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Information about your diet after surgery on your gut

Advice on food and drink following surgery on the gut.

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Eating and drinking after your gut surgery

Your surgical team will recommend a gradual return to drinking and then eating. For example, they will want to check that you can tolerate drinks before they suggest that you eat.

The rate at which you can return to your usual diet depends on the type of surgery you have had, and your gut’s response to your surgery. Everyone is different and gut function takes longer to return in some people than in others. Your team will let you know when you can progress to the next stage.

What can I eat and drink after surgery?

Stage 1. Clear fluids (CF)

Water, tea/coffee without milk, herbal tea, clear fruit juice e.g. apple juice, clear fruit squash e.g. elderflower, flavoured still water, jelly, Fortijuice, Bovril/Marmite drinks (made with hot water).

Stage 2. Free fluids (FF) 

Includes any clear fluids plus: Tea/coffee with milk, milk, milky drinks e.g. milkshakes, fruit smoothies*, fruit juice*, yogurt*, ice cream, soup*, Meritene shake, Meritene soup, Forticreme/Fortisip/Fortisip Compact.

*no bits e.g. no fruit pips/seeds/pulp/pith, small pieces of vegetables in soup.

Stage 3. Light diet (LD)

Introduce small portions of soft and low fibre foods by selecting foods from the ‘Foods to choose’ column of the tables on pages 4-6. Fibrous foods are normally recommended as part of a healthy diet. The fibre helps to move food and fluids through the bowel and adds bulk to stools. However, for the first week or two after gut surgery, a diet lower in fibre is likely to be better tolerated.

The Light Diet: sample day meal plan

For your first day of the Light Diet on the ward, you could choose:

Breakfast

  • Small bowl of low fibre cereal
  • Slice of white bread toast
  • Butter and yeast extract
  • White roll, butter and seedless jam
  •  A thick and creamy yogurt

Mid-morning

  • Banana snack
  • Rice pudding pot
  • A thick and creamy yogurt
  • A plain biscuit

Lunch

  • Tomato or chicken soup and a white bread roll
  • Ocean pie
  • Plain ham/egg/cheese sandwich (white bread)
  • Chocolate sponge (or any plain sponge pudding)

Mid-afternoon

  • Cheese and biscuits snack
  • Milkshake Jelly and ice cream

Dinner

  • Plain or cheese omelette (no vegetables)
  • Mashed potato and gravy
  • Small portion of shepherd’s pie or lasagne
  • Ice cream and jelly

From day 2 onwards choose similar foods but start to increase your portion sizes. Start to introduce small portions of well-cooked root vegetables such as carrots and swede, and tinned peeled fruit e.g. pear/peach slices.

See ‘Stage 4. Return to your usual diet’ for tips on how to build up your diet so you’re eating normally for you.

Types of food

Breads, crackers and flour products

Foods to choose:

  • White bread and rolls
  • English muffin
  • Crumpets
  • Waffles
  • Pancakes
  • Scones
  • White crackers e.g. cream crackers, water biscuits or Matzo

Foods to avoid:

  • Wholemeal, wholegrain, granary or seeded bread and rolls
  • 50:50 bread
  • Bread or bread products with nuts, seeds, or dried fruit
  • Wholemeal cracker e.g. Ryvita

Breakfast cereals

Foods to choose:

  • Corn flakes
  • Frosted flakes
  • Rice Krispies
  • Puffed wheat
  • Oat based cereals e.g. rolled oat porridge, Ready Brek

Foods to avoid:

  • Wholemeal, wholegrain, granary or seeded bread and rolls
  • Bran based cereals e.g. All Bran, Branflakes
  • Wholewheat cereals e.g. Shreddies, Shredded
  • Wheat, Weetabix
  • Cereals containing dried fruit or nuts e.g. granola, muesli, crunchy nut flakes

Starchy foods

Foods to choose:

  • White rice
  • White pasta or noodles
  • Potatoes without their skins
  • e.g. boiled, mashed or sweet
  • Couscous or bulgur wheat
  • Tapioca
  • Cassava
  • Polenta

Foods to avoid:

  • Brown rice
  • Wholemeal pasta or noodles
  • Wholegrains e.g. quinoa, pearl barley
  • The skins of potatoes

Dairy products

Foods to choose:

  • Milk
  • Hard, soft or cream cheese
  • Yoghurt
  • Crème fraiche
  • Fromage frais
  • Cream

Foods to avoid:

  • Yoghurt with pips, nuts, or seeds
  • Cheese with fruit or nuts

Vegetables and salad

Aim for two portions per day.

Foods to choose:

  • Most well cooked, soft or mashable vegetables without the peel or seeds
  • Passata (sieved tomato)
  • Vegetable based soups

Foods to avoid:

  • Raw or lightly cooked vegetables
  • Vegetables with seeds e.g. cucumber or tomato
  • Vegetables with skins or husks e.g. peas, sweetcorn, celery
  • High fibre vegetables e.g. mushrooms, spinach, cabbage
  • Beans, pulses and legumes

Fruit

Aim for two portions per day.

Foods to choose:

  • Soft, ripe, peeled fruit without seeds, pips and stalks e.g. banana, peach, plum or apple
  • Most canned or cooked fruits e.g. fruit cocktail

Foods to avoid:

  • Citrus fruits
  • Berries e.g. blackberries or strawberries
  • Prunes
  • Dried fruit
  • Fruit juice with bits
  • Smoothies that contain whole blended fruits

Nuts and seeds

Foods to choose:

  • Smooth peanut butter

Foods to avoid:

  • All nuts and seeds
  • Crunchy peanut butter
  • Coconut

Meat, fish and alternatives

Foods to choose:

  • Lean meat
  • Poultry
  • Fish
  • Eggs e.g. poached, scrambled, omelette
  • Quorn and meat-free mince or pieces
  • Tofu and tempeh
  • Meat based soups

Foods to avoid:

  • Tough, gristly meat
  • Fatty or fried meats
  • High fat processed meats e.g. sausages, burgers, kievs
  • Pies/pastry
  • Fried eggs

Desserts

Foods to choose:

  • Custard
  • Ice cream
  • Sponge pudding
  • Milk puddings e.g. mousse, rice pudding, Crème caramel
  • Jelly
  • Stewed / tinned fruit (see above for details)

Foods to avoid:

  • Puddings with dried fruit, nuts, seeds or coconut

Snacks

Foods to choose:

  • Plain biscuits
  • Plain cake and scones
  • Chocolate
  • Confectionery e.g. fudge
  • Sweets
  • Crisps
  • Popcorn

Foods to avoid:

  • Biscuit, cakes or scones
  • made with wholemeal flour
  • Oat biscuits/flapjacks
  • Cereal bars
  • Biscuits, cakes and chocolate with nuts, seeds or dried fruit

Drinks

Foods to choose:

  • Smooth fruit juice
  • Squash
  • Fizzy drinks
  • Tea, coffee or fruit tea

Foods to avoid:

  • Fried foods

Miscellaneous

Foods to choose:

  • Smooth fruit juice
  • Jelly jam
  • Smooth marmalade
  • Lemon curd
  • Honey or syrup
  • Gravy
  • Sauces e.g. Ketchup, brown sauce, mustard, soy sauce
  • Salad dressings e.g. mayonnaise or vinaigrette

Foods to avoid:

  • Jam/marmalade with bits
  • Pickles and chutneys

If you need to follow this diet for a longer period of time (e.g. more than a month) your medical/surgical team or dietitian will advise.

Stage 4. Return to your usual diet

When you no longer need a Light Diet, increase the size of your food portions and the amount of fibre in your diet.

If you have returned home while eating a Light Diet, you may wonder when you can start stage 4. The best guide is how you are tolerating your Light Diet.

If you feel you could eat larger portions, first eat larger portions of the Light Diet foods. If you tolerate these larger portions, then gradually include some of the higher fibre foods in the ‘Foods to avoid’ column of the tables on pages 4 to 6. The best way to start is to change from white to wholemeal bread for 1 week. Then try higher-fibre fruits and vegetables for a week, and finally introduce other foods such as nuts and seeds.

Following surgery you need more energy and protein to heal wounds and fight infection (up to 20% more). If you are struggling your dietitian may advise nutritional supplements

Do you have any other useful tips?

  • Eat little and often. Smaller meals with snacks may be easier to manage
  • Chew food well
  • Ensure you are drinking plenty. Aim for 8 to10 cups/glasses of fluid a day
  • To ensure you get enough vitamin C consider including a glass of fruit juice or vitamin C enriched squash daily
  • Some people find high fat foods are poorly tolerated and therefore may be best avoided e.g. fried or fatty foods
  • Caffeine can increase the speed that foods and fluids move through the bowel. Consider choosing decaffeinated drinks
  • If you are on the Light Diet for more than a month, and are unable to manage 5 portions of fruits and vegetables a day, you may need a multivitamin and mineral supplement. Speak with your doctor, GP or dietitian for further advice

Contact details

Royal Sussex County Hospital

Dietician 01273 696955 Ext. 64290

The Princess Royal Hospital

Dietician 01444 441881 Ext. 68313

This leaflet is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

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