Patient Education Materials

	Patient Education

Patient Education - G

Diet After an Esophagectomy

An esophagectomy (ee-soff-uh-JEK-tuh-mee) is surgery to remove the esophagus. After this type of surgery, it is common to have some problems eating for a few months.

What can I expect after surgery?

For the first few months after surgery, you may have problems such as:

weight loss
dumping syndrome (nausea, diarrhea, abdominal cramping, light-headedness)
excess gas
trouble swallowing

Your diet plan after surgery is designed to lessen your discomfort and allow you to enjoy eating.

What type of diet will I have?

You will have several types of diet. Your diet will change slowly based on your rate of re-covery and how well you can tolerate food. In general, your diet plan will advance as follows:

clear liquid diet, for the first few days after surgery
full liquid diet
soft diet

Each person tolerates food in a different way. Based on how you progress after surgery, your doctor may advance your diet plan more slowly.

How can I help myself?

Follow the tips below to make eating more comfortable and enjoyable.

To reduce discomfort

Eat small, frequent meals (6 to 8 per day). This helps you get all the nutrients you need.
Take small bites, and chew your food well. This helps you to swallow and to digest your food.
Drink most of your fluids between meals. Limit your fluid with meals to 1/2 cup (4 ounces). Limit fluid with snacks to 1 cup (8 ounces).
If you eat sweets, eat them at the end of your meal. Sweets are digested more quickly than other foods. Eating sweets first could lead to low blood sugar, or hypoglycemia (HI-po-gly-SEE-mee-uh).
Choose foods that are soft and moist because they can be easier to digest. Avoid gummy foods, such as bananas and some breads.
Sit up straight when you eat. This way, gravity can help food move through your digestive tract. After you eat, continue to sit for 30 to 60 minutes.
Eat your last meal or snack at least 2 to 3 hours before you go to bed.

To avoid gas

Do not use a straw, chew gum, or smoke because these activities make you swallow air. Keeping extra air out of your digestive tract helps to reduce gas.

Avoid foods that produce gas, such as:

broccoli
cabbage
cauliflower
corn
dried beans
lentils
onions
peas

Avoid the following foods and drinks if they produce gas:

alcoholic drinks
caffeine
citrus and tomato products
sodas (carbonated drinks)

Clear liquid diet

Right after surgery, you follow a clear liquid diet, which is:

clear juice (apple, grape, and cranberry)
clear broth (chicken, beef, and vegetable)
flavored gelatin (such as Jell-O)
tea and coffee

Sodas (carbonated drinks) are not allowed for 6 to 8 weeks after surgery. After this time, you can try sodas in small amounts.

Full liquid diet

A full liquid diet contains all the liquids of the clear liquid diet, plus:

blended yogurt (not with pieces of fruit or seeds)
cream of wheat or cream of rice cereal
ice cream
instant breakfast drinks and nutrition supplements (such as Boost or Ensure)
milk
pudding
sherbet
strained cream soups (not tomato or broccoli)

Note: Dairy products may cause diarrhea right after surgery. Dairy products include milk, cottage cheese, ice cream, and pudding. You may need to avoid milk products at first. Then try them in small amounts as you ad¬vance your diet. You can also try products that are lactose reduced or lactose free.

Soft diet

A soft diet consists of bland, lower-fat, soft foods and drinks:

Food	Foods to Choose	Foods to Avoid
Breads	pancakes, waffles, and french toast crackers toasted bread	bread, bread products, and crackers that contain nuts, seeds, fresh or dried fruit, or coconut, or are highly seasoned, such as garlic or onion flavored crackers sweet rolls, coffee cake, and donuts
Cereals	any cereals, except those listed as foods to avoid	coarse cereals such as bran, Grape Nuts, and granola any cereals with fresh or dried fruit, coconut, seeds, or nuts
Desserts	plain cakes, cookies, and pies pudding and custard ice cream, ice milk, frozen yogurt, and sherbet gelatin made from allowed foods	desserts that contain chocolate, coconut, nuts, seeds, fresh or dried fruit, peppermint, or spearmint
Drinks	regular milk tea or coffee powdered drink mixes non-citrus juices such as cranberry, grape, apple, or blends of these nectars	sodas (carbonated drinks) alcoholic drinks citrus juices such as orange, grapefruit, lemon, and lime drinks that contain herbal ingredients, such as St. John's wort or ginseng.
Eggs	any, except those listed as foods to avoid	fried eggs and highly seasoned eggs, such as deviled eggs
Fats Eat in moderation	butter and margarine mayonnaise and vegetable oils mildly seasoned salad dressings made with allowed ingredients plain cream cheese	highly seasoned salad dressings, cream sauces, and gravies bacon, bacon fat, ham fat, lard, and salt pork fried foods nuts
Fruits	any canned or cooked fruits or fruit juice, except those listed as foods to avoid	all fresh and dried fruits fruits with seeds or skin, such as berries, figs, and raisins all citrus fruits and juices ripe bananas
Meats, fish, poultry, and cheese	finely ground, lean beef, lamb, pork, veal, fish, and poultry, prepared any way except fried cottage and ricotta cheeses mild cheeses such as American, brick, baby Swiss, or mozzarella smooth peanut butter plain, flavored, or fruited yogurt, except those listed as yogurts to avoid casseroles and stews prepared with allowed ingredients	tough meats with gristle fried, highly seasoned, smoked, and fatty meats, fish or poultry such as frankfurters, lunch meats, sausage, bacon, spareribs, beef brisket, sardines, anchovies, duck, and goose chili and other spicy foods shellfish strongly flavored cheeses such as sharp cheese and cheese that contains peppers or other seasoning crunchy peanut butter any yogurt that contains nuts, seeds, coconut, strawberries, or raspberries.
Potatoes and Starches	peeled white or sweet potatoes rice and barley pastas, such as enriched noodles, spaghetti, and macaroni	fried potatoes, potato skins, and potato chips fried, brown, or wild rice popcorn
Soups	mildly flavored meat stocks cream soups made with allowed ingredients	highly seasoned soups and tomato-based soups
Sweets Eat in moderation and with a meal. Note: If dumping syndrome occurs, you may need to avoid these.	sugar, syrup, honey, jelly, and seedless jam unfilled hard candies and plain candies made with allowed ingredients molasses other candy made with allowed ingredients	jam, marmalade, and preserves marshmallows any candy that contains nuts, seeds, fresh or dried fruit, coconut, peppermint, or spearmint
Vegetables	cooked vegetables without seeds or skins, such as asparagus tips, baby peas, beets, carrots, chopped spinach, green and wax beans, and winter squash	raw vegetables tomatoes, tomato juice, tomato sauce and vegetable juice, such as V-8 gas-producing vegetables such as broccoli, brussels sprouts, cabbage, cauliflower, corn, cucumbers, green peppers, onions, radishes, rutabagas, sauerkraut, and turnips dried beans, peas, and lentils
Other	salt, flavored extracts, condiments, spices, and herbs (depending on how your body reacts to them) ketchup, mustard, and vinegar (in moderation, depending on how your body reacts to them)	fried or highly seasoned foods nuts, seeds, and coconut pickles and olives chili sauce, barbecue, horseradish, black pepper, chili powder, and onion and garlic seasonings any other strongly flavored seasoning, condiment, spice or herb not tolerated well sodas (carbonated drinks) alcoholic drinks any food not tolerated.

Sample menu

Breakfast	1/2 cup canned fruit (non-citrus) 2 small pancakes 1 teaspoon margarine 1 teaspoon jelly or syrup 1/2 cup milk
Mid-Morning Snack	3 graham crackers 1 tablespoon peanut butter 1 teaspoon jelly 1 cup tea
Lunch	2-3 ounces beef patty (finely ground) 1/2 cup mashed potatoes 1/2 cup canned peaches 1/2 cup milk 1 teaspoon margarine
Mid-Afternoon Snack	4-6 saltine crackers 1 tablespoon cream cheese 1 cup milk or 1/2 cup fruit juice
Dinner	2-3 ounces roast chicken (finely ground) 1/2 cup rice 1/2 cup cooked carrots 1/2 cup canned pears 1 teaspoon margarine 1/2 cup tea
Evening Snack	1/4 cup cottage cheese 1/2 cup applesauce 1 cup milk