An esophageal stent is a tube placed in the esophagus to keep a blocked area open so the patient can swallow soft food and liquids. Esophageal stents are used to treat a variety of conditions. These stents help to relieve dysphagia, allowing patients to maintain nutritional support perorally versus enteral nutrition. This article provides dietary recommendations following esophageal stent placement, focusing on strategies to prevent blockage and ensure adequate nutrition.
Esophageal Stents: An Overview
Esophageal cancer is a debilitating disease for patients, and symptoms often do not present until late in the disease process. In fact, the majority of esophageal cancer patients present with Stage III and Stage IV cancer at diagnosis. Radiation therapy, chemotherapy, surgery, and metallic stents all play a role in providing palliative treatment to these patients. Surgery, while a viable option in early stages of esophageal cancer, may not be an option for Stage III and Stage IV patients. Metal stents are delivered via a small introducer system designed to keep the stent constrained until deployment.
The placement of an esophageal stent is often done on an outpatient basis. Your esophageal stent procedure may take place under general anesthesia or sedation. The doctor puts a tube called a delivery system or a through-the-scope delivery system into your esophagus. The doctor will then use the stent to open the blockage in your esophagus. After your procedure, you will rest and recover as your care team monitors your progress for a few hours. When you are ready, the doctor will release you to go home. Make sure someone is there to drive you as you will still be unsteady from the anesthesia. Chest discomfort immediately following your procedure is normal. Your doctor may prescribe over-the-counter pain medicines as you need them. As you recover, be mindful of what you eat and adhere to a low-residue diet. Some stents are temporary, while others are permanent.
Initial Post-Procedure Diet
Once the stent has been placed, your medical team will advise you on when it is safe to start eating and drinking again. You will start with fluids and then build up gradually to a soft diet.
Long-Term Dietary Guidelines
The stent has been placed to allow you to eat as normally as possible. However, it is possible for the stent to become blocked. The most common reason for blockage is from food that is swallowed without being sufficiently chewed or from foods that do not break down enough when chewed. To minimize the risk of stent blockage and ensure adequate nutrition, consider the following guidelines:
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- Eat Small Meals: Consuming smaller, more frequent meals can reduce the burden on the esophagus and facilitate easier passage of food through the stent.
- Add Moisture: Use sauces, gravy, and cream to add moisture to your meals.
- Drink Fluids: Drink throughout your meal to help clear your stent. Warm or carbonated beverages are recommended, but all fluids are beneficial.
Foods to Favor and Those to Avoid
Navigating the complexities of post-stent placement diets involves understanding which foods are less likely to cause complications and which pose a higher risk of obstruction or discomfort.
Recommended Foods
Focus on incorporating foods that are soft, easily digestible, and well-moistened to facilitate smooth passage through the esophagus and stent.
- Well-Cooked and Softened Vegetables: Opt for vegetables that are cooked until tender and easy to chew. Examples include steamed carrots, cooked spinach, and mashed sweet potatoes. Ensure they are free from tough skins or fibers that could potentially cause a blockage.
- Soft Fruits: Choose fruits that are naturally soft or can be easily mashed. Bananas, cooked applesauce, and puréed fruits are excellent options. Avoid fruits with small seeds or tough skins.
- Moist Protein Sources: Select protein sources that are tender and easy to swallow. Good choices include soft-cooked eggs, well-moistened ground meats, and flaky fish. Tofu can also be a good option if it is prepared in a way that makes it soft and moist.
- Smooth Dairy Products: Dairy products like yogurt, pudding, and soft cheeses can be easily consumed and provide essential nutrients. Opt for full-fat versions if weight maintenance is a concern.
- Well-Cooked Cereals and Grains: Choose cereals and grains that are cooked thoroughly until soft. Oatmeal, cream of wheat, and well-cooked pasta are good examples. Ensure they are adequately moistened with milk, broth, or sauce.
Foods to Avoid or Modify
Certain foods are more likely to cause complications, such as blockages or discomfort, and should be approached with caution or avoided altogether.
- Dry and Sticky Foods: These foods can be difficult to swallow and may increase the risk of stent blockage. Examples include dry bread, crackers, peanut butter, and sticky candies.
- Fibrous Vegetables and Fruits: Raw vegetables, fibrous fruits, and those with tough skins or seeds can be challenging to digest and may lead to obstructions. Examples include celery, raw apples, corn on the cob, and fruits with small seeds like strawberries or raspberries.
- Tough Meats: Meats that are tough, chewy, or contain gristle can be difficult to swallow and may increase the risk of blockage. Examples include steak, pork chops, and sausages with casings.
- Nuts and Seeds: These foods are small, hard, and difficult to chew completely, making them a significant risk for stent blockage.
- Spicy Foods: Spicy foods can irritate the esophagus and cause discomfort. It is generally recommended to avoid or limit their consumption, especially if you are experiencing any inflammation or irritation.
- Alcohol and Caffeine: These substances can irritate the esophagus and may exacerbate any existing discomfort. Limiting or avoiding alcohol and caffeine is generally recommended following stent placement.
Tips for Modifying Foods
In some cases, it may be possible to modify certain foods to make them safer and easier to consume. Here are some tips:
- Puree or Blend: Use a blender or food processor to puree or blend foods into a smooth consistency. This can be particularly helpful for fruits, vegetables, and meats that may otherwise be difficult to swallow.
- Moisten Foods: Add sauces, gravies, broths, or other liquids to moisten foods and make them easier to swallow.
- Cut Food into Small Pieces: Cut food into very small, manageable pieces to reduce the risk of choking or blockage.
- Cook Thoroughly: Ensure that all foods are cooked thoroughly until they are soft and tender.
- Remove Skins and Seeds: Remove skins and seeds from fruits and vegetables to make them easier to digest.
Importance of Proper Chewing
One of the most critical aspects of preventing stent blockage is thorough chewing. Take small bites and chew each bite completely before swallowing. This reduces the size of food particles and makes them easier to pass through the stent.
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Stay Hydrated
Adequate hydration is essential for overall health and can also help to keep food moving smoothly through the esophagus. Aim to drink plenty of fluids throughout the day, such as water, juice, or herbal tea.
Addressing Potential Issues
Despite following dietary guidelines, stent blockage can still occur. If you experience difficulty swallowing, chest pain, or regurgitation of food, contact your healthcare provider immediately.
Other Considerations
It’s important to maintain all follow-up visits, even if you’re feeling well. Non-clinical testing has demonstrated that the WallFlex Esophageal Stent System, Ultraflex Esophageal NG Stent System and Agile Esophageal Stent System are MR Conditional. Please consult with your physician. Your physician should refer to the package insert for details.
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