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Diet After Nissen Fundoplication Surgery

This diet information is for patients who have recently had Nissen fundoplication surgery. The diet will help control diarrhea, excess gas, and swallowing problems, which may occur after this type of surgery.

Keeping Your Stomach from Stretching

Eat small, frequent meals (six to eight per day). This will help you get the majority of nutrients you need without causing your stomach to feel full.
Drinking large amounts of fluids with meals can stretch your stomach. Drink fluids between meals as often as you like. But limit fluids to 1/2 cup (4 fluid ounces) with meals, and one cup (8 fluid ounces) with snacks.
Since sweet foods have a tendency to digest quickly, eat them at the end of your meal.
Sit upright while eating and stay upright for 30 minutes after each meal. Do not lie down after eating. Sit upright for 2 hours after your last meal or snack of the day.
Take small bites and chew your food well to help aid swallowing and digestion.
Foods that are soft and moist will be easier to digest. Avoid gummy foods, such as bananas and soft or crusty types of breads, which can be hard to swallow.

Avoiding Gas

Avoid drinking through a straw and do not chew gum or tobacco. These actions cause you to swallow air, which produces excess gas in your stomach.
Avoid any foods that you know cause stomach gas and distention. These foods include corn, dried beans, peas, lentils, onions, broccoli, cauliflower, and any food from the cabbage family.
Avoid caffeine, carbonated beverages, alcohol, citrus fruits and juices, tomato products, and chocolate.

When will I be able to eat a soft diet?

After Nissen fundoplication surgery, your diet will be changed slowly, depending on your progress and your tolerance for food.

Generally, you will be on a clear liquid diet for the first three days after your surgery. Then you will advance to the full liquid diet for three days.

The next diet you will be on is the Nissen soft diet. Please be aware that everyone’s tolerance for food is different. Your doctor may have you advance more slowly, depending on your progress.

Clear Liquid Diet

The clear liquid diet you will follow right after your surgery includes the following liquids:

Apple juice
Cranberry juice
Grape juice
Chicken broth
Beef broth
Flavored gelatin (Jell-O)
Decaf tea

Carbonated drinks (sodas) are not allowed for the first six to eight weeks after surgery. After this time you can try them again in small amounts.

Full Liquid Diet

The full liquid diet you will follow contains anything on the clear liquid diet, plus:

Milk (no chocolate milk)
Cream of wheat or cream of rice
Strained creamed soups (no tomato or broccoli)
Vanilla and strawberry ice cream (no whole strawberries)
Sherbet
Plain, blended or custard-style yogurt without pieces of fruit or seeds
Carnation Instant Breakfast (no chocolate-flavored)

Please note: Dairy products, such as milk, cottage cheese, ice cream, and pudding, may cause diarrhea in some people just after surgery. You may need to avoid milk products at first and try them in small amounts as you advance your diet.

Nissen Soft Diet

Beverages

Foods to Choose	Foods to Avoid
Regular milk (no chocolate milk) Decaf tea Powdered drink mixes (in moderation) Non-citrus juices (apple, grape, cranberry, or blends of these)	Chocolate milk, cocoa, or other chocolate-flavored drinks Drinks containing caffeine, such as coffee or tea Decaf coffee Carbonated drinks Alcohol Citrus juices like orange, grapefruit, lemon, and lime

Breads

You may start eating all allowed bread products seven days after your surgery.

Foods to Choose	Foods to Avoid
Pancakes, French toast, and waffles Crackers (saltine-type, round-butter type, graham) Toast	Untoasted bread, bread products, bagels, and crackers with nuts, seeds, fresh or dried fruit, coconut, or those that are highly seasoned, such as garlic- or onion-flavored crackers Sweet rolls, coffee cake, or donuts

Cereals

Foods to Choose	Foods to Avoid
Any, except those in the Avoid column Well-cooked oatmeal (plain or flavored, no dried fruits, raisins or nuts) Cold cereal (Cornflakes, Rice Krispies, Cheerios)	Very coarse cereals such as bran, granola, and shredded wheat Any cereal with fresh or dried fruit, coconut, seeds, or nuts

Desserts

Eat in moderation, and do not eat desserts or sweets by themselves. You may start eating cakes, cookies, and pies seven days after surgery.

Foods to Choose	Foods to Avoid
Plain cakes, cookies, and pies (pumpkin, custard, apple - no skins, and peach) Pudding and custard Ice cream, ice milk, frozen yogurt, and sherbet Gelatin Fruit ices and Popsicles	Desserts containing chocolate, coconut, nuts, seeds, fresh or dried fruit, peppermint, or spearmint

Eggs

Foods to Choose	Foods to Avoid
Any, except those listed in the Avoid column	Fried eggs and highly seasoned eggs (deviled eggs)

Fats

Foods to Choose	Foods to Avoid
Butter and margarine Mayonnaise and vegetable oils Mildly seasoned cream sauces and gravies Mildly seasoned salad dressings made with allowed ingredients Plain cream cheese	Salad dressings, rich cream sauces, and gravies Bacon, bacon fat, ham fat, lard, and salt pork Fried foods Nuts

Fruits

Foods to Choose	Foods to Avoid
Any canned or cooked fruit or fruit juice, except those listed in the Avoid column	All fresh fruits, especially citrus fruits and dried fruit Fruits with seeds or skin, such as berries, figs, and raisins All citrus fruit juices and pineapple juice Ripe bananas

Meat, Fish, Poultry and Cheese

Foods to Choose	Foods to Avoid
Finely ground lean beef, tender cuts of lamb, pork, veal, poultry, and fish (Note: meats, poultry, and fish should be prepared any way except fried. Try baking, broiling, boiling, roasting, stewing, or simmering). Cottage and ricotta cheeses Mild cheese such as American, brick, mozzarella, and baby Swiss Smooth peanut butter Plain custard or blended fruit yogurt	Tough meats with a lot of gristle Fried, highly seasoned, smoked, and fatty meat, fish, or poultry, such as frankfurters, luncheon meats, sausage, bacon, spare ribs, beef brisket, sardines, anchovies, duck, and goose Chili and other entrees made with pepper or chili powder Shellfish Strongly flavored cheeses, such as sharp cheese, and cheese containing peppers or other seasonings Crunchy peanut butter Any yogurt with nuts, seeds, coconut, strawberries, or raspberries

Foods to Choose

Foods to Avoid

Finely ground lean beef, tender cuts of lamb, pork, veal, poultry, and fish
(Note: meats, poultry, and fish should be prepared any way except fried. Try baking, broiling, boiling, roasting, stewing, or simmering).
Cottage and ricotta cheeses
Mild cheese such as American, brick, mozzarella, and baby Swiss
Smooth peanut butter
Plain custard or blended fruit yogurt

Tough meats with a lot of gristle
Fried, highly seasoned, smoked, and fatty meat, fish, or poultry, such as frankfurters, luncheon meats, sausage, bacon, spare ribs, beef brisket, sardines, anchovies, duck, and goose
Chili and other entrees made with pepper or chili powder
Shellfish
Strongly flavored cheeses, such as sharp cheese, and cheese containing peppers or other seasonings
Crunchy peanut butter
Any yogurt with nuts, seeds, coconut, strawberries, or raspberries

Potatoes and Starches

Foods to Choose	Foods to Avoid
Peeled, mashed or boiled white or sweet potatoes Oven-baked potatoes without skin Well-cooked white rice, enriched noodles, barley, spaghetti, macaroni, and other pastas	Fried potatoes, potato skins, and potato chips Fried, brown, or wild rice Popcorn

Soups

Foods to Choose	Foods to Avoid
Mildly flavored meat stocks Cream soups made from allowed foods	Highly seasoned soups and tomato soups, cream soups made with gas-producing vegetables, such as broccoli, cauliflower, onion, etc.

Sweets

Use in moderation and do not eat large amounts of sweets by themselves.

Foods to Choose	Foods to Avoid
Sugar, syrup, honey, jelly, and seedless jam Unfilled hard candies and plain candies made with allowed ingredients Molasses Marshmallows Other candy made from allowed ingredients	Jam, marmalade, and preserves Chocolate in any form Any candy containing nuts, coconut, seeds, peppermint, spearmint, or dried or fresh fruit

Vegetables

Foods to Choose	Foods to Avoid
Cooked soft vegetables without seeds or skins, such as green beans, wax beans, carrots, squash, beets, chopped spinach, and asparagus tips	Raw vegetables, tomatoes, tomato juice, tomato pasta, tomato sauce, and V-8 juice Gas-producing vegetables such as broccoli, brussels sprouts, cabbage, cauliflower, onions, corn, cucumber, green peppers, rutabagas, turnips, radishes, and sauerkraut Dried beans, peas, and lentils

Miscellaneous

Foods to Choose	Foods to Avoid
Salt and spices in moderation Mustard and vinegar in moderation	Fried or highly seasoned foods Nuts, coconut, and seeds Pickles and olives Chili sauces, ketchup, barbecue sauce, horseradish, black pepper, chili powder, and onion and garlic seasonings Any other strongly flavored seasoning, condiment, spice, or herb not tolerated well Chocolate Carbonated drinks Anything with caffeine Alcoholic beverages Any food not tolerated

Sample Menu

Breakfast	1/2 cup canned fruit (non-citrus) 1/2 to 3/4 cup cereal 1 small pancake 1 teaspoon margarine 1 teaspoon jelly 1/2 cup 2% milk 1 teaspoon sugar
Mid-morning Snack	3 graham crackers 1 tablespoon peanut butter 1 teaspoon jelly 1 cup decaf tea
Lunch	3 oz. beef patty (finely ground) 1/2 cup mashed potatoes 1/2 cup canned peaches 1/2 cup fruit juice (non-citrus) 1 teaspoon margarine 1 packet of salt
Mid-afternoon Snack	4 to 6 saltine crackers 1 tablespoon cream cheese 1 cup 2% milk
Dinner	3 oz. roast chicken (finely ground) 1/2 cup white rice 1/4 cup carrots 1/2 cup canned pears 1 teaspoon margarine 1/2 cup decaf tea 1 teaspoon sugar
Evening Snack	1/4 cup cottage cheese 1/2 cup applesauce 1/2 cup milk