Fractional nutrition after removal of the stomach. Nutrition after removal of the stomach for cancer

A cancerous diagnosis of the stomach is not a sentence. Treatment for some types of cancer includes. This can lead to a number of changes in lifestyle and eating habits. A gastrectomy is the removal of part or all of the stomach. Special attention It is given to what kind of food after removal of the stomach in cancer is assigned to the patient. Lack of main digestive organ significantly affects the power supply.

To solve the problems of the stomach, if other types of treatment do not help, removal of the organ is used in the following cases:

benign tumors;
bleeding;
inflammation;
perforation of the stomach wall;
polyps, or growths inside your stomach;
stomach cancer;
severe ulcer or duodenal ulcer.

With a stomach ulcer, it is necessary to maintain normal stomach acidity. Gastric juice lowers acidity if you drink cabbage juice and walk slowly after eating.

There are three main types of gastrectomy:

Partial resection - removal of part of the stomach. As a rule, the lower half of the stomach is removed, the remaining part is connected to the intestines.
Removal of the entire stomach - the esophagus is connected to the small intestine.
Removed as part of weight loss surgery - up to ¾ of the stomach can be removed during a gastrectomy sleeve, the remainder is pulled up and held together, creating a smaller belly and appetite.

After gastric surgery, the ability to absorb liquids and food remains. However, you will need to make a few lifestyle changes after the procedure. The diet is strictly observed after the operation.

Certain types of surgeries can also be used to treat obesity. By making the stomach smaller, it fills up more quickly. This may help you eat less. However, Obesity Surgery is performed when other options have failed. Less invasive procedures include:

diet;
exercise;
treatment, blood tests, to monitor performance;
consultation with a nutritionist and physician.

How to prepare for surgery

Before your surgery, your doctor will order blood tests and imaging tests. This ensures that you are healthy enough for the procedure. You may have to stop taking certain medications before surgery.

The patient should tell their doctor about other illnesses or pregnancy. The patient must stop smoking.

Smoking adds Extra time for recovery and may create more complications.

Gastrectomy risks include:

acid reflux;
diarrhea;
dumping syndrome with insufficient digestion;
incision wound infection;
chest infection;
internal bleeding;
leakage from the stomach;
nausea;
vomit;
stomach acid seeps into the esophagus, causing scarring, narrowing of strictures;
blockage of the small intestine;
avitaminosis;
weight loss.

How is a resection performed?

There are two various ways performing a gastrectomy. All of them are performed under general anesthesia. This means you will be in deep sleep during the operation and you will not be able to feel pain.

Open surgery – involves one large incision.

Laparoscopic surgery - uses small incisions and specialized instruments. It includes less pain and more fast time recovery. These are more advanced surgeries with a lower complication rate.

After the operation, the doctor will close the incision with stitches and the wound will be bandaged. The patient will undergo a rehabilitation phase under the supervision of a nurse. After the operation, the patient may stay in the hospital for one to two weeks. During this period, tubes will pass through the nose to the stomach.

This will allow the doctor to remove any fluids produced by the stomach and help keep you feeling nauseous. The patient will be fed intravenously for three days. On the fourth day, a gradual 30-50 grams of nutrition begins after removal of the stomach in cancer with a gradual increase in portions.

Swallowing problems

Swallowing problems often occur after gastric surgery. Food usually passes very quickly into the stomach from the esophagus. Food is partially digested, so it must enter the intestines in small quantities. The stomach can hold about 2 liters of food and drink. Without a stomach, food enters the intestines almost undigested, and the intestines will only take in a large number of at once. This means that you should eat very slowly and little by little.

Sometimes the intestines won't take in more and there will be a problem with swallowing. Your doctor may prescribe medications to help speed up the passage of food. They are usually taken before meals. When the body adapts, the problem will be partially solved on its own. But this does not mean that you will be able to eat large amounts of food.

diet therapy

The first months after the operation, a wiped diet No. R is prescribed. After returning home, you may need to adjust your eating habits. Some changes may include when the stomach is removed:

chew food thoroughly;
eat less food during the day;
gradual increase in portion;
varied fractional nutrition;
mashed food;
avoid foods with high content fibers;
eat foods rich in calcium, iron and vitamins C and D;
take vitamin supplements.

Recovery after gastrectomy can take a long time. After all, your stomach and small intestine will gradually expand. Then you will be able to consume more fiber and eat more. enough vitamins and minerals.

Stomach oncology, with oncology it is better to eat crushed and jelly-like food. Proper nutrition is always difficult for any healthy person, but the diet after the removal of the stomach for cancer will be even stricter. Nausea may be a problem. A cancer patient may lose their appetite for a while and lose weight.

Weight to be supported good food. This is not the time to restrict your diet. If you are losing weight or have problems with food, then eat whatever you want in a pureed form. Eat small meals every 2 to 3 hours until you feel better. In the future, eat 4-5 times a day.

The menu should be varied: dietary meat and fish, buckwheat, oatmeal, cottage cheese, eggs, mashed vegetables and fruit jelly, mashed soups, compotes. It is necessary to give preference to meat products: rabbit, chicken, turkey, veal, beef. Exclude: lamb, pork, semolina and millet. Food should not be salty.

Bread can be eaten one month after the operation. You can consult a nutritionist who can give you ideas on how to deal with some of the side effects treatment.

If part or all of the stomach is removed, you will have to eat less food, but more often. Recommended to stay in vertical position after eating. Your doctor or nutritionist can help you determine your diet.

When part or all of the stomach is removed, the food that is swallowed quickly passes into the intestines, resulting in various symptoms after meal. Some patients have problems with nausea, diarrhea, sweating and flushing after eating. This is called dumping syndrome. When part or all of the stomach is removed, the food that is swallowed quickly passes into the intestines, leading to various complications.

Sometimes people may need nutritional supplements to get the nutrients they need. individual people may need to be fed through a tube inserted into small intestine. It is done through a small hole in the skin on the abdomen during minor surgery to help prevent weight loss and improve nutrition. Less commonly, a tube known as a gastrostomy or G-tube may be placed in the lower abdomen.

After cancer treatment, the patient should receive a dietary table and put habits healthy eating in place.

Eating healthy and avoiding alcohol and smoking can reduce your risk from a range of cancers, as well as many other health benefits.

Informative video

Gastrectomy is a serious surgical intervention in the work of the digestive system of the body, when part of the stomach or the entire organ is removed. Postoperative recovery treatment process is not only drug treatment. Diet after gastrectomy is important integral part this process. This operation is carried out according to certain indications:

stomach cancer;
complication of gastric ulcer in the form of perforation;
polyps having a precancerous nature;
stenosis of the pylorus of the stomach;
obesity.

After gastric resection recovery period, which has long time and takes months. This is very important point in the rehabilitation of the patient, which determines the further quality of his life.

Why do I need a diet after gastrectomy

Removing part or all of the stomach fundamentally changes the process of digestion. In order to restore this process, it takes time and a special strict diet that will spare the sick stomach. The slightest error in food will immediately give pathological symptoms in the form of pain in the abdomen, heaviness in the stomach, belching. Often after the operation, a complication in the form of a dumping syndrome develops.

Due to the decrease in the volume of the stomach, food immediately in large quantities passes from the esophagus into the "small" stomach and small intestine. For successful absorption nutrients this area of digestion begins to be intensively supplied with blood. Pathological condition develops rapidly and is accompanied by headache, dizziness, lowering blood pressure, tachycardia, which leads to fainting.

To avoid complications and restore normal function digestion, diet in the recovery period plays a primary role.

Basic principles of nutrition

In order for the rehabilitation of patients after gastric resection to proceed normally, it is necessary to follow certain principles in the diet:

food and drinks should be warm, temperature not higher than 24 degrees;
fractional meals are required - up to seven times a day;
the volume of a single serving of food or liquid should be from 30-50 to 200 grams;
cooking products only by steaming, stewing or baking;
use food products only in crushed form;
food should be rich in proteins;
it is necessary to chew food thoroughly;
observe the daily routine and try to eat at the same time;
after eating, rest for half an hour is recommended.

Important! Strict adherence to the basic principles in nutrition after gastric resection is the key to the rapid restoration of the digestive system of the body.

Approved Products

After the operation, the patient in the hospital immediately begins to receive dietary nutrition. Before discharge, a dietitian must consult with a subsequent recommendation on dieting. Be sure to indicate the products that can be eaten and which are subject to exclusion from consumption.

Read also Foods that increase stomach acid

soft-boiled chicken eggs;
steamed omelet;
low-fat dairy products;
yesterday's dried white bread;
"light" poultry meat, lean beef;
crackers, biscuits;
semi-liquid cereals from rice, buckwheat, oatmeal;
Not fatty varieties fish;
vegetables - pumpkin, zucchini, potatoes, eggplant, bell pepper;
weak black or green tea;
compotes with a small amount of sugar from dry fruits.

Prohibited Products

In order for the recovery period after removal of the stomach to proceed calmly, it is necessary to exclude the following foods from the diet:

fatty meats;
confectionery;
smoked and canned foods;
salted and pickled vegetables;
fresh pastries and soft wheat bread;
carbonated drinks;
coffee and strong black and green tea;
peas, beans.

Particular attention should be paid to the choice of food products and strict adherence to the diet during surgery for oncology.

Nutrition during the removal of stomach cancer has its own characteristics. In the first two days after the operation, nutrition is carried out parenterally. The patient should not eat or drink anything by mouth. After 48-72 hours, it is allowed to drink weak meat or vegetable broth in the amount of 20 grams . The menu is gradually expanding. A week later, you can eat soups-puree with mashed vegetables.

After two weeks, the diet expands even more, and dishes are added in the form of slimy chopped cereals boiled in water, mashed boiled vegetables, chopped meat in a blender, steamed, with pasta.

Gradually, the patient gets used to eating certain foods after surgery for oncology. The most difficult period of recovery takes place within two months, when the patient adapts to the "new" life. During this period, the patient, except medical nutrition under the supervision of a nutritionist, undergoes drug treatment recommended by a gastroenterologist.

Correction of the diet is carried out by a nutritionist, taking into account general condition patient, nature and volume surgical intervention. Often, when asked how long it is necessary to follow a diet after surgery, doctors say that for a long time, perhaps more than one year.

I.D. Maksimova, Candidate of Medical Sciences,
A.F. logins, Candidate of Medical Sciences

Gastric cancer continues to be one of the most common oncological diseases. The main method of treatment of tumors of this localization is surgical. Gastric surgery is a serious intervention that requires careful preparation, carried out not only medical staff but also by the patient and his family.

Preoperative preparation consists in a general strengthening treatment - protein-rich food, a sufficient amount of liquid, vitamins, tonics. And in the presence of a narrowing of the outlet section of the stomach and a delay in the food masses in it - eating only soft, sometimes pureed food for adequate evacuation of it from the stomach.

No less serious attitude requires the postoperative period. In the early postoperative period patients are deprived of the opportunity to take water and food through the mouth. Meals are held intravenous administration nutrient solutions, including protein and amino acid. The body's need for various substances determined on the basis of a blood test.

During this period, the patient for 2 days fasting is prescribed, active aspiration of gastric contents is carried out. WITH 3 days to if not congestion in the stomach, you can give "weak" tea, rosehip broth, not very sweet compote without berries in small portions (20-30 ml) 5-6 times a day. For the introduction of protein products from the first days, the use of protein enpit (40 g per glass of water) is recommended. Usually, in the first 2–3 days, 30–50 g of such a solution is given through a probe, and later, after removing the probe, through the mouth. The diet is based on the principle gradual increase load on the gastrointestinal tract and the inclusion of a sufficient amount of protein. The specific type of enteral nutrition should be recommended by the doctor. The use of enpits allows you to bring the amount of animal protein in the diet to physiological norm provide the body with essential vitamins and minerals.

WITH 3–4 days after the operation, they begin to expand the diet and prescribe mucous soups, meat, fish and curd purees and souffles, soft-boiled eggs, and with 5th–6th day- steam omelettes, pureed cereals and vegetable purees in small quantities (50 g per serving). From the 5th day, with good tolerance to such nutrition, each meal should already include protein products. Gradually, the portions of food taken at a time are increased (from 50 ml on the 3rd day to 200-250 ml on the 7th day and up to 300-400 ml on the 10th day). Thus, in the early postoperative period, patients will receive a sufficient amount of high-grade protein in an easily digestible form.

A sparing diet is prescribed to patients after 1 to 2 weeks. after surgery for 4 months. In the presence of complications such as gastritis of the stomach stump, anastomosis, peptic ulcer, patients should follow the diet for a longer time. The main purpose of the diet is to prevent or reduce inflammatory process, warning dumping syndrome .

This is a physiologically complete diet with a high protein content (meat, fish), a normal content complex carbohydrates(cereals, cereals, vegetables, unsweetened fruits) and a sharp restriction of easily digestible carbohydrates (sugar, sweets, confectionery, fruit water, canned juices), with a normal fat content, limitation of mechanical and chemical stimuli of the mucous membrane and receptor apparatus gastrointestinal tract, With maximum limit nitrogenous extractives (especially purines), refractory fats (mutton), fat breakdown products resulting from frying (aldehydes, acroleins), with the exception of strong stimulants of bile secretion and secretion of the pancreas and intestinal glands, foods and dishes that cause dumping syndrome (sweet liquid milk porridges, for example, semolina, sweet milk, sweet tea, hot fatty soup, etc.).

Meat is given in a chopped form, and side dishes in an unmashed form (porridge-smear, mashed potatoes). Salads, fresh fruits and vegetables, brown bread are excluded. All dishes are boiled, mashed or steamed. Third courses at lunch - unsweetened (no sugar) or with the addition of xylitol (10-15 g per serving). The patient is given a strictly limited amount of sugar,

Complex therapy aimed at compensating impaired functions various systems organism, begins after 2 weeks. after surgery and lasts 2-4 months. Diet is an important part complex treatment in this period. This is a physiologically complete diet with a high protein content (140 g), a normal content of fats (110–115 g) and carbohydrates (380 g) with a restriction of mechanical and chemical irritants of the mucous membrane and the receptor apparatus of the gastrointestinal tract. Refractory fats, extractives, easily digestible carbohydrates, fresh milk are excluded. Patients must comply with the fractional diet. It is necessary to strictly limit the intake of easily digestible carbohydrates in order to avoid the development of hypoglycemic and dumping syndrome. At the same time, the appointment of only a protein diet without a sufficient amount of carbohydrates is impractical, because under conditions of carbohydrate restriction, proteins can be uneconomically used to cover energy expenditure, which leads to an increase in protein deficiency in the body. However, given the loss of the peptic factor in such patients, preference should be given to protein products that are easily "attacked" by trypsin - fish and dairy. Reception of products from coarse fiber And big amount connective tissue must be limited or they are subjected to heat treatment.

Approximate diet for this period:

Bread products - yesterday's wheat bread, wheat bread croutons, biscuits, unsweetened. Bread is allowed no earlier than 1 month after the operation.
Soups - on vegetable, cereal broths, pureed, excluding white cabbage and millet.
Meat and fish dishes - various dishes from lean beef, chicken, turkey, rabbit, veal with tendons removed, lean fish (cod, pike perch, carp, pike, bream, silver hake, carp, ice) in chopped form (mashed potatoes, soufflé, dumplings, meatballs, rolls, cutlets). These dishes are boiled, steamed, baked (after pre-boiling).
Eggs and egg products - soft-boiled egg, no more than one per day, protein omelet.
Milk and dairy products - milk with tea and other products or in various dishes: if tolerated - whole milk. Kefir is switched on 2 months after the operation. Sour cream only as a condiment. Cottage cheese non-acidic, freshly prepared, mashed.
Vegetables and greens - boiled, pureed. Cabbage only cauliflower, boiled with butter, stewed zucchini and pumpkin; carrot, beetroot, mashed potatoes.
Fruits, berries, sweets - limited quantities of natural fruits.

In the future, even in the absence of signs of disease of the operated stomach, one should within 2–5 years adhere to a fractional diet (4-5 times a day), limit the use of foods and dishes containing easily absorbed carbohydrates, fresh milk. The diet should be sufficiently varied, taking into account the individual tolerance of products. Patients with a good result of the operation and in compliance with a fractional diet, as a rule, do not need drug therapy.

If there are symptoms of post-gastroresection disorders, their treatment can be conservative and surgical. Diet therapy is at the forefront of conservative treatment diseases of the operated stomach. Food should be varied, high-calorie, high in protein, vitamins, normal fat and complex carbohydrates with a sharp restriction simple carbohydrates. It should also take into account the individual tolerance of foods and dishes. Patients usually tolerate boiled meat, low-fat sausage, low-fat meat cutlets, fish dishes, soups on weak meat and fish broths, fermented milk products, vegetable salads and vinaigrettes seasoned with vegetable oil. The worst tolerated are sugar, milk, sweet tea, coffee, compote, honey, sweet liquid milk porridge, pastries from pastry, especially hot ones. Meals should be fractional, at least 6 times a day.

With dumping syndrome, it is recommended to start eating with hearty meals, after eating it is advisable to lie in bed or reclining in an armchair for 30 minutes. Products are used unwiped, their chemical composition And energy value- 138 g of protein, 110-115 g of fat, 390 g of carbohydrates, total energy value - 3000 kcal. Fractional diet - 5-6 times a day. According to the set of products, the diet differs significantly from the wiped one.

Bread products - gray wheat bread, yesterday's baking, lean and unsweetened varieties of bakery products and cookies. Seeded rye bread.
Soups - on vegetable broths and cereals, vegetarian. Borscht, cabbage soup, beetroot soup from fresh cabbage. Low-fat meat soup once a week.
Meat and fish dishes - various products from lean beef, chicken, turkey, rabbit, veal, lean fish (cod, pike perch, carp, saffron cod, pike, carp, etc.). These products are boiled, baked, stewed; can be cooked in pieces.
Eggs and dishes from them - soft-boiled egg, no more than 1 per day, protein omelet.
Cereals and pasta - crumbly and viscous cereals, puddings, cereal casseroles - unsweetened; pasta boiled and in the form of casseroles. Recommended buckwheat, hercules and rice porridge, semolina is limited.
Vegetables and herbs - raw, boiled, baked, stewed. Non-acidic sauerkraut, boiled cauliflower with butter, stewed zucchini and pumpkin, salads, vinaigrettes, green pea. Tomatoes with vegetable oil. Early raw finely chopped greens can be added to various dishes.
Fruits and berries, sweet and sugary foods - not very sweet fruits and berries in in kind and in the form of unsweetened compotes, kissels, mousses. Limited to grapes and grape juice which causes bloating. Sugar, honey, sweets, jam - extremely rare.
Milk and dairy products - milk with tea and other drinks or as part of various dishes, if tolerated - whole milk, yogurt, kefir, acidophilus milk. Sour cream as a seasoning and in salads. The cottage cheese is not sour, fresh.
Fats - butter, ghee, olive, sunflower.
Snacks - mild cheese, low-fat herring, doctor's sausage, diet sausages, meat pate home cooking, ham without fat. salads, vinaigrettes, jellied fish on gelatin, jelly from boiled legs on gelatin.
Sauces and spices - on a vegetable broth, sour cream, with the addition of butter.
Drinks and juices - “weak” tea, weak coffee with milk, unsweetened, fruit and berry, vegetable juices, rosehip decoction.

It is forbidden to use the same foods and dishes as when prescribing a pureed diet, except for white cabbage.

An approximate one-day menu when using an unmashed diet:

1st breakfast: boiled meat, salad of tomatoes and cucumbers with sour cream, hercules porridge without sugar, tea with milk.

2nd breakfast: cheese 50 g, apple.

Dinner: Vegetarian borscht, boiled meat stew with mixed vegetables, xylitol jelly.

Afternoon snack: boiled fish, boiled beets.

Dinner: meat soufflé, stewed carrots, cheesecake with cottage cheese without sugar.

For the night: a glass of kefir, fresh cottage cheese 100 g.

All day: rye bread - 150 g, white bread - 150 g, sugar - 30 g.

All dishes must be boiled or steamed in an unpurified form. Separate baked dishes without a rough crust are allowed, the third dish at lunch is unsweetened or on xylitol (10–15 g per serving). Sugar is given to the patient in a strictly defined amount.

Drug therapy for dumping syndrome is much less effective, so sensible dietary advice is more helpful.

Dumping syndrome (from the English dumping - dropping), dumping syndrome is one of the leading post-resection disorders. It occurs in some patients after partial or complete removal stomach due to a violation of the nervous and enzymatic regulation of the organs involved in digestion. As a rule, there is an accelerated evacuation (“dropping”) of food from the stomach stump into the intestine, a violation carbohydrate metabolism and function of the remainder of the stomach. The attack begins after eating (more often after taking easily digestible food rich in carbohydrates) and is manifested by a sharp general weakness (sometimes with a disorder of consciousness), dizziness, profuse sweating, increased heart rate and lower blood pressure, drowsiness, belching, regurgitation or vomiting, pain in the epigastric.

The basic principles of the diet after resection of the stomach and the end of the course of intravenous nutrition can be formulated in three words: "less", "smaller" and "more often". That is, the serving should be minimal, thoroughly wiped, the number of such servings per day increases to at least six. Only after two or three months you can move on to unblended food, which should still remain sparing.

Dietary nutrition after gastric resection surgery

Resection - surgical removal parts of the stomach produce at peptic ulcer who did not succumb therapeutic treatment, with perforation of an ulcer, with prolonged gastrointestinal bleeding, severe pyloric stenosis, and more. Nutrition immediately after gastric resection is carried out in the hospital (intravenous first) and is therefore not included here.

How to eat after gastric resection as the stump heals?

After about 7-10 days, the patient is transferred to a gentle pureed food:

1. At the same time, they limit the amount of food eaten at one time: no more than 250 grams of soup or 1 glass of liquid, only 2 dishes for lunch.

2. Mandatory frequent, at least 5-6 times a day, meals.

3. In the therapeutic diet after gastric resection, the content is increased to 90-100 grams and the amount of easily digestible (sugar, jam, sweet drinks, honey) is limited to 300-350 grams.

4. In some cases, it is necessary to completely exclude sugar-containing foods and dishes (you can use sugar substitutes).

What can you eat after gastric resection as a source of protein? For this purpose, dishes from boiled minced meat, boiled fish, egg white omelettes, fresh mashed or calcined cottage cheese. At poor tolerance fats (regurgitation, bitterness in the mouth, diarrhea), especially in pure form, they are limited to 60-70 grams per day. In case of intolerance to whole milk in the diet after gastric resection surgery, it is replaced fermented milk products or used in meals.

Be sure to include in the diet of preparations containing multivitamins, iron and other minerals.

From the diet after surgery for resection of the stomach exclude: meat, fish and mushroom broths, fatty meats, poultry and fish; pastry and puff pastry products, very fresh bread, all fried foods, smoked meats, canned food (except canned food for children and diet food), salted fish and vegetables, tapas, raw unmashed vegetables and fruits.

2-4 months after surgery good health you can gradually switch to unrubbed sparing nutrition, that is, without mechanical sparing.

5-6 months after the operation, sometimes earlier, with a satisfactory function of the gastrointestinal tract, it is possible to switch to a normal diet, taking into account the noted features of the composition of the diet and diet. At the same time, self-monitoring of nutrition is extremely important, that is, the determination of those foods and dishes that are well or poorly tolerated.

Postoperative nutrition for patients undergoing gastric resection

After resection of the stomach, a complication is possible, accompanied by a deterioration in digestion and absorption of food, metabolic disorders, disorders of the cardiovascular and nervous systems, called dumping syndrome, or simply dumping (from the English. dumping - “dumping”, “ejection”).

Dumping is caused by the rapid passage of food from the stomach stump into the small intestine, which causes: weakness, sweating, dizziness, palpitations, sensations of heat, chills, less often fainting, abdominal pain and bloating, rumbling, diarrhea, belching.

Most often, dumping occurs after eating foods containing sugar, honey, sugary drinks, ice cream, as well as fresh flour products, potatoes, bananas, milk, cottage cheese, fatty hot soups. Cold and hot food and its large amount in 1 meal often provoke dumping.

Therefore, a strict accounting of all intolerable dishes and an individual selection of the menu are important.

At the same time, nutrition for patients who have undergone gastric resection should not significantly limit the amount of food consumed, as this leads to malnutrition, hypovitaminosis, anemia, and other disorders.

To prevent dumping postoperative nutrition after resection of the stomach should be gentle, with high content protein up to 110-120 grams (men), 100-110 grams (women), carbohydrate restriction 350 and 300 grams, respectively, mainly due to sugar (no more than 30 grams up to complete exclusion) and bakery products from wheat flour 1st and highest grade.

Along with the diet, it is advisable to use medications that normalize motor function upper divisions digestive tract, as well as enzyme preparations (festal, digestal, creon, mezim) to improve digestion.

Be sure to supplement the diet with multivitamin-mineral preparations.

What is a gastrectomy

A gastric resection is an operation in which a significant part of the stomach is removed, usually from a quarter to two thirds. Basically, resection is performed when various dangerous diseases stomach (tumors, ulcers), and the operation can also be performed as a means of combating serious forms of obesity. The first resection was performed in 1881 by Theodor Billroth, this German surgeon also brought to life two main famous method resection of the stomach with subsequent restoration of functioning digestive processes at the patient. In addition to the methods of the Billroth operation, since the 2000s, methods of gastric resection have been known that do not affect the direct fundamental anatomical functionality of the organ - longitudinal or vertical resection.

In fact, resection is carried out by excising the affected area of the stomach, followed by restoring the state of healthy continuity of the gastrointestinal tract. Continuity is recreated by making a connection between the stomach stump and the jejunum or duodenum by anastomosis.

Resection is complicated in that it affects one of the central elements of supplying the body with resources - digestive system. A person cannot not eat, so it is very important for an adequate operation and subsequent recovery process. proper diet, which ultimately has greatest influence to the opportunity optimal recovery functions of the stomach after resection. Immediately before the operation (from a month to a week), it is necessary to strengthen the stomach through a diet - take vitamins and tonics, use rich in protein food to prepare the stomach and body in general for stress. An even more serious approach requires a postoperative diet, which is divided into several periods. In the first days after the operation, the patient should be prescribed fasting, then, for some time, food will be provided, of course, in the hospital, through droppers, then through a tube. Subsequently, the doctor will prescribe a diet distributed over several periods.

After these operations, food very quickly comes from the esophagus and the rest of the stomach (with its resection - partial removal) into the small intestine, where the absorption of essential nutrients occurs. At the same time, soon after eating, the patient may experience a feeling of heaviness in the epigastric region, weakness, sweating, dizziness, palpitations, dry mouth, bloating (flatulence), drowsiness, and a desire to lie down.

These phenomena are defined as dumping syndrome. Helps avoid complications proper organization nutrition.

Diet after gastrectomy

Those who have undergone gastric surgery must observe the following rules:

Eat often, 5-6 times a day, little by little. Eat slowly, chewing thoroughly.
Limit the use of foods and dishes containing easily and quickly absorbed carbohydrates, especially sugar, honey, jam, sweet milk porridge, sweet tea.

It is advisable to take the third dish not immediately, but 1/2–1 hour after dinner, so as not to overload the stomach. The amount of liquid at one time should not exceed 200 ml.

Particular attention should be paid to nutrition in the first 2–3 months after discharge from the hospital: it is at this time that the digestive system adapts to new conditions in connection with the operation.

It is very important that the food after stomach surgery is tasty, varied, and includes all the main nutrients. Particular importance is attached to complete animal proteins (found in lean meat, chicken, fish, eggs, cottage cheese, cheese) and vitamins (included in vegetable dishes, which are constituent elements of fruits, berries, vegetable and fruit juices, rosehip broth, etc. ).

Particular attention should be paid to nutrition in the first 2-3 months after discharge from the hospital: it is at this time that the digestive system and the body as a whole adapt to new conditions in connection with the operation.

The tactics of diet therapy can be schematically represented as follows. In the first 2-3 months after the operation, it is usually recommended to eat at least 5 times a day, using mostly chopped dishes and foods that have been pureed or steamed. In fact, the same diet is recommended as for peptic ulcer (dietary table No. 1, “wiped” option). However, you need to limit sweets. After 2–3 months, the attending physician may recommend an “unworn” version of the dietary table No. 1. After 3–4 months after the operation, the dietary table No. 5 is allowed.

Therapeutic nutrition in the first days after gastric resection:

1st day. The patient does not receive food.

2nd day. Weak tea, fruit jelly, mineral water(30 ml every 3-4 hours). Kissels are not very sweet.

3rd and 4th day. 1st breakfast - soft-boiled egg or steam omelet, half a glass of tea; second breakfast - juice, or jelly, or mineral water, mashed rice porridge. Lunch - slimy rice soup with meat puree or meat cream soup. Snack - tea or rosehip broth. Dinner - cottage cheese or meat soufflé. At night - unsweetened fruit jelly (1/2 cup).

5th and 6th day. Breakfast - soft-boiled egg, or steam omelet, or meat soufflé, tea with milk. The second breakfast is mashed rice or mashed buckwheat porridge. Lunch - pureed rice soup, steamed meat soufflé. Snack - cottage cheese soufflé without sugar. Dinner - steamed meat dumplings, carrot puree. At night - fruit jelly without sugar.

7th day. Breakfast - 2 soft-boiled eggs, liquid rice or buckwheat porridge, tea. The second breakfast is cottage cheese steam soufflé without sugar. Lunch - mashed rice soup with potatoes, steamed meat cutlets, mashed potatoes. Snack - fish steam soufflé. Dinner - calcined cottage cheese, kissel. White bread crackers are allowed.

A week after the surgery, diet No. 1 is prescribed, a “wiped” option with a restriction of easily absorbable carbohydrates.

soups on vegetable broth with various pureed vegetables, pasta or cereals;
dishes from low-fat varieties of meat, poultry (chicken, turkey) and fish (cod, hake, ice, saffron cod, pike perch, carp, perch) boiled or steamed. Meat is mainly in the form of cutlets, dumplings, meatballs, mashed potatoes, soufflé;
dishes from potatoes, carrots, beets, cauliflower, pumpkins, zucchini, mashed in the form of mashed potatoes, soufflés or puddings;
milk porridges (rice, oatmeal, barley, buckwheat, "Hercules"), soufflé, puddings from mashed cereals, dishes from vermicelli, pasta, homemade noodles;
soft-boiled egg, steam omelet;
whole, dry, condensed milk without sugar (added to the dish), sour cream, cream, freshly prepared cottage cheese;
fruits and berries boiled, pureed or baked;
mild cheese, low-fat ham;
honey, jams, marshmallows, marshmallows in limited quantities, subject to good tolerance;
weak tea with milk or cream, weak coffee with milk or cream;
fruit, berry (not very sweet), vegetable juices, rosehip broth;
butter, ghee, vegetable oil (added to ready meals);
slightly dried wheat bread, lean cookies, crackers.

Meat, fish, mushroom broths, fatty meats, poultry (ducks), fish, all fried foods, pickles, smoked meats, marinades, spicy snacks, pastry, pies, raw unmashed vegetables and fruits, radishes, rutabaga are excluded from the diet.

Approximate diet menu after gastric resection ("wiped" option):

Breakfast: soft-boiled egg, buckwheat, rice or Hercules porridge, coffee with milk.

Second breakfast: baked apple, rosehip broth.

Lunch: vegetarian potato soup, meat steam cutlets with milk sauce, pureed fresh fruit compote or jelly.

Afternoon snack: milk, biscuits lean.

Dinner: boiled fish and potatoes.

At night: kefir or weak tea with milk.

3 to 4 months after gastric surgery, the "unmashed" diet #1 or #5 is usually allowed.

soups on vegetable broth with various cereals, vegetables, pasta, beetroot soups, milk soups with cereals, fruit soups with rice. Low-fat meat soup is allowed 1-2 times a week, provided it is well tolerated;
dishes from lean meats, poultry, fish - boiled, baked (pre-boiled), stewed (with juice removed);
fresh vegetables (tomatoes, cucumbers, carrots), boiled and stewed vegetables (carrots, potatoes, beets, zucchini, pumpkin, cauliflower). Non-sour sauerkraut is allowed, fresh herbs(parsley dill);
various cereals (cereals and pasta) - rice, buckwheat, oatmeal, millet; krupeniki, puddings, fruit pilaf, boiled vermicelli, pasta;
soft-boiled egg, scrambled eggs;

5-6 months after partial or complete removal of the stomach, the attending physician, depending on the state of health, may recommend that the patient adhere to a diet of table No. 5 or 15.

whole milk (with good tolerance) or with tea, dairy dishes, kefir, curdled milk, acidophilus, sour cream (mainly as a seasoning), freshly prepared cottage cheese. They also cook cottage cheese, various puddings, soufflés, dumplings;
fruits and berries ripe, raw and baked (apples);
dairy, sour cream, fruit sauces;
Doctor's sausage, low-fat ham, jellied fish, cheese, boiled tongue, salads from raw and boiled vegetables, soaked herring;
jam, honey, marshmallows, marshmallows, jams (in very limited quantities);
tea, weak coffee with and without milk. Compotes from fresh fruits, berries and dried fruits (not very sweet);
fruit, berry (not very sweet), vegetable juices. A decoction of rose hips;
butter and vegetable oil (oil is added to ready meals);
wheat, rye, preferably slightly dried, bread, crackers, lean cookies, products made from lean dough.

Products from pastry, pickles, smoked meats, marinades, canned snacks, radishes, turnips, hot spices are excluded from the diet.

Approximate diet menu ("non-mashed" option):

Breakfast: tomato salad or vegetable vinaigrette, boiled meat, loose buckwheat porridge, tea with milk.

Second breakfast: fresh or baked apple or raw grated carrots.

Lunch: salad, vegetarian borscht, boiled fish (cod, hake, ice) with boiled potatoes, sauerkraut, compote.

Afternoon snack: fresh fruit.

Dinner: scrambled eggs, buckwheat cereal, tea.

At night: kefir or curdled milk.

5–6 months after partial or complete removal of the stomach, the attending physician, depending on the state of health, may recommend that the patient adhere to a diet of table No. 5 or 15. If there are no complications and pronounced concomitant diseases, it is allowed to include low-fat foods in the diet, more fresh vegetables and fruits, meat and fish broths, of course, with good patient tolerance.

Based on the book by M. Gurvich "Nutrition for Health".