Post procedure diet - post gastrectomy
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To provide a diet and meal frequency appropriate for patients in the early post-operative phase after a gastrectomy or oesophagogastrectomy, and to minimise risk of dumping syndrome or oesophageal blockage.
Characteristics
Foods may be naturally softer, or cooked to alter texture. Food is provided in six small meals per day. High protein foods (minimum 5g protein per serve) are served at mid meals 3 times per day.
Where appropriate, clinicians may consider ordering this diet for patients:
- Post gastrectomy or oesophagogastrectomy.
Nutritional adequacy
Patients ordered this diet will require monitoring of their protein and energy intake; they may require appropriate oral supplements.
Precautions
Patients require assessment and monitoring by a dietitian.
Paediatrics
Suitable for use in paediatrics when combined with an age-appropriate diet.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | Meats are minced and fish is flaked Small (1/2) serves | Crispy and crunchy foods e.g. some fried foods Meat with gristle Dishes with hard pastry or a hard base (e.g. pizza) Dishes with crisp topping |
| Sauces, gravies | All | - |
| Starchy vegetables / pasta / rice | Mashed potato (including high protein) Plain pasta, rice, noodles, couscous, polenta, semolina, quinoa | All other potato dishes Fried rice |
| Vegetables | Tender cooked vegetables, easily mashed with a fork (e.g. carrots, sweet potato) Small serves (single scoop) Added milk and margarine may be used to increase energy density | All others |
| Soups | Offer a Band 1 soup at each meal All soups without hard lumps and using allowed ingredients | - |
| Sandwiches | None | - |
| Salads, dressings | None | - |
| Breads, cereals | Rolled oats, semolina, wheat biscuits and other plain cereals with milk | Cereals with dried fruit (e.g. muesli) All breads |
| Spreads | Smooth nut butters, honey, yeast spreads, jam, hummus, tahini Butter and margarine | All others |
| Hot breakfast choices | Scrambled or poached eggs, omelettes, baked beans, canned spaghetti Semolina Pancakes and pikelets with syrup | All others (including fried bacon |
| Fruit | Soft fruit including bananas, kiwi fruit, canned fruit | Large pieces fruit (e.g. apple, grapes) Dried fruit and peel Fibrous fruit (e.g. pineapple) |
| Yoghurt | All yoghurt and yoghurt-like desserts (e.g. Fruche) including those with soft fruit | Yoghurt with muesli or dried fruit |
| Desserts | All milk-based soft desserts Cakes made with allowed ingredients Ice cream, jelly | Any desserts or cakes with hard pastry, nuts or dried fruit |
| Milk and cheese | All others | Cheese with dried fruit or nuts |
| Beverages | Fruit juices at breakfast only Cordial at mid meals Tea, coffee | Carbonated soft drinks |
| Biscuits | Easily crumbled biscuits and crackers e.g. shortbread or cream biscuits | All others |
| Miscellaneous | Liquid or pudding nutritional supplements Salt, pepper, herbs and spices, sugar and sweetener Cream Plain chocolate without nuts or dried fruit | Whole nuts |
References
- Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
- Rogers C (2011). Postgastrectomy nutrition. Nutrition in Clinical Practice, 26(2):126-136.
- Carey S, Laws R, Ferrie S, Young J and Allman-Farinelli M (2013). Struggling with food and eating–life after major upper gastrointestinal surgery. Support Care Cancer, 21:2749–2757.