Post-Gastrectomy Nutrition

Katrina Claghorn, R.D.
Last Modified: November 1, 2001

Question
Dear OncoLink "Ask the Experts,"
My father had a gastrectomy for his gastric cancer 3 weeks ago. He is currently undergoing chemotherapy. The main problem for him now is discomfort after eating even small amounts of food. We feel he is not getting enough nutrition.

I would like to know what type of diet my father should be on? And which nutritional supplements should he have? Your quick response would be greatly appreciated.  
Thanks for help in advance.
R.W.


Answer
Katrina Claghorn, R.D., Oncology Dietitian for The University of Pennsylvania Health System, responds:

Dear R.W.,

Small, frequent meals consisting of bland, low fiber foods are best tolerated following gastric surgery. Often, milk products can cause bloating, abdominal pain and diarrhea. When these symptoms are present low lactose milk products (such as Lactaid) maybe substituted.

Nutritional supplements such as Ensure, Sustacal, Boost and even Carnation Instant Breakfast are also helpful since they provide an easy way to consume additional calories and protein. Ensure and Sustacal are low lactose and Carnation Instant Breakfast can be made with Lactaid milk.

For a person such as your father, who has had stomach surgery, which has reduced his stomach capacity and who is now experiencing decreased food intake due to chemotherapy, a mostly liquid diet may be best tolerated. Soups, puddings and bland foods will be easiest for him to eat. Provide small meals and offer nutritional supplements between meals. Three cans of highcalorie/high protein supplements will provide about half of your father's nutritional needs.

You should also keep a food diary of all the foods he eats with the amount and the time it was eaten. This will provide his doctors with an objective assessment of your father's food intake and nutritional status and help them determine if more aggressive intervention is needed.

You may also want to see a registered dietitian who can develop an individualized meal plan for your father, as well as provide you with ways to control the side affect to the therapy and ensure that your father's nutrition needs are being met.

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