Esophagectomy is a surgery to remove all or part of the esophagus, which is the tube food moves through on its way from the mouth to the stomach. When the esophagus is removed, the stomach is pulled up into the chest and reattached to keep the food passageway intact. This stretching of the stomach takes away the ability to eat large meals, as there is no longer a large "holding area" for food to be digested. Nutrition is an important part of healing and preventing weight loss after surgery. Patients can experience nausea, vomiting, acid reflux, and dumping syndrome. This article will review some ways to decrease these symptoms. Check with your healthcare team for specific recommendations for your case and for a meal plan immediately after surgery.
After the surgery, the remaining esophagus may not be able to move foods as easily from your mouth to your stomach. Certain foods can block the esophagus or be difficult to swallow. Some people complain of food "sticking", or have midsternal (behind the breast bone) pain. This may be prevented or resolved by sipping fluids when eating solid foods, chewing foods well, eating soft or chopped foods and avoiding tough, gummy, or stringy foods.
You may also get gastroesophageal reflux symptoms, such as heartburn and reflux of stomach contents, causing intolerance to certain foods, especially acidic, fatty, and very hot or very cold foods. Gas and bloating sometimes occur after surgery. Therefore, you may wish to avoid foods that are known to cause gas.
Each person is different and will tolerate different foods. Only you can decide which foods 'agree' with you and which don't. Below are ideas that may help you to manage your symptoms. The most important guide is how you feel after eating a food.
Dumping syndrome is another possible concern after esophageal surgery. This happens when undigested food is "dumped" too quickly from the stomach into the small intestine. Symptoms such as nausea, feelings of fullness, and crampy abdominal pain are followed by diarrhea, usually within 15 minutes of a meal. Some individuals may also experience low blood sugar 1 to 2 hours after meals, which may cause weakness, nausea, sweating, hunger, fast heart rate, anxiety, and shaking.
Please note that some of the suggestions for managing dumping syndrome conflict with recommendations provided for decreasing reflux and for ease of swallowing. Use the suggestions that help manage your symptoms.
Breakfast | Lunch | Dinner |
½ Banana Cold/Hot Cereal (1/2 cup) 1 Slice Toast Margarine (1 tsp) *Milk (1/2 cup) | Hamburger patty (2 oz) Toasted hamburger bun Sliced tomato & lettuce Mayonnaise/Ketchup Applesauce (1/2 cup) *Milk (1/2 cup) *Tea (1/2 cup) | Broiled Chicken (3 oz) Broccoli (1/2 cup) 1 small baked potato Margarine (2 tsp) Fruit Cocktail (1/2 cup) *Tea/Coffee (1/2 cup) |
Midmorning Snack | Afternoon Snack | Bedtime Snack |
Cheese (1 ounce) Graham crackers (4) *Milk (1/2 cup) | Turkey (1 ounce) Crackers (6) Mustard Vegetable Soup (1 cup) | Peanut butter ( 2 Tbsp) Crackers (6) *Fruit Juice (1/2 cup) |
*If experiencing dumping syndrome, liquids should be given 30-60 minutes before or after the meal and limited to ½ to 1-cup servings.
This list contains general recommendations as to how well specific foods are tolerated by people after esophagectomy.
Generally Well Tolerated | Generally Not Tolerated | |
Beverages | Milk as tolerated, tea, unsweetened or diluted fruit drinks, water | Alcohol, sweetened fruit drinks*, carbonated beverages*, coffee*, chocolate milk drinks and milkshakes* |
Breads & Cereals | Unsweetened dry cereals, cooked cereals (oatmeal, farina, grits, cream of wheat, cream of rice) Well toasted breads and dense coarse breads/rolls may be tolerated | Soft, breads, rolls, bagels, English muffins, thick-crust pizza, soft pretzels **Hard pretzels & corn chips may cause discomfort |
Desserts | Sugar-free pudding or custard, sugar free gelatin, artificially sweetened frozen yogurt, ice cream, sherbet and ice milk, sugar-free popsicles | All doughy baked desserts, all sweets and desserts made with sugar, dried fruits, or chocolate* |
Fats | Butter, margarine, salad dressing, vegetable oils, sour cream, cream cheese | Sweetened salad dressings* |
Fruits | Unsweetened canned fruits and fruit juices, fresh fruits | All dried fruits, sweetened fruit juice, fruits canned in light or heavy syrup* Citrus fruits* |
Meats & Meat Substitutes | Ground or chopped meats, slow cooked tender meats (pot roast and stews), lean, tender meats, fish, poultry, shellfish, eggs, smooth peanut butter, cottage cheese, cheeses, tofu and soy products | Tough, stringy, or grisly meats. Highly spiced or seasoned meats* Fried meats* |
Potatoes & Other Starches | Potatoes, rice, barley, noodles, pasta | Any to which sugar has been added* |
Soups | Soups made with well cooked and tender meats | Soups prepared with heavy cream or high fat ingredients* or tomato based* |
Sweets | Sugar substitutes and sweets made with sugar substitutes | Sugar*, syrup*, honey*, jelly*, jam*, molasses*, marshmallows* |
Vegetables | Cooked fresh or frozen vegetables, canned vegetables or vegetable juices, raw vegetables as tolerated, small pieces may be easier to swallow | Fried vegetables* Tomato sauces* |
Miscellaneous | Salt, pepper, mildly flavored sauces and gravies, other seasonings as tolerated | Hot peppers*, tomato products*, products made with mint*, acidic foods*, vinegars* |
*If no adverse symptoms occur, these foods can be added as tolerated.
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