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What is this information about?
This information is about the special diet that you should follow after you have had your anti-reflux operation.
Why have I been given this information?
You have been given this information because you have had an operation to treat gastric reflux. Gastric reflux is when food and acidic stomach contents come back up your food-pipe (oesophagus) after you have eaten. This can damage your food-pipe and be painful or uncomfortable.
Following the advice in this information will help you to recover well, have less discomfort and get the nutrition that you need after your operation.
What was done when I had my operation?
You have had an operation which has:
- repaired the area known as the hiatus where your food pipe (oesophagus) joins your stomach
- wrapped the top of the stomach (the fundus) around or over the base of the oesophagus
This can be done in different ways, but it will be like what is shown in the diagram below:
Will I get pain from trapped wind (gas) after my operation?
You may have some pain from trapped wind. Having the operation will make it more difficult for you to burp and trapped wind may build up in your tummy (abdomen). This can cause pain known as ‘gas bloat’. You may feel the pain in your abdomen, but you may feel it in your left shoulder, even though the problem causing the pain is not in your shoulder. This is called ‘referred pain.’
Very rarely, pressure, caused by the trapped wind, can build up on the operation site and cause complications.
What can I do to avoid getting pain from trapped wind?
Every time you swallow you always swallow some air too. To avoid swallowing too much air, which can lead to pain from trapped wind, you may need to change the way you eat and drink.
Do:
- chew your food for about 10 times before you swallow each mouthful.
- hold fluid in your mouth for 1 – 2 seconds before you swallow it when drinking. This will help you to avoid gulping air down with the drink.
- give yourself longer to eat your meals to avoid having to rush.
What type of diet (the types of food I eat) should I have at different stages after my operation?
Your diet (the types of food you can eat) will change as you recover after your operation. As time goes by, you will be able to eat more types of food.
After your operation you should have:
- first two weeks liquid diet. Be aware, you cannot have carbonated (fizzy) drinks.
- weeks two to four, pureed diet
- weeks four to six soft diet
- after six to eight weeks normal diet
What should I do if I find it difficult to move onto the next stage of the diet (for example, from the pureed diet to the soft diet)?
If it is difficult for you to move on to the next stage of the diet, for example if it is uncomfortable for you to eat any of the foods or you are having pain after you have eaten, go back to the previous stage of the diet. You can try moving on to the next stage again a few days later.
What types of food should I eat, or avoid, at each stage of the diet?
The foods suggested for different stages of the diet are a guide to give you an idea of the right types of food that you should eat at each stage. You can vary them to suit what you like to eat. The consistency of the food is the most important thing.
Foods to avoid
Over time it is likely that you should be able eat nearly all the foods that you could before your operation. Some foods can cause discomfort or even complications if you try them too soon after your operation.
Do leave these as the last types of food that you start having again as you build-up towards a full diet.
- Carbonated (fizzy) drinks. These can cause gas to build up in your stomach which can be painful
- Doughy foods (such as bread, pastries, or cakes). These foods suck-up the moisture in your mouth and form into a ball that can get stuck when you swallow it. Toasted multigrain bread, which does not do this so much, can be eaten as part of the ‘soft diet’ after 4 weeks
- Acidic fruit juices (for example orange, pineapple, grapefruit, and tomato)
These can cause irritation. Try apple or blackcurrant juice instead.
Will I lose weight when I am on the diet?
It is usual to lose some weight when you are on the special diet after your operation. Even if you feel you may need to lose some weight, it is not a good thing to lose weight in the time after your operation. So that you do not lose weight when you are on the special diet, choose full-fat options in the diet below. For example, use whole, full-fat milk rather than skimmed. If you are losing weight, you could:
- add 3-4 tablespoons of dried milk powder (such as Marvel) to a pint of milk so that you get more calories
- try high calorie or protein drinks such as Build Up or Complan. You can buy these from chemists or supermarkets
Liquid diet (first two weeks after your operation)
Being on a liquid diet means that you are only having foods that could be sucked up through a straw. Although you do not have to suck your foods through a straw, they should be smooth and almost a liquid consistency, without lumps or strands.
Do:
- use a blender or food processor to puree your food and a sieve to strain out any lumps, skins, husks, or pips
- make your food more fluid (runny) if you need to by adding stocks, sauces, or milk. Do not just add water as this will reduce the calorie content and cause you to lose weight, which is not good for you while you are on the special diet after your operation
The types of food that you can have during the Liquid Diet stage are slightly limited but include:
- breakfast cereals such as porridge, Ready Brek or Weetabix (pureed well) with extra milk
- soups with no solid lumps
- instant desserts such as mousses or crème caramel
- thin rice pudding, custard, or semolina with extra milk
- milk shakes or nutritional shakes. For example, Yop, Yazoo or Complan
- milk, coffee, tea, or hot chocolate
For the first few days after your operation, you may find that very cold or very warm liquids cause irritation, so room temperature or lukewarm is better at first.
Pureed diet (two to four weeks)
Pureed diet (two to four weeks)
- pureed rolled oats or porridge
- semolina
- soggy cereal with lots of milk. For example, Weetabix
- rice, pasta, or noodles pureed into a soup
- bread
- cereals with dried fruit or nuts in them
- crunchy cereals
- pasta or rice if they have not been blended or liquidised into a puree
Food group: fruit
- canned or stewed fruit that has been pureed
- pureed or mashed soft, fresh fruit such as banana, strawberries, or mango. Do remove seeds, pips, or skin if they are inedible or would not blend to a pureed texture
- pureed pitted (with the stones removed) prunes
- hard fruits or fruits which are not ripe
- fruits with segments such as oranges or tangerines
- fruits with a stringy texture such as pineapple
- dried fruit or dried fruit peel
- fruit with seeds or stones such as grapes or cherries
Food group: vegetables
- pureed vegetables. For example, potato, pumpkin, carrot, sweet potato, or cauliflower
- pureed broccoli, courgette, or spinach. These can be watery when they are pureed but you can thicken them by adding some pureed potato, or any of the other pureed vegetables listed in the point above
- fresh salads
- vegetables with a tough skin, such as sweetcorn
- undercooked or stringy vegetables which cannot be pureed or made into a smooth texture
Food group: meat, fish, poultry, eggs, and legumes (legumes are things such as beans, peas, lentils, and chickpeas)
- meat, chicken, or fish which has been cooked until it is soft. Make sure that there is enough liquid with it so that it can be pureed. This could be the liquid it was cooked in, or you could add some sauce
- soufflé or mousse. For example, salmon mousse
- pureed legumes such as baked beans or lentils
- tough, gristly, dry, or undercooked meat, chicken, or fish
- dry or overcooked eggs such as fried or hardboiled egg
- undercooked legumes
- nuts and seeds
Food group: milk, yoghurt, and cheese
- smooth cheese such as ricotta or cream cheese
- smooth yoghurt with no lumps
- fromage frais
- custard
- smooth ice cream with no lumps
- hard or dry cheese
- semi-solid cheese such as cottage cheese
- yoghurt with nuts, seeds, or pieces of fruit in it
- ice cream with chocolate chips, nuts, or other lumps in it
Soft diet (four to six weeks)
Soft foods are foods that can be easily broken up with a fork. Avoid dry, hard, and crunchy foods. Use sauces or gravy to moisten foods to make them softer to swallow.
Food group: breads, cereals, rice, pasta, and grain products
- toast. Although toast can be dry and hard, it is easier for your body to cope with at this stage after your operation than soft, doughy bread. Choose a multigrain loaf
- soft, plain cereals. For example, porridge, Weetabix, cornflakes, or rice crispies
- soft, doughy bread
- cereals with dried fruit or nuts
- crunchy cereals
- dry or hard pastry
- pizza
Food group: fruit
- fresh fruits that are naturally soft, such as banana. Remove any tough or hard seeds, pips, or skin.
- soft pitted prunes
- hard fresh fruits such as apple
- fruits with segments such as oranges or tangerines
- fruits with a stringy texture such as pineapple
- dried fruit or dried fruit peel
Food group: vegetables
- well-cooked (soft enough to be mashed with a fork) vegetables served in small pieces, soft enough to be mashed with a fork
- any raw vegetables with tough skin. For example, sweetcorn, hard, fibrous, or stringy vegetables such as celery
Food group: meat, fish, poultry, eggs, and legumes
- casseroles with small pieces of very tender meat
- flaked fish
- egg. Scrambled, poached or an omelette are best
- legumes, cooked until they are soft. For example, baked beans or dhal
- dry, tough, chewy, or crispy meats
- meat with gristle
- nuts or seeds
Food group: milk, yoghurt, and cheese
- most cheeses, yoghurt, and custard
- hard, dry, or crispy cooked cheese
Who can I contact if I need further information or support?
Worthing and Southlands dietitians:
Worthing Hospital, Lyndhurst Road, Worthing, West Sussex, BN11 2DH.
Phone
01903 205111
Ext. 5669
Email
[email protected]
St Richard’s dietitians:
St Richard’s Hospital, Spitalfield Lane, Chichester, West Sussex, P019 6SE.
Phone
01243 831498
Email
[email protected]
The information contained in this diet sheet was produced by: Mr R Bowyer, Mr W Hawkins, Mr C Pring and Mr G Slater from the Department of Upper GI (gastrointestinal) Surgery, St Richard’s Hospital, and the dietitians at University Hospitals Sussex NHS Foundation Trust.
Please help us to improve this information by contacting us to tell us if:
- it told you what you needed to know about your special diet
- it was easy for you to understand
- you can suggest any ways of making this information better
If you need this leaflet in an alternative format like large print, Braille, or a language other than English, please contact the dietitians.