Recovering from abdominal surgery requires careful attention to nutrition to support healing, prevent complications, and achieve weight-loss goals, if applicable. A well-planned diet plays a crucial role in this process. This article provides a detailed guide to the dietary stages, recommended foods, foods to avoid, and essential considerations for a successful recovery.
Understanding the Post-Surgery Meal Plan
Surgery gives you a brand new digestive tract, so you must treat it with care. Many people worry whether life after surgery will mean that they’re restricted in everything they can eat. This isn’t true! Following the post-surgery meal plan will help make sure you can still enjoy many of your favorite foods. The Kaiser Permanente post-surgery meal plan is designed to be your guide to nutrition after metabolic and bariatric surgery. Slowly reintroducing different textures and foods is important for helping your new digestive tract adjust, healing from surgery, maximizing weight loss, and making sure you are able to tolerate more foods in the long run. As you move through the stages of the post-surgery meal plan, you will learn which foods work for you.
Staged Dietary Approach
A gastric bypass diet, often used as a model, follows a staged approach to help you ease back into eating solid foods. How quickly you move from one step to the next depends on how fast your body heals and adjusts to the change in eating patterns. Your doctor or a registered dietitian will talk with you about the diet you'll need to follow after your surgery, including what types of food and how much you can eat at each meal.
Stage 1: Clear Liquids (First Few Days)
For the first day or so after surgery, you'll only be allowed to drink clear liquids. The first few days after surgery, you will need to have clear liquids only, so you will be choosing clear protein supplements.
Stage 2: Pureed Foods (Approximately One Week)
After about a week of tolerating liquids, you can begin to eat strained and blended, or mashed up, foods. You can eat 3 to 6 small meals a day. Each meal should consist of 4 to 6 tablespoons of food.
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Stage 3: Soft Foods (A Few Weeks)
After a few weeks of pureed foods, and with your doctor's OK, you can add soft foods to your diet. You can eat 3 to 5 small meals a day. Each meal should consist of one-third to one-half cup of food.
Stage 4: Firmer Foods (Around Eight Weeks)
After about eight weeks on the gastric bypass diet, you can gradually return to eating firmer foods. Start with eating three meals a day, with each meal consisting of 1 to 1-1/2 cups of food. Depending on how you tolerate solid food, you may be able to vary the number of meals and amount of food at each meal.
General Dietary Recommendations
Portion Control and Meal Frequency
Keep meals small. Eat several small meals a day. You might start with six small meals a day, then move to four meals and finally, when following a regular diet, three meals a day. When transitioning back to solid foods, patients may feel full more quickly than before surgery. To avoid discomfort, it is better to eat several small meals throughout the day rather than three large ones. This approach makes digestion easier and reduces bloating or gas.
Eating and Drinking Habits
Eat and drink slowly. To avoid dumping syndrome, take at least 30 minutes to eat your meals and 30 to 60 minutes to drink 1 cup of liquid. Chew food thoroughly. The new opening that leads from your stomach into your small intestine is very narrow and can be blocked by larger pieces of food. Blockages prevent food from leaving your stomach and can cause vomiting, nausea and abdominal pain. Chew foods completely, into puree form, before swallowing. Sip liquids between meals, not with meals. To avoid dehydration, you'll need to drink at least 8 cups (1.9 liters) of fluids a day. Limit coffee or tea to 1 small cup (12 ounces or 200 mg of caffeine) a day and observe your tolerance.
Food Choices
Focus on high-protein foods. Avoid foods that are high in fat and sugar. Choose high-calorie, high-protein foods and fluids for these meals to meet your nutritional needs.
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Specific Food Recommendations
Recommended Foods
Commonly, doctors recommend bland, easy-to-digest foods that are gentle on the belly and help nourish and heal the body. Some of these include:
- Applesauce
- Canned fruit
- Cooked vegetables
- Lean protein (tofu, egg whites, canned tuna)
- Low-fat dairy (skim milk, low-fat yogurt, low-fat cottage cheese)
- Mashed potatoes
- Toast
- Tofu
- White rice
For seniors after abdominal surgery for colorectal cancer or another serious gastrointestinal (GI) condition, doctors often recommend bland, easy-to-digest foods that are gentle on the belly and help nourish and heal the body.
Foods to Avoid
There are some key foods and drinks to be cautious of for the rest of your life. Eating these foods can make you very uncomfortable and lead to diarrhea and vomiting. These foods have limited nutritional value, may cause pain and discomfort, and take up a lot of space in your tiny stomach pouch. This leaves less room for the important nutrients you need to get after surgery. Foods high in fiber, such as bread and whole-grain cereals, are difficult for the stomach to fully digest.
Doctors commonly recommend avoiding these foods:
- Alcohol
- Beans
- Fatty meats
- Fried foods
- Fibrous fruits such as raspberries, blackberries, apples, and pears
- Raw vegetables
- Rich, oily snacks
- Seeds and nuts
- Spicy foods
- Sugary or artificially sweetened beverages
- Whole grain bread and pasta
Potential Complications and How to Manage Them
The greatest risks of the gastric bypass diet come from not following the diet properly. If you eat too much or eat food that you shouldn't, you could have complications.
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Dumping Syndrome
If too much food enters your small intestine quickly, you are likely to experience nausea, vomiting, dizziness, sweating and diarrhea.
Dehydration
Because you're not supposed to drink fluids with your meals, some people become dehydrated. Caffeinated fluids can contribute to dehydration.
Constipation
Eat high-fiber foods. Whole grains pack a lot of fiber, which helps keep food moving through your digestive tract. Examples of whole grains include whole-grain breads and pastas; cereals such as oatmeal and cream of wheat; and barley, bulgur, quinoa, and brown rice. Vegetables and fruits are a good source of fiber as well. Increase the available fiber by having whole fruits or vegetables, such as apple slices with the skin on. You can choose produce that is fresh, frozen, or canned. If choosing canned vegetables, try to use low sodium options, or rinse them before cooking. Avoid fatty foods that are more likely to cause constipation, such as cheeses and full-fat dairy products, French fries, and red meats. Limit your intake of fried food. Drink more liquids, such as water, herbal and decaffeinated teas, and other unsweetened beverages. Try to avoid caffeinated drinks, or restrict yourself to an 8oz serving per day to ensure that you are meeting your fluid goals. Maintaining adequate fluid intake helps to maintain bowel regularity. Set a goal of at least 64oz per day, unless otherwise advised by your surgeon.
Blocked Opening of Your Stomach Pouch
Food can become lodged at the opening of your stomach pouch, even if you carefully follow the diet. Symptoms of a blocked stomach opening include ongoing nausea, vomiting and abdominal pain. Blockages prevent food from leaving your stomach and can cause vomiting, nausea and abdominal pain.
Weight Gain or Failure to Lose Weight
The Role of Protein
Protein plays a vital role in healing since it helps the body rebuild tissue after surgery. Red meats have protein, but they tend to be high in saturated fat, which is not good for our heart health. If having red meats, try to choose a lean cut such as flank steak or strip steak, or cutting off the fat marbling to reduce the saturated fat. Lean sources of protein are better options. Try choosing seafood and fish; lean meats like chicken or turkey and pork; and non-meat proteins like eggs, tofu, beans and other legumes. Including reduced fat and no fat dairy products, such as milk, yogurt and cottage cheese can help you get enough protein after surgery. If you experience constipation when consuming dairy products before surgery we do not recommend including dairy products after surgery.
Patient-Controlled Nutrition (PCN)
In contrast to traditional approaches, Patient-Controlled Nutrition (PCN) allows patients to choose the timing and type of diet based on their comfort and preference. This method has shown promise in accelerating recovery. A study involving laparoscopic appendectomy patients demonstrated that those following PCN tolerated a regular diet sooner and had shorter hospital stays compared to those on a traditional, progressively advanced diet. The most reliable indicator of tolerability to postoperative oral feeding is the subjective opinion of the patients themselves, and the choice of diet should depend on the patient’s comfort and preference. Indeed, patients usually want to choose the time and type of diet, especially if surgical complications do not occur (in which case a nil per os diet might be required).
Additional Tips for a Smooth Recovery
Planning and Tracking
Planning and tracking are powerful tools when it comes to making any behavior change. Remember, you don’t have to track every day. Maybe you’ll track habits for a few days every once in a while to identify habits or patterns that may not be serving you. Or maybe you’ll plan and track every day to provide daily inspiration when you meet your goals. List foods that you use to make all meals and snacks. Post this list on the refrigerator. Keeping track of your progress toward a goal, even if only for a few days a week, can help you focus on clear goals, get motivated, identify patterns or habits, and see your progress. You may find it helpful to use a food diary or app to record what you are eating and drinking. Record the specific food or drink, the amount, and any symptom you have. Bring your food diary to follow-up appointments after surgery.
Managing Constipation
Many people have constipation after surgery. Often it can be a side effect of anesthesia or pain medicine. Since constipation can put stress on an incision - besides being painful - I warn my patients about this risk and strongly encourage them to do everything they can to help prevent or manage constipation.
The Importance of Vitamin
This vitamin promotes healing.
Avoiding Alcohol
You may feel like celebrating getting out of the hospital, but you shouldn’t toast to your good health with alcohol! One reason? Alcohol can dehydrate your body, which may hamper healing. In addition, you should never drink alcohol if you’re taking pain medication.
Addressing Loss of Appetite
Some people don’t feel like eating after surgery. They may not be hungry, or they may feel nauseous. Another strategy you can use when you’ve lost your appetite: add calories to the foods you normally eat. For example, instead of eating plain apple slices, try spreading some peanut butter on them. Some patients find that it is easier to tolerate liquid calories rather than eating solid meals. Try making smoothies at home with yogurt or non-dairy milk, peanut butter, and fruit! Remember to use whole fresh or frozen fruit to increase the fiber available in the smoothie. Let your doctor, nurse, or other member of your post-surgery team know about any problems you’re having with eating.
Trying New Foods
Try new foods one at a time.
Caregiver Support
Family caregivers and seniors have a lot to manage in the recovery period, between pain management and following the prescribed nutrition regimen-on top of everyday responsibilities at home. Visiting Angels professional caregivers can help lighten your load with non-medical home care services, including meal planning and preparation as part of your senior’s care plan. Communicate the care plan to your Visiting Angels office-our caregivers can help keep an eye on Mom or Dad’s eating habits and prepare appropriate meals and snacks. Contact your Visiting Angels office so these dietary instructions can be added to your loved one's care plan.