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Post-Esophagectomy Diet

Esophagectomy is a surgery to remove all or part of the esophagus, which is the tube food moves through on its way from the mouth to the stomach. When the esophagus is removed, the stomach is pulled up into the chest and reattached to keep the food passageway intact. This stretching of the stomach takes away the ability to eat large meals, as there is no longer a large "holding area" for food to be digested. Nutrition is an important part of healing and preventing weight loss after surgery. Patients can experience nausea, vomiting, acid reflux, and dumping syndrome. This article will review some ways to decrease these symptoms. Check with your healthcare team for specific recommendations for your case.

After the surgery, the remaining esophagus may not be able to move foods as easily from your mouth to your stomach. Certain foods can block the esophagus or be difficult to swallow. Some people complain of food "sticking", or have midsternal (behind the breast bone) pain. This may be prevented or resolved by sipping fluids when eating solid foods, chewing foods well, eating soft or chopped foods and avoiding tough, gummy, or stringy foods.

You may also get gastroesophageal reflux symptoms, such as heartburn and reflux of stomach contents, causing intolerance to certain foods, especially acidic, fatty, and very hot or very cold foods. Gas and bloating sometimes occur after surgery. Therefore, you may wish to avoid foods that are known to cause gas.

Each person is different and will tolerate different foods. Only you can decide which foods 'agree' with you and which don't. Below are ideas that may help you to manage your symptoms. The most important guide is how you feel after eating a food.

Diet Basics After Esophageal Surgery

Tips to avoid heartburn or reflux

Tips for avoiding gas and bloating

Dumping Syndrome

Dumping syndrome is another possible concern after esophageal surgery. This happens when undigested food is "dumped" too quickly from the stomach into the small intestine. Symptoms such as nausea, feelings of fullness, and crampy abdominal pain are followed by diarrhea, usually within 15 minutes of a meal. Some individuals may also experience low blood sugar 1 to 2 hours after meals, which may cause weakness, nausea, sweating, hunger, fast heart rate, anxiety, and shaking.

Please note that some of the suggestions for managing dumping syndrome conflict with recommendations provided for decreasing reflux and for ease of swallowing. Use the suggestions that help manage your symptoms.

Tips to Avoid Dumping Syndrome

Sample Meal Plan

Breakfast

Lunch

Dinner

½ Banana

Cold/Hot Cereal (1/2 cup)

1 Slice Toast

Margarine (1 tsp)

*Milk (1/2 cup)

Hamburger patty (2 oz)

Toasted hamburger bun

Sliced tomato & lettuce

Mayonnaise/Ketchup

Applesauce (1/2 cup)

*Milk (1/2 cup)

*Tea (1/2 cup)

Broiled Chicken (3 oz)

Broccoli (1/2 cup)

1 small baked potato

Margarine (2 tsp)

Fruit Cocktail (1/2 cup)

*Tea/Coffee (1/2 cup)

Midmorning Snack

Afternoon Snack

Bedtime Snack

Cheese (1 ounce)

Graham crackers (4)

*Milk (1/2 cup)

Turkey (1 ounce)

Crackers (6)

Mustard

Vegetable Soup (1 cup)

Peanut butter ( 2 Tbsp)

Crackers (6)

*Fruit Juice (1/2 cup)

*If experiencing dumping syndrome, liquids should be given 30-60 minutes before or after the meal and limited to ½ to 1-cup servings.

Food List

This list contains general recommendations as to how well specific foods are tolerated by people after esophagectomy.

Generally Well Tolerated

Generally Not Tolerated

Beverages

Milk as tolerated, tea, unsweetened or diluted fruit drinks, water

Alcohol, sweetened fruit drinks*, carbonated beverages*, coffee*, chocolate milk drinks and milkshakes*

Breads & Cereals

Unsweetened dry cereals, cooked cereals (oatmeal, farina, grits, cream of wheat, cream of rice)

Well toasted breads and dense coarse breads/rolls may be tolerated

Soft, breads, rolls, bagels, English muffins, thick-crust pizza, soft pretzels

**Hard pretzels & corn chips may cause discomfort

Desserts

Sugar-free pudding or custard, sugar free gelatin, artificially sweetened frozen yogurt, ice cream, sherbet and ice milk, sugar-free popsicles

All doughy baked desserts, all sweets and desserts made with sugar, dried fruits, or chocolate*

Fats

Butter, margarine, salad dressing, vegetable oils, sour cream, cream cheese

Sweetened salad dressings*

Fruits

Unsweetened canned fruits and fruit juices, fresh fruits

All dried fruits, sweetened fruit juice, fruits canned in light or heavy syrup*

Citrus fruits*

Meats & Meat Substitutes

Ground or chopped meats, slow cooked tender meats (pot roast and stews), lean, tender meats, fish, poultry, shellfish, eggs, smooth peanut butter, cottage cheese, cheeses, tofu and soy products

Tough, stringy, or grisly meats.

Highly spiced or seasoned meats*

Fried meats*

Potatoes & Other Starches

Potatoes, rice, barley, noodles, pasta

Any to which sugar has been added*

Soups

Soups made with well cooked and tender meats

Soups prepared with heavy cream or high fat ingredients* or tomato based*

Sweets

Sugar substitutes and sweets made with sugar substitutes

Sugar*, syrup*, honey*, jelly*, jam*, molasses*, marshmallows*

Vegetables

Cooked fresh or frozen vegetables, canned vegetables or vegetable juices, raw vegetables as tolerated, small pieces may be easier to swallow

Fried vegetables*

Tomato sauces*

Miscellaneous

Salt, pepper, mildly flavored sauces and gravies, other seasonings as tolerated

Hot peppers*, tomato products*, products made with mint*, acidic foods*, vinegars*

*If no adverse symptoms occur, these foods can be added as tolerated.


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