Losing weight after removing the stomach. Diet after gastric resection. Nutrition after surgery

Improving the well-being and accelerating the recovery of patients with in many respects depends on how correctly the convalescent diet is adhered to.

Patients with gastric cancer will have to reconsider their eating habits, if necessary, exclude certain foods. A certain diet is followed before and after the operation, the choice of food depends on the stage of the cancer.

If a person with a history of stomach cancer wants to reduce all the symptoms of his disease and avoid a relapse of the pathology after and, then he needs to completely revise his usual diet.

Many dishes will no longer be allowed to eat, some will have to be limited. Every day on the table there should be those foodstuffs that will help stop the process of cancer formation. It will be necessary to refuse the food in which the content of carcinogens is possible.

The general principles of dietary nutrition for gastric cancer include:

• Reducing the amount of food consumed at a time. Portions should be as small as possible, but you can eat up to 8 times a day, trying to keep the same intervals between meals.
• Compliance with a certain temperature regime. Dishes should not be hot or too cold. The food is better absorbed, the temperature of which is close to the temperature of the human body.
• Optimal mechanical processing of food. All food entering the stomach should be well chewed. This reduces the stress on the organ and ensures better absorption of all nutrients.
• Cooking food only steamed, boiled or baked. Fried foods contain carcinogens and substances that irritate the gastric mucosa.
• Avoiding irritating substances- spices, seasonings.
• Eating only fresh meals. It is advisable to cook boiled dishes immediately before meals.
• Reducing salt in the diet. A dose of 5 grams of salt is considered safe; if possible, it is better to replace it with permitted spices.
• Increasing the amount of plant foods in the diet. Fruits and vegetables contain fiber, which promotes good bowel movement. Plant foods are also rich in vitamins and enzymes that limit the growth of cancer cells.
• Decrease in fat intake. A patient with stomach cancer is advised to compose his diet for the day so that it contains no more than 30% fat and most of it should be obtained from plant foods.

A special diet is followed before and after surgery on the stomach to remove the cancer. It is more difficult to organize proper and nutritious nutrition in stage 3-4 cancer - in advanced cases of malignant organ damage, the patient may refuse food altogether.

What can you eat?

A patient with gastric cancer should always know exactly what to eat.

This will help to create a varied menu that satisfies both the taste needs and the body's need for vitamins and minerals.

Allowed for use:

• Vegetable soups, all components in them must be pureed.
• Porridge, they should be well boiled, preferably liquid.
• Low-fat meat and fish. They are mostly steamed, boiled or baked.
• Slimy cereal soups.
• Dairy soups.
• Eggs. Omelets and soft-boiled eggs are allowed.
• Cottage cheese with a minimum percentage of fat.
• Bread baked from premium and first grade flour. The bread should not be fresh.
• Kissels and jellies made from ripe fruits.
• Butter and vegetable fats.

Be sure to eat ripe vegetables and some fruits. In case of stomach cancer, it is recommended to eat fruits with red and yellow-green color, they contain many carotenoids that have an antitumor effect on the body.

It is useful to eat onions, carrots, red peppers, the nutrients in these vegetables are preserved even during heat treatment. The development of cancer cells is also hindered by substances such as anthocyanins; there are many of them in eggplants, red cabbage, and beets.

It is imperative for oncology to include citrus fruits, sea buckthorn, garlic, spinach in your diet. In early spring, you can diversify your diet with salads with radishes, parsley, young shoots of nettles, beet tops, dandelion.

The work of the gastrointestinal tract is improved by the influence of black beets, it can be added to salads. With anemia, and during the recovery period after surgery, fresh pumpkin and dishes from it are useful. You can drink green and weak ordinary tea, mineral water without gases, liquid jelly, compotes.

List of prohibited foods

Patients with any form of malignant gastric lesions need to remember that tumor processes are rapidly formed under the influence of food with preservatives, dyes, and various flavors.

Carcinogens can also linger in excessively fatty, over-fried foods; hot, salty and coarse foods irritate the mucous layer.

• Rich broths made from meat, fish, mushrooms.
• Hot spices, shop sauces.
• Too salty and smoked foods.
• Pickled snacks, canned food.
• Fruits and vegetables that are not fully ripe.
• Alcohol in any form.
• Coffee, strong tea, carbonated drinks.
• Various semi-finished products.
• Sweets - cakes, pastries, sweet pastries, chocolate. Excessive sugar increases the putrefactive processes in the digestive organs.

Non-recommended foods are completely banned for the entire period of treatment and recovery. Those patients who have successfully recovered from cancer need to remember that a relapse of the disease is largely prevented by proper nutrition. Therefore, it is necessary to follow a certain diet throughout life.

Menu before and after surgery

Patients with gastric cancer are most often prescribed a surgical operation, which involves the removal of the entire organ or part of it together with the tissues affected by the tumor.

In order for the operation to be carried out with maximum efficiency, it is necessary to warn the patient that his nutrition must be changed several days and weeks before the operation.

Before the removal of gastric cancer, it is necessary to eat easily digestible dishes, it is better if they are mashed or mashed. It is necessary to achieve optimal bowel emptying, plant food helps in this.

You need to eat in small portions, but you need to choose those foods that contain the largest amount of substances useful to the body. Fortified foods will strengthen the immune system, which will improve the recovery period after surgery.

But much more attention is paid to the organization of proper nutrition for already operated patients. The functions of the stomach after its removal are taken over by the intestine, but this organ by nature is not adapted to digest food, so it needs help.

The strictest dietary regime should be observed in the early recovery period, after a few weeks, the food is expanded, but the doctor should tell the operated person all the nuances of eating meals.

• Feeding the patient in the first days after surgery through an installed tube or by intravenous infusion.
• A gradual increase in the load on the stomach.
• Strict restriction in the choice of dishes.
• Eating minimal portions of food.

In the first postoperative days, the doctor may recommend fasting. At this time, intravenous solutions are administered to a person, so there is no strong desire. The doctor may further recommend starting with baby food - mixtures, mashed potatoes.

Enpits are widely used - a dry product rich in proteins. It is diluted and administered in 30-50 ml enteral route, and then, as usual, through the mouth. This drink brings the protein content in the body to normal, which is necessary for the functioning of internal organs.

Approximately on the third day after the operation to remove the cancer of the stomach, you can gradually start eating mucous soups, soufflé from meat or fish, fresh cottage cheese, soft-boiled eggs. Then boiled porridge, scrambled eggs, mashed mashed boiled vegetables are gradually introduced. The food portion is increased from 50 grams to 300-400 grams 10 days after surgery.

Two weeks after the removal of part of the stomach, you can already switch to a sparing diet, which will have to be followed for at least three to four months.

Therapeutic nutrition for cancer patients is aimed at preventing the development of inflammation, at sparing the gastric mucosa.

It is necessary to sharply limit the use of sweets, you cannot eat all prohibited foods. There should be enough protein in the daily menu in the form of meat and fish dishes, it is recommended to eat porridge-spread. The transition from completely mashed dishes to those where there are already pieces of food is carried out gradually.

New products and dishes are introduced into the diet carefully, you need to carefully treat all your sensations. During the recovery period after resection of the stomach for cancer, the body adapts to the changed conditions for the digestion of food, and therefore at this time there is no need to load the digestive organs with heavy food.

Approximate dietary menu for a day for a patient on the third day after removal of gastric cancer:

• For breakfast - a steamed meatball of lean meat and a small amount of rice porridge in the water. You can drink green tea or rosehip broth.
• For the second breakfast - mashed apple puree.
• For lunch, half a serving of chopped vegetable soup, half a glass of plain yogurt or kefir.
• For an afternoon snack - small vermicelli with a small amount of unsalted cheese.
• For dinner - half a portion of stewed vegetables and a small piece of steamed fish.
• Before going to bed, you can eat a little grated cottage cheese or drink half a glass of kefir.

Nutrition during and after chemotherapy

Chemotherapy is a necessary part of treating cancer patients, but this method of treatment imposes a tremendous burden on the body.

Anticancer drugs destroy not only atypical cells, healthy cells also die under their influence.

Due to this, a person's immunity falls, the functioning of internal organs is disrupted, and the blood system is affected.

Correctly organized nutrition helps to strengthen the body's resistance, improves the state of the immune system.

The main tasks of dietary nutrition during chemotherapy for stomach cancer:

• Good nutrition. It is necessary to choose those products and dishes that will ensure the intake of all the necessary substances into the body. Especially there should be a lot of protein required to build new cells. Protein is found in turkey, beef, seafood, eggs. It is imperative to eat fresh and thermally processed vegetables and fruits. Fermented milk products should also be present on the table.
• Appetite stimulation. With chemotherapy, there is almost no desire to eat, but in order for the recovery process to proceed as necessary, a person must definitely eat. It is better if these are high-calorie dishes - pastries, meat dishes, nuts. These foods give the body the energy it needs. If the doctor permits, then you can add some seasonings to your food and drink freshly squeezed non-acidic juices.
• Reduction of dyspeptic disorders and nausea. Side effects from the use of antineoplastic agents decrease when taking a large amount of water - you need to drink at least two liters per day and it can also be fruit drinks, rosehip decoction, sugar-free complements. It is necessary to abandon foods that contribute to the reverse reflux of the food lump into the esophagus, which only increases the nausea. These foods include tomatoes, citrus fruits, sweet and fatty foods. Hot and cold temperatures can also make nausea worse.

After a course of chemotherapy, you should never forget about proper nutrition. Patients with gastric cancer should eat a variety of foods, but at the same time, all prohibited foods should be excluded.

Nutrition for inoperable patients with grade 3-4

In the event that a person with gastric cancer at stages 3-4 can still eat himself, and not through a tube, he should adhere to the following rules in nutrition:

• Eliminate meat broths, red meat itself, salty, canned and smoked foods completely from the diet. Unripe fruits, sauerkraut, spices, coffee, alcohol are not allowed.
• The diet should be selected so that every day a person receives the carbohydrates, proteins, and fats he needs in terms of quantity.
• Eat up to 8 times a day, the portions of food are made the most minimal.
• The intervals between meals should be the same as possible.

If a probe is installed, then life is supported by the introduction of special mixtures. If it is not possible to acquire them, then well-crushed and mashed soups, liquid cereals, omelet, soft-boiled eggs are injected through the probe.

Life-long anti-relapse diet for stomach cancer

After the operation, a person can switch to the usual set of dishes after about a year or a little more. Naturally, this is allowed if there are no complications and no contraindications.

The transition should be gradual, the emphasis in nutrition is on plant foods. It is recommended to constantly drink natural yoghurts and juices.

The plant-milk diet improves metabolic processes, promotes the production of enzymes and thus has a positive effect on the functioning of the gastrointestinal tract.

Recovering patients need to remember that one of the causes of malignant gastric lesions is inaccuracies in nutrition. Therefore, for the rest of his life, a person should adhere to a healthy lifestyle with the use of only healthy foods.

Dish recipes

Despite the restriction in the choice of products, patients with gastric cancer can prepare dozens of delicious and healing dishes.

• Steamed chicken cutlets. Chicken meat must be freed from the skin and bones, scrolled in a meat grinder. Add a slice of black bread soaked in milk to the minced meat. Then cutlets are formed, they need to be cooked in a double boiler.
• Meat puree with zucchini. Boiled beef without fat must be minced. Minced meat in an amount of 200 grams is stewed with water until completely soft. During this time, young zucchini is freed from seeds and peels, cut and boiled until tender. Cooked zucchini are wiped through a sieve and need to be stewed for a few more minutes. The yolk from the egg is mixed with ¼ of warm milk, this mass is combined with the zucchini. Then the squash puree is mixed with meat, a little butter and a drop of salt are added.
• Steam curd soufflé. Rub cottage cheese in the amount of 100 grams, add a pinch of sugar, 10 grams of semolina, yolk from an egg to it. Add the whipped protein to the curd mass and put it in a mold. Cook soufflé for a couple of 20-30 minutes.

What kills our stomach, the following video will tell about it:

Feb-18-2017

What is gastric resection

A gastric resection is an operation that removes a large portion of the stomach, usually a quarter to two-thirds. Basically, resection is performed in the event of various dangerous diseases of the stomach (tumors, ulcers), and the operation can also be performed as a means of combating serious forms of obesity. For the first time the resection was performed in 1881 by Theodore Billroth, this German surgeon also implemented two main known methods of gastric resection with the subsequent restoration of the functioning of the patient's digestive processes. In addition to the methods of Billroth's operation, methods of gastric resection have also been known since the 2000s that do not affect the direct fundamental anatomical functionality of the organ - longitudinal or vertical resection.

In fact, resection is carried out by excision of the affected area of ​​the stomach, followed by restoration of the state of operable continuity of the gastrointestinal tract. Continuity is recreated by producing a connection between the stomach stump and the jejunum or duodenum by anastomosis.

Resection is difficult in that it affects one of the central elements of the body's supply of resources - the digestive system. A person cannot not eat, so the correct diet is very important for an adequate operation and the subsequent recovery process, which, ultimately, has the greatest impact on the possibility of optimal restoration of gastric functions after resection. Immediately before the operation (from a month to a week), it is necessary to strengthen the stomach through diet - take vitamins and tonics, eat protein-rich foods to prepare the stomach and the body in general for stress. An even more serious approach is required by the postoperative diet, which is divided into several periods. In the first days after the operation, the patient should be prescribed fasting, then food will be provided for some time, of course, in the hospital, through droppers, then through a tube. Subsequently, the doctor will prescribe a diet distributed over several periods.

After these operations, food very quickly flows from the esophagus and the rest of the stomach (with its resection - partial removal) into the small intestine, in which the main nutrients are absorbed. In this case, soon after eating, the patient may experience a feeling of heaviness in the epigastric region, weakness, sweating, dizziness, heart palpitations, dry mouth, bloating (flatulence), drowsiness, desire to lie down.

These phenomena are termed dumping syndrome. Proper nutritional management helps to avoid complications.

Diet after gastric resection

Those who have had stomach surgery should follow these rules:

1. Eat often, 5-6 times a day, little by little. Take food slowly, chewing thoroughly.
2. Limit the use of foods and dishes containing easily and quickly absorbed carbohydrates, especially sugar, honey, jam, sweet milk porridge, sweet tea.

It is advisable to take the third dish not immediately, but 1 / 2–1 hour after lunch, so as not to overload the stomach. The amount of liquid at one time should not exceed 200 ml.

Particular attention should be paid to nutrition in the first 2-3 months after discharge from the hospital: it is at this time that the digestive system adapts to new conditions in connection with the operation.

It is very important that food after stomach surgery is tasty, varied, and includes all the main nutrients. Particular importance is attached to complete animal proteins (contained in lean meat, chicken, fish, eggs, cottage cheese, cheese) and vitamins (included in vegetable dishes, which are components of fruits, berries, vegetable and fruit juices, rosehip broth, etc.). ).

Particular attention should be paid to nutrition in the first 2-3 months after discharge from the hospital: it is at this time that the digestive system and the body as a whole adapt to new conditions in connection with the operation.

Diet therapy tactics can be schematically represented as follows. In the first 2-3 months after the operation, as a rule, it is recommended to eat at least 5 times a day, using mainly chopped meals and products, mashed or steamed. In fact, the same diet is recommended as for peptic ulcer disease (dietary table No. 1, "shabby" option). However, sweets must be limited. After 2–3 months, the attending physician may recommend a “non-rubbed” version of dietary table No. 1. In 3-4 months after the operation, dietary table No. 5 is allowed.

Medical nutrition in the first days after gastric resection:

1st day. The sick person does not receive food.

2nd day. Weak tea, fruit jelly, mineral water (30 ml every 3-4 hours). Kissels are not very sweet.

3rd and 4th day. 1st breakfast - soft-boiled egg or steam omelet, half a glass of tea; second breakfast - juice, or jelly, or mineral water, mashed rice porridge. Lunch - slimy rice soup with meat puree or meat cream soup. Afternoon snack - tea or rosehip broth. Dinner - curd or meat soufflé. At night - unsweetened fruit jelly (1/2 cup).

5th and 6th day. Breakfast - a soft-boiled egg, or a steam omelet, or a meat soufflé, tea with milk. Second breakfast - mashed rice or grated buckwheat porridge. Lunch - mashed rice soup, steamed meat soufflé. Afternoon snack - sugar-free curd soufflé. Dinner - steamed meat dumplings, carrot puree. At night - fruit jelly without sugar.

7th day. Breakfast - 2 soft-boiled eggs, liquid rice or buckwheat porridge, tea. Second breakfast - cottage cheese steam soufflé without sugar. Lunch - mashed rice soup with potatoes, steamed meat cutlets, mashed potatoes. Afternoon snack - fish steamed soufflé. Dinner - calcined cottage cheese, jelly. White bread rusks are allowed.

A week after the surgery, diet No. 1 is prescribed, a "shabby" version with a restriction of easily absorbable carbohydrates.

• vegetable broth soups with various mashed vegetables, pasta or cereals;
• dishes from lean meats, poultry (chicken, turkey) and fish (cod, hake, ice, navaga, pike perch, carp, perch) boiled or steam. Meat mainly in the form of cutlets, dumplings, meatballs, mashed potatoes, soufflé;
• dishes from potatoes, carrots, beets, cauliflower, pumpkin, zucchini, mashed, soufflé or puddings;
• milk porridges (rice, oatmeal, barley, buckwheat, "Hercules"), soufflés, puddings made from pureed cereals, dishes from vermicelli, pasta, homemade noodles;
• soft-boiled egg, steam omelet;
• whole milk, dry, condensed without sugar (added to the dish), sour cream, cream, freshly prepared cottage cheese;
• boiled, mashed or baked fruits and berries;
• mild cheese, low-fat ham;
• honey, jams, preserves, marshmallows, marshmallows in limited quantities, subject to good tolerance;
• weak tea with milk or cream, weak coffee with milk or cream;
• fruit, berry (not very sweet), vegetable juices, rosehip broth;
• butter, ghee, vegetable (added to ready-made dishes);
• slightly dried wheat bread, uncooked biscuits, crackers.

Meat, fish, mushroom broths, fatty meats, poultry (ducks), fish, all fried foods, pickles, smoked meats, marinades, spicy snacks, pastry, pies, raw vegetables and fruits, radishes, rutabagas are excluded from the diet.

Approximate diet menu after gastric resection ("rubbed" option):

Breakfast: soft-boiled egg, buckwheat porridge, rice or Hercules, coffee with milk.

Second breakfast: baked apple, rosehip broth.

Lunch: vegetarian potato soup, steamed meat cutlets with milk sauce, grated fresh fruit compote or jelly.

Afternoon snack: milk, non-tasty cookies.

Dinner: boiled fish and potatoes.

At night: kefir or weak tea with milk.

3-4 months after gastric surgery, the “untouched” diet option # 1 or # 5 is usually allowed.

• vegetable broth soups with various cereals, vegetables, pasta, beetroot soup, milk soups with cereals, fruit and rice soups. Low-fat meat soup is allowed 1-2 times a week, provided that it is well tolerated;
• dishes from lean meats, poultry, fish - boiled, baked (pre-boiled), stewed (with the removal of juice);
• fresh vegetables (tomatoes, cucumbers, carrots), boiled and stewed vegetables (carrots, potatoes, beets, zucchini, pumpkin, cauliflower). Non-acidic sauerkraut, fresh herbs (parsley, dill) are allowed;
• various cereals (cereals and pasta) - rice, buckwheat, oatmeal, millet; cereals, puddings, fruit pilaf, boiled noodles, pasta;
• soft-boiled egg, omelet;

5-6 months after partial or complete removal of the stomach, the attending physician, depending on the state of health, may recommend that the patient adhere to diet table number 5 or 15.

• whole milk (with good tolerance) or with tea, dairy dishes, kefir, yogurt, acidophilus, sour cream (mainly as a seasoning), freshly prepared cottage cheese. They also prepare curds, various puddings, soufflés, dumplings;
• fruits and berries, ripe, raw and baked (apples);
• dairy, sour cream, fruit sauces;
• sausage type "Doctor", low-fat ham, jellied fish, cheese, boiled tongue, salads from raw and boiled vegetables, soaked herring;
• jam, honey, marshmallow, marshmallow, jams (in very limited quantities);
• tea, weak coffee with or without milk. Fresh fruit, berry and dried fruit compotes (not very sweet);
• fruit, berry (not very sweet), vegetable juices. Rosehip decoction;
• butter and vegetable oil (butter is added to ready-made dishes);
• wheat, rye, better slightly dried, bread, crackers, uncooked biscuits, products made from uncooked dough.

Products made from butter dough, pickles, smoked meats, marinades, canned snack foods, radishes, rutabagas, and hot spices are excluded from the diet.

Approximate diet menu ("non-rubbed" option):

Breakfast: tomato salad or vegetable vinaigrette, boiled meat, crumbly buckwheat porridge, tea with milk.

Second breakfast: fresh or baked apple or raw grated carrots.

Lunch: salad, vegetarian borscht, boiled fish (cod, hake, ice) with boiled potatoes, sauerkraut, compote.

Afternoon snack: fresh fruit.

Dinner: scrambled eggs, buckwheat groats, 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, may recommend that the patient adhere to a diet of table No. 5 or 15. If there are no complications and pronounced concomitant diseases, it is allowed to include low-fat dishes in the diet, more fresh vegetables and fruits, meat and fish broths, of course, with good patient tolerance.

Based on the book by M. Gurvich "Nutrition for Health".

Content of the article:

Diet after removal of the stomach for cancer is an obligatory part of the treatment, since due to the operation, the function of the gastrointestinal tract is disrupted. If earlier the digested food mass got into the small intestine, now it does not undergo the necessary processing, therefore the substances necessary for the body 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 removed completely. Even if the operation was successful, there were no serious complications, the patient needs to prepare for long-term rehabilitation. When the stomach is completely removed, it is important to take vitamins in the form of medications, especially vitamin B12, since it is absorbed in the stomach, and pernicious anemia can develop without additional treatment.

However, the prognosis is favorable if the patient underwent surgery on time, and then he underwent rehabilitation, 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 the cancer, the general condition of the patient.

Gastric resection is a similar operation, however, the patient does not remove the entire organ, but only part of it: from a quarter to 2/3. Then the stomach stump is connected to the duodenum. This is also a serious operation, 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 early days

Immediately after the operation on the stomach, the patient cannot eat, so he does not need to bring anything to the hospital. The first 2 days he is starving, and on the third day the doctor may allow him to drink a little compote or a decoction of rose hips, or sweet tea. The patient is given water every 15 minutes, giving him 1 tsp. liquids.
Doctors do not recommend something right after the surgery, feeding the patient is organized by the medical staff of the clinic. In order for the body to receive all the necessary nutrients, it can be injected intravenously with special mixtures of proteins and amino acids. Also, the doctor may prescribe protein enpit. The patient receives 30-50 ml of this solution. First, it is introduced through a tube, 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 received protein enpit is increased.

Nutrition after surgery

After 4 or 5 days, the doctor will switch the patient to a normal diet, provided that he does not have abdominal distention 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 the operation is very strict, but it cannot be violated, since proper nutrition is an important part of the patient's rehabilitation.

After resection of the stomach, the patient must eat according to a special scheme. 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 decrease this period, it depends on the patient's well-being.

Diet No. 0A

Diet No. 0A, appointed on the 4th or 5th day. Features of this diet: little salt (no more than 1 or 2 g) and a lot of water (1.8-2.2 liters). 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, it is allowed to eat 1 or 2 soft-boiled eggs.

What you can eat:

• slimy decoctions to which cream is added;
• light meat broth, no fat;
• jelly from fruits or berries;
• juices from vegetables or fruits;
• sweetened rosehip drink.

So far, you cannot eat dense foods, even if they are puree, and also drink milk.

Diet number 0B

This diet is needed 6 or 8 days after surgery for stomach cancer. The patient should take up to 2 liters of liquid, and the amount of salt is slightly increased, up to 4 or 5 g. The patient can eat up to 6 times a day, portions - 400 g. What can you? The menu is the same as for diet number 0A, but the list of allowed foods is larger:

• soups with cereals;
• the patient can already eat mashed porridge, cooked from rice or buckwheat, but only if they are liquid;
• soft-boiled eggs or protein omelet are allowed;
• in the patient's menu there is also meat, fish (puree), but only dietary.

Diet # 0B

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

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

Dumping Syndrome

Approximately 10-30% of patients after surgery performed on the stomach experience dumping syndrome, when food is quickly dumped from the stomach into the intestines, carbohydrate metabolism, the balance of gastrointestinal hormones, and so on are disturbed. Such patients complain of weakness, severe dizziness after eating, headache. They have a feeling of heat, sweat profusely, the patient may faint.

To prevent these and other unpleasant symptoms from appearing, especially if a person has stomach cancer oncology, a number of simple rules must be followed:

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 for a while about sweets, sugar, cakes, drinks, and canned juices.
3. Reduce the amount of fat, fried foods are also not allowed.
4. Patients should not eat food that increases bile secretion or because of which increases the secretion of the pancreas.

If unpleasant symptoms nevertheless appear, they must be reported to the attending physician, who should observe the patient after gastrectomy or resection. He will find the right treatment.

Diet 10 days after surgery

What can a patient without a stomach eat or a patient who has had a part of their stomach cut off? 9-12 days after the surgical intervention, the patient is transferred to the dietary table No. 1, but the worn-out option is chosen. The patient should eat often, food intake - about 5 or 6 times a day. Servings should be small, about 250 g, if it is liquid, then no more than one glass.

The diet should contain a lot of proteins, so patients need to eat chopped meat or boiled fish, cook omelets from proteins, and do not give up fresh cottage cheese. Fats are also needed, but in moderation. If the patient is sick from such food, the amount of fat is reduced. The patient should eat a 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 foods and canned food. All fried foods, bread, flour products, pickles are also prohibited. All vegetables and fruits must be ground before use.

Eating a few months after surgery

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

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 work 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 gastric cancer, due to which part of his stomach or the entire organ has been removed, the menu can still be varied. Here is a list of foods and foods that you can eat with this disease:

• slimy soups, which added oatmeal, buckwheat, rice, put a little butter or cream;
• you can cook meat dishes, for example, veal, chicken, turkey;
• white bread croutons;
• you need to cook fish dishes, and this is 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;
• useful jelly or jelly from berries.

Prohibited foods

To avoid abdominal pain 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 amount:

• strong broths;
• you cannot 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 not eat fried foods, as well as pickles;
• mushrooms;
• raw vegetables, especially legumes, cabbage, rutabagas, 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, juices from the store;
• sweets and jams are also not allowed, as well as ice cream, cakes, chocolates.

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

Resection of the stomach or its part in a number of cases is the only possible method of treatment and saving the patient's life. Stomach surgery is a radical treatment for extensive malignant neoplasms ( stomach cancer ), not amenable to conservative treatment, polyps, gastric 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 pronounced complications, rehabilitation takes a long period of time, and nutrition after stomach surgery is the most important component of this process.

Diet after resection of the stomach or after removal of part of the stomach

Parenteral nutrition after gastric resection begins with sequential Diet number 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 / micronutrients and an increased amount of free fluid. The use of salt is sharply limited.

On the first postoperative day, the patient is shown hunger; on the 2nd day - the diet includes 250 ml of warm sweet tea and rosehip infusion (50 ml), which are given after 15-20 minutes in a teaspoon; for 4-5 days in the absence of bloating and normal peristalsis, appoint Diet number 0A and 2 soft-boiled eggs; for 6-8 days Diet number 0B ; for 9-11 days - Diet number 0B .

• Diet number 0A ... Contains 5-10 g of proteins, 15-20 g of fat and 180-200 g of carbohydrates. The volume of free liquid is at the level of 1.8-2.2 liters, sodium chloride is not more than 1-2 g. The energy value of the daily diet varies within 760-1020 Kcal. Food is served liquid. Fractional diet - up to 7-8 times a day and the amount of food for one meal is not more than 250 g. The diet includes slimy decoctions with cream, light low-fat meat broth, fruit and berry jelly / jelly, sweet rosehip decoction, fruit and berry juices ... Dishes of puree and dense consistency, drinks containing carbon dioxide, whole milk are completely prohibited.
• Diet number 0B ... Contains 40-50 g of proteins, 50 g of fat and 250 g of carbohydrates. The volume of free liquid is up to 2 l / day, sodium chloride is not 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 foods Diet number 0A the diet expands due to the addition of slimy cereal soups cooked with vegetable broth, soft-boiled eggs, liquid mashed rice and buckwheat cereals, protein steam omelets, dietary meat and fish puree, sweet berry jelly.
• Diet 0B ... It is a transitional diet to the subsequent physiologically complete nutrition. Contains 80-90 g of protein, 70 g of fat and 320 g of carbohydrates. The volume of free liquid is 1.5 l / day. Sodium chloride is not more than 6-7 g. The energy value of the daily diet is 2100-2400 Kcal. Food is served puree. Diet - 5-6 times a day. The diet additionally includes cream soups / mashed potatoes, mashed meat and fish, steamed, cottage cheese, grated with cream, sour milk drinks, baked apples, mashed fruit / vegetable puree and 50-75 g of white bread crumbs.

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

The diet contains an increased amount of protein (100-110 g), which is used as dishes from boiled minced meat, boiled fish, fresh mashed / calcined cottage cheese, omelets from egg whites. 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 (and in pure form too), which is manifested by bitterness in the mouth, regurgitation, diarrhea, their number is limited to 60-70 g. The carbohydrate content is reduced to 300-320 g due to easily digestible carbohydrates.

In a number of 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 exclude foods containing sugar, since the use of easily digestible carbohydrates is one of the reasons for its occurrence.

To slow down the evacuation of food from the stomach stump, it is recommended to use viscous and jelly-like dishes. You can practice separate meals of a dense and liquid consistency, starting with a dense one, as well as eating while lying down. Eating food in even small portions 6-7 times a day. After eating, you need to lie / lie in bed for 30-40 minutes. You can also practice before eating carbohydrate food, the use of butter, which inhibits the excretion 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, hot snacks, salted fish and vegetables, solid animal fats, raw vegetables and fruits that are not pureed.

If the patient feels well, 3-4 months after the operation, he is gradually transferred to the not shabby version. Diets number 1 ... The diet is physiologically complete, contains an increased amount of proteins and an almost normal amount of fats and complex carbohydrates. The restriction applies to simple carbohydrates in order to prevent the development of dumping syndrome. The culinary methods of processing food are preserved: the food is boiled or steamed, and after boiling, it is baked or stewed. In terms of the set of products, the diet of this diet option is more extensive, but the rules and restrictions are the same.

Allowed the use of low-fat meat soups, borscht, cabbage soup (once a week), dried wheat bread, low-fat varieties of fish and beef, chicken dishes, non-nutritious 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, diet varieties of sausages, fresh fruits and berries.

In the absence of complications and satisfactory function of the gastrointestinal tract, 6 months after the operation, the patient can switch to a normal diet, but taking into account the diet and the characteristics of the chemical composition of the diet. It is possible to independently correct the set of food products in the diet, taking into account individually intolerable products. With a pronounced loss of body weight (by 10-15%) after gastric resection, especially for cancer, the caloric content of the daily diet should be increased compared to the physiological norm by increasing the content of the main food nutrients recommended for the diet.

When complications such as inflammation of the anastomosis or gastric stump occur, peptic ulcer prescribe a rubbed version Diets number 1 , and during exacerbation - sequentially No. 1A and 1B with the introduction of changes in them, taking into account the intolerance of certain products. In general, the nutrition of patients with diseases of the operated stomach should be individualized.

It is advisable to include specially developed dietary nutritional mixtures in food after stomach surgery - “ Nutrizone », « Nutridrink », « Berlamin Modular », Which should be administered in small portions, can be diluted with water, with a constant assessment of their tolerance.

Diet food 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 ). Full rehabilitation of patients is long and usually occurs by the end of the first year after surgery.

Indications

Stomach resection and complications of the operated stomach.

Allowed Products

The diet after resection of the stomach when transferring the patient to Diet number 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 the second courses, low-fat types of red meat (veal, beef), well-boiled chicken or turkey meat are used and passed through a meat grinder.

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

With good tolerance, 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 boiled eggs.

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

Approved Products Table

Fully or partially limited products

In the patient's diet after surgery on the stomach, bakery and confectionery products, fresh bread, pastries, products from any type of dough are excluded. Strong broths based on meat or fish, dishes from fatty meats and fish, as well as products based on them (canned food, sausages, smoked meats), solid animals and culinary fats, fried foods, pickles, mushrooms, various snacks, vegetables and raw fruits, fatty cottage cheese, cheese, sour cream, dairy products.

You can not include in the diet of various sauces and seasonings, spices. It is forbidden to use drinks with gas, strong tea, coffee, concentrated vegetable and fruit juices, any alcoholic beverages.

Prohibited Products Table

Nutrition menu after gastric resection (Nutrition mode)

The menu for the week after resection of the stomach should ensure the alternation of various protein and cereal dishes in order to prevent its uniformity, with strict adherence to the permitted methods of culinary processing of products and, most importantly, observance of the portion size. It should be remembered that meat / fish dishes are allowed to be consumed in the form of mashed potatoes or soufflés once a day. If milk is intolerant, it must be replaced with other products or consumed in small portions, as well as diluted with weak tea.

Complete or partial removal of an organ in oncology is a cardinal method of fighting cancer. How much can you eat after surgery, and what diet principles should you follow after stomach removal for cancer?

What is gastric resection

This is an operation that involves the excision of a part of the damaged organ. After resection of 1/4 or 2/3 of the stomach, the stump is connected to the duodenum. To shorten the rehabilitation period, the patient should eat properly.

Gastrectomy is a complex surgical procedure prescribed for stomach cancer, if there are no other ways to save the patient's life. In this situation, the damaged organ is eliminated entirely, and the patient will have to prepare for a long recovery.

The prognosis is favorable if the surgery was performed on time and the patient followed all the specialist's prescriptions.

Features of the digestion of patients after gastrectomy

When the organ is removed, the digestive process undergoes major changes, so you should carefully follow the advice of a nutritionist. It is necessary to ensure that the body receives all the nutrients.

After excision of the organ, especially if the tumor has also affected the intestines, the patient may not be bothered at all by the feeling of hunger. In this case, it is worth trying to eat food by counting calories. Naturally, losing weight in the first time after surgery is a variant of the norm, the main thing is to prevent a pathological decrease in body mass index. Even if the feeling of hunger does not arise, it is necessary to eat in order to find the strength to restore the body.

Another feature of digestion is the difficulty in absorbing certain beneficial compounds, especially vitamin B12. The explanation is simple: when the organ is removed, there is no protein synthesis, which ensures the absorption of cobalamin in the intestine. Therefore, a patient who has undergone a total resection of the stomach needs the intake of vitamin from the outside for several months.

Complications after gastric resection

Adaptation of the body to changed nutritional conditions takes about a year and is often accompanied by the development of complications:

• Reflux esophagitis is an inflammatory reaction of the esophagus resulting from the reflux of bile and the contents of the small intestine. The main clinical sign of pathology is heartburn.
• Dumping syndrome.
• Anemia.
• Intensive weight loss.

Dumping Syndrome

Roughly, 30% of patients after gastric resection for cancer are diagnosed with dumping syndrome. In this state, food enters the intestines too quickly, metabolism changes. The patient is worried about general weakness, dizziness, headache that occurs after eating. There is marked sweating and, sometimes, fainting.

In order to avoid the appearance of unpleasant symptoms, you should adhere to some basic rules:

1. The menu for the week includes an increased amount of proteins.
2. Reduce the intake of easily digestible carbohydrates.
3. Reduce lipid intake.
4. Eliminate the use of foods that stimulate the formation of bile or the production of pancreatic secretions.

If undesirable symptoms occur, notify a specialist. He will prescribe the optimal therapy.

The main rules of medical nutrition

Nutrition after removal of the stomach for cancer must meet serious requirements. After discharge from the hospital, you should switch to a sparing diet that excludes complex foods. The main rules of the diet for gastric resection are:

• Eating food in small quantities, but much more often: 6-8 times a day, since part of the gastrointestinal tract now does not participate in digestion. After eating, it is worth maintaining an upright position of the body for a while. More than 3 hours should not pass between meals.
• Elimination of fluid intake with food. It is best to drink water between meals.
• After resection of the stomach, the patient needs to keep a log of the food eaten and record the body's reaction to them. This will allow you to determine the food that provokes the development of dyspeptic disorders.

Standard food, which previously did not provoke an allergic reaction, can now cause intolerance. The body must be given time to get used to the new state and product.

Diet after gastric resection

Nutrition when removing the stomach for oncology is built in accordance with the list of acceptable and excluded dishes, with the obligatory observance of the permitted methods of culinary processing, advice on portion sizes and regimen.

What can you eat

Diet for gastric resection should include:

• soups made from oatmeal, rice, buckwheat, diluted with cream (a little) or butter;
• lean poultry (turkey or chicken), veal;
• white bread croutons;
• fish (pollock, pike hake, cod);
• oatmeal, buckwheat, rice porridge;
• omelet or soft-boiled eggs;
• milk, cottage cheese, cream (in the absence of individual intolerance);
• berry jelly or jelly.

Prohibited foods

To prevent the formation of abdominal pain and other undesirable symptoms, do not include in the diet after gastric resection:

• rich broths;
• fresh bread, flour and confectionery products;
• fatty meat, canned food, any smoked meats (for example, sausages);
• millet, pearl barley, barley and corn grits;
• pasta;
• fried or salted foods;
• mushrooms;
• sour cream or cottage cheese of excess fat;
• raw vegetables, primarily legumes, cabbage, radishes, onions, etc.;
• hot spices and sauces;
• coffee, carbonated and alcoholic drinks, strong tea, shop juices;
• ice cream.

Menu after removal of the stomach

A well-chosen nutritious diet after organ removal is an integral part of the rehabilitation period. It consists of the sequential prescription of certain diets - 0A, 0B, 0V. Immediately after the operation, the patient is shown hunger. On the second or third day, it is allowed to use weak tea, mineral water without gas, rosehip decoction, slightly sweet jelly.

Diet No. 0A

It is recommended 4-5 days after organ excision. They consume no more than 2 g of salt and a lot of liquid (over 2 liters) per day. You will have to eat 7-8 times a day, but in small portions (250 g each). It is permissible to eat one soft-boiled egg.

Allowed:

• slimy decoctions;
• low-fat meat broth;
• fruit jelly;
• vegetable juice;
• rosehip drink.

Milk and dense meals are excluded.

Diet number 0B

This diet is prescribed 6-8 days after surgery. You should drink up to 2 liters of water, consume no more than 5 g of salt per day. They eat 6 times a day, the size of 1 portion is 400 g. The list of permitted products is expanded:

• cereal soups;
• liquid rice or buckwheat cereals;
• omelet;
• lean meats and fish.

Diet # 0B

It can be done for 9-11 days. The patient is allowed to consume no more than 1.5 liters of water and 7 g of salt per day. Food is taken 5-6 times a day, the menu is diversified:

• puree soups;
• white bread croutons (no more than 75 g);
• fruit and vegetable purees;
• baked apples;
• low-fat cottage cheese;
• fermented milk drinks.

Menu 10 days after resection

At this time, the patient is transferred to the dietary table No. 1. The number of servings is 5-6 times a day (250 g each). Drink 1 glass of liquid at a time, no more.

The diet should be enriched with proteins, so the patient needs to eat boiled meat or fish, fresh cottage cheese. Fats and easily digestible carbohydrates are not overused.

All dense meals, fruits and vegetables are used in pureed form.

Sample menu after 1 month and year

If a person feels great, it makes no sense to eat exclusively grated food. After a couple of months, you can eat regular food, adhering to a number of restrictions. Alcohol, smoked, pickled or fried foods are still excluded. The diet is supplemented with herbs from their own plot, boiled vegetables, meat soups.

If side effects do not develop, then six months or a year after resection, the menu may become the same as everyone else's. But the diet should not be canceled.

If you correctly think over the menu with a remote organ, the patient will immediately recover and gradually diversify his diet.

Baked apples

Ingredients:

• apples;
• sugar to taste.

The apples are thoroughly washed and cored with a knife. A small amount of sugar is poured into the resulting hole. Place the fruit in a preheated oven and bake at 180 degrees for half an hour.

Berry jelly

Ingredients:

• raspberries - 50 g;
• black currant - 100 g;
• cornstarch - a tablespoon;
• water -1 liter;
• sugar to taste.

Boil water in a saucepan, add frozen or washed berries. Cook for 2-3 minutes. Strain the berries through a sieve, squeeze out the juice. Stir the starch in a glass of cool water. Pour sugar into a saucepan with a drink and slowly pour in starch, put on fire and bring to a boil, stirring. The cooled jelly can be drunk.

Components:

• eggs - 4 pcs.;
• salt - half a teaspoon;
• milk - 150 ml;
• vegetable oil - a teaspoon;
• butter to taste.

The eggs are mixed with salt. Milk is poured into the resulting mixture and mixed again. Transfer the mass to a pre-lubricated form. An omelet is baked in a preheated oven at 200 degrees for 30 minutes. The finished dish is served cut into portions and drizzled with butter.

Proper nutrition after gastrectomy is a necessary component of therapy, since the function of the gastrointestinal tract changes due to surgery. It must be remembered that in the absence of an organ, the food mass is not subjected to the necessary processing, and nutrients are absorbed more slowly.