastrectomy, the patient’s menu may be the same as everyone else’s. However, it is very important not to forget about the regime - you need to eat little and often. In addition, a person who has undergone stomach cancer and such a complex operation should not risk his health and eat junk food, and even more so drink alcohol.

Authorized Products

What can you eat after gastric sleeve surgery? Much - the patient’s diet may well be healthy, varied and tasty.

Doctors include the following approved products:

• porridge (rice, oatmeal, buckwheat);
• chicken, turkey, rabbit, veal;
• unrich meat broths;
• fish (hake, cod, pike perch, pollock);
• omelettes and soft-boiled eggs;
• fermented milk products, cottage cheese;
• cream, butter (in moderation);
• vegetable oil;
• vegetables and fruits;
• jelly, jelly;
• yesterday's bread;
• still water and compotes.

Prohibited Products

Errors in nutrition after gastric resection can cause severe pain syndrome and digestive disorders. To prevent this from happening, patients should forget about the following products:

• fatty meats, fish, cheeses;
• offal, lard;
• rich broths;
• confectionery and fresh bread;
• some porridges (corn, pearl barley);
• sausages and smoked meats;
• canned food;
• vegetables containing coarse fiber (especially cabbage, radish);
• legumes;
• pickles;
• mushrooms;
• whole milk;
• ice cream, sweets;
• soda, store juice;
• strong coffee and tea;
• sauces.

Sample menu for the week

The weekly menu for a person who has undergone gastrectomy, at the stage of restoring the full functioning of the gastrointestinal tract, may be as follows:

• Monday. Breakfast – oatmeal, tea. 2nd breakfast – chicken cutlet steamed, berry jelly. Lunch – vegetable soup, a slice of bread, compote. Afternoon snack – baked apple, glass of kefir. Dinner – omelet, boiled fish, tea.
• Tuesday. Breakfast - buckwheat, tea. 2nd breakfast – cherry jelly, two crackers. Lunch – soup with meatballs, bread. Afternoon snack – vegetable salad (boiled), compote. Dinner - rice porrige, cottage cheese. At night - a glass of kefir.
• Wednesday. Breakfast – soft-boiled egg, cottage cheese, tea. 2nd breakfast – baked apple. Lunch – meat soup with cereal, a piece of fish, bread. Afternoon snack – berry jelly, toast. Dinner - mashed potatoes, meat pate ( homemade), tea. At night - a glass of yogurt.
• All subsequent days you can alternate these dishes.

The duration and nature of the recovery period after excision of part of the stomach depends to a large extent on how the patient eats. When preparing a diet for such a patient, the doctor makes sure that the operated organ first heals well, and only then learns to re-digest gastric contents.

Useful video about life after gastrectomy

It is known that during treatment of a malignant neoplasm of the stomach, the body’s strength is depleted, the immune system weakens, and the risk of infection by pathogenic microorganisms increases significantly. To support the body, accelerate regeneration processes in the stomach tissues and strengthen the body’s immune system, it is necessary to adhere to certain dietary principles. Of course, in the postoperative period it is unacceptable to rely only on dietary nutrition. For full recovery, besides healthy eating it is necessary to take medications prescribed by a doctor and undergo healing procedures. It is the correctly selected and prepared products that help slow down the process of cellular degeneration, which significantly reduces the risk of relapse.

General recommendations for dietary nutrition in the postoperative period

Correct balanced diet after removal of the stomach for cancer, it significantly improves the patient’s condition. Develops diet menu a gastroenterologist who takes into account factors such as the patient’s health status, age, treatment method used, and degree of advanced cancer.

Thanks to an analytical approach to treatment, experts have identified the main rules that must be used when building a nutrition program during the rehabilitation period. These include:

• fractional regular meals - the weight of portions varies from 30 to 300 grams, and the minimum number of meals is 6-7 times a day;
• limiting fat intake;
• reducing consumption of sugar and other sweet foods, including baked goods;
• reducing salt intake;
• refusal of drinks containing alcohol;
• mandatory consumption of fiber, easily digestible carbohydrates and green tea.

Some products for oncology, when entering the body, slow down recovery processes V gastrointestinal tract, loading the injured stomach, which can lead to aggravation of the patient’s condition. The table shows foods that are beneficial to the body and are strictly prohibited for consumption after surgery.

Diet after gastrectomy

During the first 24 hours after gastrectomy, the patient is unable to eat on his own. In order to deliver amino acids, lipids, protein, carbohydrates and others nutrients into the body using parenteral administration. Which microelements and vitamins the patient needs are determined using biochemical analysis blood.

The diet after removal of the stomach for cancer on days 2-3 or in the “early postoperative period” consists of gradually increasing the food load. For this, in addition to the parenteral method, enteral mixtures and solutions (for example, enpits) are administered in an amount of 40-50 ml several times a day. First, enpit is administered through an installed probe, and after two days the patient independently begins taking it per os (“by mouth”).

If the process of absorption of enpit in the gastrointestinal tract is not impaired, the patient is allowed to take 50 ml. per day unsweetened rosehip decoction, 30 ml. dried fruit compote or fresh berries, a quarter cup of green tea.

A week after part of the stomach is removed, the patient’s diet can be varied with meat- or vegetable-based soups, boiled eggs or grated cottage cheese. Portions should be no more than 50 grams, and the number of doses should not exceed 6 times. As soon as the stomach gets used to the new food, the portions can be increased, and pureed vegetables, omelettes and pureed oatmeal (rice) porridge are added to the menu. It is preferable to follow this menu for several months.

After the end of the third month of compliance strict diet, most cereals, fruits and vegetables are included in the menu. However, it should Special attention pay attention to the rules for eating dishes:

• food should only be in crushed form;
• the temperature of the dish should not be too cold or hot;
• food products must be thermally processed.

Features of the diet after gastrectomy

In the first 48 hours after the patient is prohibited from taking any foods or liquids. Nutrition of the body (as well as during gastrectomy) is carried out using parenteral administration.

On the 2-3 postoperative day, it is allowed to consume vegetable or meat broths. Complete removal of the stomach allows food to enter directly into the intestines, so portions must be increased gradually, starting from 20 grams. After some time, slimy crushed porridge, mashed potatoes without adding milk, a boiled egg, boiled vegetables, lean chopped meat and pasta are introduced into the patient’s diet.

After a month, you need to start eating chopped boiled onion, soy products, kelp and nuts in the quantity recommended by experts.

Also, to restore intestinal microflora, doctors prescribe the intake of lactobacilli and bifidobacteria. Especially if after a procedure such as gastrectomy, antibiotic treatment was carried out.

Sample menu for the 5th day after gastrectomy or gastrectomy (without complications)

• on an empty stomach – a glass of still warm mineral water without additives;
• first breakfast - boiled grated carrots and fresh kefir;
• second breakfast – carrot juice and nuts crushed into flour;
• lunch - boiled chicken, rabbit or turkey, grated beets and potatoes, compote;
• afternoon snack – biscuits with chicory tea;
• dinner – warm potato salad, a glass of milk;
• second dinner - unsweetened cookies, a glass of mineral water.

Portion weight is calculated in individually attending physician.

Diet after chemotherapy

After the procedure, the patient’s diet should include easily digestible and high-calorie foods. This is due to an increased gag reflex and decreased appetite. Particular attention should be paid to the following products after chemotherapy:

• sprouted grain – accelerates the regeneration of the epithelium, saturates the body with essential microelements and enzymes;
• beekeeping products – strengthen the patient’s immunity, coat the walls of the stomach, helping to reduce irritation of the mucous membrane;
• cabbage;
• pumpkin – contains vitamins and microelements that contribute to better rapid recovery body.

Basic principles of nutrition after chemotherapy

• it is necessary to prevent the processes of bloating and nausea, so the liquid should be consumed between meals;
• the food consumed must have a liquid, fine consistency;
• you need to eat only when you really want to eat;
• It is recommended to use such methods heat treatment like boiling or baking.

Correctly selected nutrition after surgery will help the patient in short time improve the functioning of the stomach, intestines, liver and restore suppressed immunity.

After gastric surgery, the patient can completely switch to a normal diet after 6 months. The transition from crushed to chunky food should be done gradually so as not to create stress on the intestines. IN this period Experts recommend consuming lactic acid products as much as possible and vegetable juices. It is the dairy diet after surgery that allows the body to produce the necessary enzymes for digestion of food.

Often, if the diet is not followed, the growth cancer cells continues, and the patient's condition worsens. To prevent the recurrence of stomach cancer, you need to follow a diet throughout your life.

Dietary nutrition after gastrectomy plays an important role in the recovery process of the body. In the postoperative period, the patient will have to completely change his eating habits. The diet must be balanced, because gastrectomy often provokes sudden weight loss, which is undesirable, as it is additional stress for the diseased body.

Importance and goals of diet

After gastrectomy in rehabilitation period It is important to eat right so that further recovery occurs without complications. The postoperative diet is aimed at fast healing the remaining part of the stomach, because during this period the usual food can worsen the condition. Sample menu, permitted products and recipes for preparing dishes must be approved by a gastroenterologist. After a gastrectomy, it is difficult for the patient to recover, and he quickly loses weight. Therefore, another goal of the diet after removal of the stomach is not to bring the patient to exhaustion and maintain his weight within normal limits.

After gastric resection for cancer or any other serious pathology, the anatomy of the digestive organ changes, and the conditions in which food will be digested normally change accordingly. Restorative nutrition after removal of part of an organ allows the body to gradually adapt to new conditions, due to which the risk dangerous complications is reduced to a minimum.

Features of nutrition in the early postoperative period

In the first 2-3 days after surgical intervention, regardless of the indications and odds of the pathology, eating any food is prohibited. Sometimes restrictions are imposed on water, but here everything is decided by the doctor. When the risk of early postoperative complications passes and in the absence of contraindications, you can start taking liquid in the form of vegetable broth, jelly. Then food pureed to a puree, kefir, and curd soufflé are added to the diet.

New dishes are added every week. It is recommended to feed a person mashed potatoes, boiled or steamed meat dishes, half ground vegetable soups. Freshly squeezed juices, some crackers or dried bread, and dried bread are also allowed. When the stomach is removed, food is prepared using a gentle method, without the use of salt, spices and seasonings.

After 3 months, nutrition after gastric surgery expands. You can eat half-ground food, but it is important to chew each piece thoroughly; in addition, special attention is paid to drinking liquid, which has a beneficial effect on digestion. After 6 months you can eat most familiar products and dishes, but you should follow the rules separate power supply and try not to mix foods of different composition.

Further diet

Despite some dietary restrictions, patients will not go hungry after surgery because diet table contains a lot of tasty and healthy food, however, the method of preparing it differs from the usual. It is useful to eat fractionally, 4-6 times a day, and the break between meals should not exceed 3-3.5 hours. Dishes are steamed or boiled. Fry in oil or add to prepared food frying is strictly prohibited.

To speed up stomach recovery after surgical treatment In addition to diet, your doctor may recommend using natural dietary supplements. The dosage regimen must be determined by a gastroenterologist. It is dangerous to use such supplements on your own.

What can you eat?

Diet after gastric resection for oncology or ulcerative lesion will be strict, but the list of allowed foods is not scanty, so a person will not starve. The menu must include the following food:

• Boiled eggs or in the form of a steam omelet;
• Meat lean varieties- veal, chicken, turkey;
• Lean fish;
• Vegetable oil - olive, flaxseed, sunflower;
• Dairy and fermented milk products of medium fat content;
• Hard cheeses, but not too salty and without spicy seasonings;
• Vegetables - potatoes, carrots, pumpkin, zucchini, beets, broccoli;
• Fruits - sweet apples, plums, pears, strawberries;
• Vegetarian soups;
• Nuts, peanuts, dried fruits;
• Liquid and viscous porridges on water - buckwheat, rice, oatmeal.

It is allowed to add butter to mashed potatoes - about 10 g, and it is also useful to eat a sandwich with butter and cheese in the morning. Can be prepared as a dessert cottage cheese casseroles or bake sweet fruits in the oven - apples, pears. Porridges are cooked only in water, if desired in ready dish You can add a little milk and butter. It is recommended to drink green tea with milk, dried fruit compotes, herbal infusions and infusions of chamomile, St. John's wort, mint, and rose hips.

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 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 increased amount free liquid. 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. The energy value of 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 . Pureed and pureed dishes are completely prohibited. dense consistency, drinks containing carbon dioxide, whole milk.
• 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 . It is a diet of a transitional stage to subsequent physiologically complete 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/mashed soups, pureed steamed meat and fish, pureed cottage cheese 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, in 9-12 days surgical diet after the operation ends, and the patient is transferred to the standard Pevzner (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 at 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 dense ones, 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, not pureed 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.

It is 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. It is possible to independently adjust the set of food products in the diet, taking into account individually intolerant 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 constant assessment of their tolerability.

Dietary nutrition must necessarily include taking tablets of a vitamin-mineral complex, drugs that normalize the motor-evacuation function of various parts of the gastrointestinal tract and drugs containing enzymes to improve digestion processes ( Creon , Mezim-forte ). Complete rehabilitation of 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 butter, low-fat cream or egg-milk mixture, cream to the finished dish. 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 thin porridge from buckwheat, oatmeal, rice cereals, 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 healthy. Drinks include juices from fresh berries, weak tea with cream, rosehip infusion.

Table of permitted products

Fully or partially limited products

The diet of a patient after gastric surgery excludes bakery and confectionery, fresh bread, pastries, products made from any type of dough. 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 the week after gastrectomy should ensure the alternation of various protein and cereal dishes in order to prevent monotony, while strictly observing the permitted methods of culinary processing of products and, most importantly, observing the 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.

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 stomach or duodenum. This operation is performed in cases where the disease is not amenable to 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 in 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 it goes directly 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 very quickly and the cardiovascular system reacts violently to this.

Some patients are alarmed by significant weight loss after surgery and especially by the fact that their weight, despite good nutrition, does not increase after several years. 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: cells are built from them various organs and tissues, including blood. Therefore, a person’s daily diet at any time after gastrectomy should contain 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 therapeutic treatment, or cancer and polyposis of the stomach. 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 occurs immediately, because alcohol is quickly absorbed through the mucous membrane small intestine and gets into 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, taken orally 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 nervous system, 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.

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