Total gastrectomies are surgical procedures in which your stomach is removed, usually due to cancer or ulcer disease. The surgeon uses intestinal tissue to recreate a pouch that is attached to your esophagus and small intestine, enabling it to function as your stomach. The procedure may leave you with frequent heartburn, vitamin deficiencies and discomfort after eating (a condition known as dumping syndrome). Making dietary changes is crucial to living a healthy life after a total gastrectomy.
Making Changes
Your doctor may refer you to a nutritionist in order to best create an individualized plan to meet all of your dietary needs. According to the University of Maryland, Greenebaum Cancer Center, after a gastrectomy, you cannot absorb vitamin B12 from food; therefore, patients undergoing a total gastrectomy usually require vitamin B12 shots. Vitamin B12 is crucial for maintaining nerve health and healthy blood cells.
Jackson Siegelbaum Gastroenterology guidelines recommend that you eat small, frequent meals. Aim to have 5 to 6 small meals with no more than 4 ounces of fluid during the meal. This prevents food from overwhelming your small pouch and from moving too quickly through your GI (gastrointestinal) tract, enhancing your body's ability to absorb nutrients. Do not drink liquids during your meal; instead, drink 30 minutes prior to or 1 hour after your meal. After eating, rest for approximately 15 minutes to slow the food moving through your GI tract.
Anti-Dumping Diet Plan
Dumping syndrome is characterized by nausea, rapid heart rate, abdominal discomfort, diarrhea, cramping, increased perspiration and dizziness shortly after eating. Sugar often increases the symptoms as do high-fat foods and too much protein.
Jackson Siegelbaum Gastroenterology's Anti-Dumping diet recommends including all of the food groups in your diet for optimal nutrition. Consume at least 2 cups per day of dairy products that you can tolerate such as buttermilk, milk, cream soups, yogurt, cheese and low-calorie puddings. Include at least 3 servings of vegetables per day and 2 servings of fresh fruit, canned fruit or unsweetened fruit juice. Include at least 4 servings of breads such as rice, unsweetened cereal, pasta, crackers, breads, pretzels and rolls. Aim for between 5 and 6 ounces of eggs, peanut butter, poultry, beef, pork and seafood. Limit your desserts to low-calorie gelatins, popsicles and items sweetened with a sugar substitute.
After a total gastrectomy you should avoid foods such as ice cream, malted milk, milkshakes, dried fruits, sweetened fruit juice, sugary cereals, doughnuts, cake, cookies, pie, candy, regular soft drinks and anything sweetened with sugar.
Sample Menu
Breakfast: 4 ounces of unsweetened cranberry juice, 1 slice of toast with 1 teaspoon of low-calorie jelly and 1 poached egg.
Mid-morning snack: 1/2 cup of unsweetened cereal with skim milk.
Lunch: 3-ounce hamburger on a bun with ketchup, 1/2 cup of broccoli tossed with a teaspoon of butter or margarine and salt/pepper.
Mid-afternoon snack: 1 slice of bread with 1 ounce of turkey breast, 1 tbls. of mayonnaise and lettuce; 1/2 cup of low-calorie gelatin.
Dinner: 3 ounces of grilled chicken breast, 1/2 cup of steamed green beans, 1/2 cup of mashed potatoes and salt/pepper.
Nighttime snack: 1/4 cup of low-fat cottage cheese topped with 3/4 cup of fresh sliced pear.
