Nutrition Post Gastrectomy

What is a gastrectomy? Anaemia

A gastrectomy is an operation that When all or part of your stomach is
removes all or part of the stomach. As a removed, your body may be unable to
absorb vitamin B12 from your food, and it
result, the stomach is smaller with less
is harder to absorb iron. Both of these
room for food to be held. It may also
nutrients are required for healthy blood.
mean that food is not digested properly Your doctor may need to give you
before moving to the next part of the gut injections to replace vitamin B12. To help
causing nutritional problems. This sheet your body get the iron it needs you can:
explains how you can overcome these Eat foods high in iron: red meat, liver,
problems kidney and breakfast cereals with
added iron (eg Special K,
Some common problems and their cornflakes, etc).
management Eat foods high in vitamin C within
A gastrectomy can cause problems hour of eating iron rich foods. These
as described below. However not include fruit (especially citrus fruits,
everyone experiences all of these. fruit juices, and berries) and
vegetables (especially tomatoes,
capsicum).
Feeling full early
Eat small meals every few hours.
Weight Loss
Eat nutritious snacks between meals.
Eat nutritious snacks between meals
Have drinks at least hour before or e.g. cheese and crackers,
after meals, not with meals sandwiches, nuts, dried fruit, yoghurt,
dairy desserts.
Diarrhoea Have a serve of at least one of the
Drink plenty of liquids, especially following at each meal: eggs, cheese,
between meals. This will not make meat, chicken, fish, or milk.
your diarrhoea worse. Choose nourishing drinks have
If diarrhoea occurs 15 to 30 mins milkshakes, Milo, Sustagen, or
after eating, you may be experiencing Ensure rather than tea and
dumping syndrome. See advice on coffee.
next page. If diarrhoea persists, seek
medical advice.
Monitor your weight weekly and let
your dietitian know if you keep losing
weight.
Make the most of what you eat.
Please refer to tips on page 3

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This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team.
Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Updated February 2013
Review: February 2015
Dumping syndrome You do not need to avoid all fibre-rich
Normally there is a muscle at the bottom foods. It is acceptable to choose some
of the stomach that controls the amount higher fibre foods in smaller amounts
of food it lets into the small intestine. than you would usually eat.
Sometimes this muscle is taken out or
Some caution is also required in the
doesnt work as well following a
early stages with eating hard foods like
gastrectomy: this can cause dumping
steak. Softer meats such as mince, those
syndrome if food moves too quickly from in casseroles or tinned (ie braised steak
the stomach into the small intestine. and onion) are advised within the first
Symptoms may include nausea, few weeks.
vomiting, bloating, cramps and
diarrhoea, palpitations, sweating, A commercial nutritional supplement is
weakness and tiredness. To help avoid recommended in the first few weeks after
any of these symptoms you should - your gastrectomy to ensure your body
Avoid large meals. Choose six to receives all the nutrients it needs to
eight small meals/snacks each day. recover. Sustagen or Ensure are
available at chemists and some
Have drinks hour before or after supermarkets. Your dietitian will advise
meals, instead of with meals. Avoid you on how much you will need every
foods and drinks containing a lot of day.
sugar eg regular cordial and soft drink
Making the most of what you eat
Eating Again If you cant manage a lot of food through
the day it is important to make the most
In Hospital of what you do eat. Suggestions include:
While youre in hospital you will slowly
work up from eating nothing, to fluids, to Dairy
a soft diet. This will take place over Adding cheese to egg dishes such as
several days. scrambled eggs or omelettes.
At Home
Add skim milk powder to your milk
drinks to make them doubly
In the weeks following your gastrectomy, nutritious.
a moderately low fibre diet is
recommended while your gut fully
Choose dairy snacks like custard,
yoghurt, ice cream, rice puddings,
recovers from the surgery. Suggestions
Fruche and other similar products
include:
available from your supermarkets
choosing white bread/pasta/rice, dairy cabinet.
avoiding very high fibre breakfast
cereals such as all bran, fibre plus, Meat and Meat Alternatives
and muesli, Add meat to dishes such as soups
avoiding large amounts of green leafy and casseroles.
vegetables and legumes (e.g. baked Add lentils and other legumes to
beans), and soups and casseroles.
choosing lower fibre fruits such as Eggs make a nutritious addition to
melons, citrus fruits, or peeled apple. meals or make an easy snack. 2
This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team.
Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Updated February 2013
Review: February 2015
Breads and Cereals Dairy foods like custard, yoghurt, rice
Add butter/margarine, jams, dips, pudding, milk desserts, milk drinks
cheese, peanut butter or your make easy snacks. Choose full
favourite spread to a variety of bakery cream varieties where possible.
products.
Choose nutrient dense sandwich General Rules for Eating after a
fillings. Try meats, canned fish, baked Gastrectomy
beans, cheese, avocado, tinned
spaghetti, egg. 9 Eat a healthy diet choosing a wide
variety of foods
Fruit and Vegetables 9 Eat food slowly
Add margarine/butter, oil or cheese to 9 Chew food well
vegetables for extra energy. For
example, make cauliflower cheese or 9 Avoid very sugary foods (such as soft
a creamy potato bake. drinks, cordials, etc)
Add ice cream, yoghurt or custard to 9 Have your fluids at different times to
fruit for extra calories and protein. your meals
9 Aim for 6 to 8 smaller meals/snacks
Easy Snacks throughout the day
Supermarket freezers can provide
ready-made meals and snacks that
require little preparation.

Sample Meal Plan in the first few weeks following your Gastrectomy
On Waking Early morning tea
Glass of fruit juice Glass of Sustagen made on milk
(unsweetened)
Late morning tea
Breakfast Tub of yoghurt
Weetbix softened with milk
Afternoon tea
Lunch Glass of Sustagen made on milk
Sandwich with boiled egg and
grated cheese Supper
Tinned fruit
Dinner Ice-cream
Shepherds pie
(diced zucchini, carrot, and +Additional
pumpkin in mince with mashed fluids between meals
potato topping)

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This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team.
Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Updated February 2013
Review: February 2015