Eating after a Gastrectomy

This dietary information is for patients who have had part or all of their stomach removed. It is important to modify old eating habits to avoid unpleasant symptoms.

What is dumping syndrome?

After stomach surgery, some patients may have what is commonly known as dumping syndrome. Without a stomach to hold the intake of food and fluids, there is no way to regulate the amount of food entering the intestine. You no longer have a reservoir to hold food so that it can gradually enter the small intestine. Instead, after a meal, the food may be “dumped” too quickly into the bowel. This may result in cramping and pain. When sugars and starches that you have eaten are dumped into the bowel, they may act like sponges, rapidly absorbing water from the body into the intestine. This leads to a number of symptoms including diarrhea, low blood sugar and feelings of weakness or dizziness.

Up to 75 % of patients who have had a partial or total gastrectomy may experience dumping syndrome. Symptoms of dumping syndrome are more common in the immediate post-operative period and often subside over time.

There are two phases of dumping syndrome; early dumping phase and late dumping phase.

Early Dumping Phase

  • Occurs 15 to 30 minutes after eating
  • Caused by rapid entry of food into the small intestine
  • Symptoms include nausea, vomiting, cramps, abdominal pain, diarrhea, and feeling full after eating only a small amount of food. Weakness, flushing, dizziness and sweating may also accompany early dumping syndrome.

Late Dumping Phase

  • Occurs 90 minutes to 3 hours after eating
  • Caused by a rapid rise in blood sugar and then a rapid decrease in blood sugar
  • Symptoms may include sweating, fast heart-rate, weakness, feeling tired, anxiety or mental confusion

General Guidelines to Prevent Dumping Syndrome

  • Eat six to eight small meals daily to avoid eating too much at a time. You may be able to tolerate larger portions over time, but keep servings small at first.
  • Have a protein food with each meal and snack such as meat, poultry, fish, eggs, milk, cheese, yogurt, nuts, tofu or peanut butter.
  • Do not drink liquids with meals. Drink 30 to 60 minutes before or after meals. Eventually you may tolerate small amounts of liquid with meals.
  • Limit high-sugar foods such as soda, juice, Ensure, Boost, cakes, pies, candy, doughnuts, cookies, fruit cooked or canned with sugar, honey, jams, jellies.
  • Choose high-fiber foods when possible. These include whole wheat breads and cereals, whole wheat pasta, fresh fruits and vegetables.
  • Choose foods high in soluble fiber. This includes apples, oats, beets, Brussel sprouts, carrots, spinach and beans.
  • Try adding a serving of fat to meals and snacks such as butter, margarine, gravy, vegetable oils, and salad dressings. Fats slow stomach emptying and may help prevent dumping syndrome.
  • Some people find that avoiding very hot or very cold foods help.
  • Chew foods well and eat slowly. Try to relax while eating.
  • Lying down right after eating may lessen symptoms.

The chart below lists foods that are better or less tolerated bypeople following gastrectomy. The foods in the “Better Tolerated Foods” list are less likely to cause dumping syndrome than the foods in the “Less Tolerated Foods” list. The “Less Tolerated Foods” are known to cause dumping syndrome in some people. It takes time and experimentation to figure out what works best for you. Keeping a food journal to track the time of day, food intake including quantity, and symptoms when they occur may be helpful in identifying problem foods and habits.

Food Group Better Tolerated Foods Less Tolerated Foods
Breads/Grains Whole grain breads, muffins, bagels, and crackers; unsweetened dry or cooked cereals, rice, pasta, barley, potatoes, pretzels, popcorn, crackers Doughnuts, sweet rolls, muffins, coffee cake, pastries, and sugary cereals.
Fruits Fresh fruit, frozen or canned fruit without heavy syrup/ added sugar, fresh- frozen fruit Dried fruits, canned fruits in syrup, sweetened juice, canned pie fillings
Vegetables All vegetables fresh, frozen or canned Vegetables with added sugar or sweetened sauces
Meats and Protein (with each meal and snack of 1-3 oz. meat, fish, poultry or cheese, 1/2 cup tuna or cottage cheese, 1-2 eggs, 1 cup plain or artificially sweetened yogurt, 1-2 tsp. peanut butter) Meats, poultry, fish, seafood, peanut butter, nuts, dried peas and beans, eggs, cheese, cottage cheese, milk, buttermilk, diet pudding, light or plain yogurt None
Fats and Oils Butter, margarine, oil, salad dressing, mayonnaise, cream, cream substitutes, sour cream, cream cheese, bacon Sweetened cream cheese, honey butter, salad dressings made with honey
Sweets and Desserts Sugar-free pudding, sugar-free gelatin, sugar-free jellies, sugar-free syrup, plain cake and cookies (no frosting), no sugar added ice cream, artificial sweetener, sugarless gum, fruit preserves and low sugar jelly Regular ice cream and popsicles, cakes, pies, frostings, cookies, jellies, jams, syrup, gelatin, high sugar desserts, sherbet, sugar, candy, molasses, sweetened toppings
Beverages (8-12 Cups) Water, milk, coffee, tea, soup, broth, artificially sweetened carbonated beverages and flavored drinks such as Crystal Light® Sugar-sweetened beverages, regular soda, lemonade, Kook-Aid, Gatorade, chocolate milk and milkshakes

Sample Meal Plan

The chart below gives an example of six small meals throughout the day. It is important to remember to drink liquids between meals.

Breakfast
  • 1 egg
  • 1 slice whole wheat toast
  • ½ banana
  • 1 cup 2% milk (drink 30-60 min after eating)
Mid-Morning Snack
  • 1 ounce cheese
  • 4 crackers
Lunch
  • 2 ounces hamburger w/lettuce & tomato
  • 1 small bun
  • 1 tablespoon mayonnaise or ketchup
  • ½ cup unsweetened fruit cocktail
  • ½ cup vegetable juice (drink 30-60 min after eating)
Mid-Afternoon Snack
  • 1 tablespoon peanut butter
  • 3 graham crackers
  • ½ cup orange juice (drink 30-60 min after eating)
Dinner
  • 2 ounces chicken breast
  • ½ cup mashed potatoes
  • ½ cup green beans
  • 2 teaspoons margarine
  • ½ cup unsweetened applesauce
  • 1 cup 2% milk (drink 30-60 min after eating)
Bed-time Snack
  • 1 slice bread
  • 1 ounce turkey
  • 1 tablespoon mayonnaise
  • 1 cup 2% milk (drink 30-60 min after eating)

11 Responses to Eating after a Gastrectomy

  1. thomasarvid says:

    My sisters and a few cousins and I all had the total gastrectomy due to the genetic mutation – as our aunt, cousin, and mom all succumbed to the deadly disgusting disease during the winter months of 2000/2001. I think we were pretty early as a family in this country to do this – so, I have been ‘stomach-less’ for quite a while. My weight has maintained fairly well – I run – and eat anything and everything continuously and drink adult beverages (too much) – but there really is no limit. However, I do have issues, which seem to be increasing lately, of ‘throwing up’ if I have that one-too-many bites. Many times at restaurants I must excuse myself and try and make it to the bathroom while my mouth is filling with saliva – and hope I make it there in time. So, I think my problem is controllable – I just eat past the capacity and then the above occurs. Immediately following, I am fine and can finish my dinner. I have been taking a multi-vitamin pretty consistently since the surgery but have tapered off on B12 and iron. I did have a chemical analysis a couple of years back and all my ‘levels’ appeared normal. I really do not notice much of a difference if I take the B12s or not – but I probably should get back on them as all the nutritionists seems to think we should. Anyway, just thought I would share. If anyone ever has any questions, don’t hesitate to ping me. Thanks

    tom

  2. Bonnie says:

    My husband has been diagnosed with the CDH1 gene – predisposed to diffused gastric cancer – we have read a lot of info regarding this surgery, consulting with specialists etc. Here’s the big BUT – he is diabetic and as far as ‘they” know, only the 2nd diabetic with CDH1 in the world. Does anybody know anyone that is diabetic and has had this surgery?

  3. Arnie says:

    I’ve had a total stomach removal due to cancer. My rare cancer was caught just in time and I am truly grateful to the fine doctors and nurses at the Peter Loughheed Hospital in Calgary, Alberta. My stomach was removed 19 months ago and eating was kind of scary at first. I stuck to the advice given here but sometimes tried new foods and was sometimes disapointed with the results. Most times these new foods were just fine and I worried for nothing! Asking questions and simply trying to introduce new foods to your diet has helped me a lot! Gaining weight has not been an easy road for me although I have always had a hard time putting on the lbs. My doctor told me not to stress about the weight and that it will come back in time! It seems like I am eating at a constant pace but gaining weight is not happening. The most important things are to stay happy and not stress about the things you cannot change!! (I’m learning all this now!) Eat often/chew yourfood/sit straight up when you eat and drink/stay away from the foods that bother YOU/work less/Be Happy

  4. Reena says:

    My father just had his whole stomach removed today ,he is vegetarian ,what food is recommeneded to him I’m so scared he won’t be able to take it .please give me advise of what he can eat and what he should avoid ,and if possible please give menu of a day .thank you

  5. karen says:

    Linda & Bert,

    Please, join our Discussion Forum (on this site under Our Community). There are a lot of us that have been through this that can share ideas that have worked for us. We also have a nutritionist on our board who may be able to provide some additional suggestions as well.

  6. Linda says:

    I have a sister in law in Portugal that had her stomach removed in November of last year. She is really struggling with the eating. Does anyone have any tips that I can pass along to help with the nausea? This is only going to be exacerbated by the fact that she has now started chemo and radiation treatments.

    Any tips would be greatly appreciated.

    • Anonymous says:

      Hi Linda
      I had my stomach removed to prevent stomach cancer 4 years ago. I am 45 years old now. Eating small amounts very slowly helps me, but I still get nausea from time to time, even today. My sister also had her stomach removed and she has tried anti nausea medicine as well as wrist bands, the kind people wear for seasickness, etc. For me, nausea is usually related to eating too quickly or eating food with too much fat or sugar. Another trick we use is peppermint or ginger in teas or small candies. The one we used a lot right after surgery was chewing Orbit Gum. The strong minty flavor seemed to help, for whatever reason. Anyway, I hope any of these ideas help your sister in law.
      Julie

  7. Bert Snyder says:

    I had my Gastrectomy in April. Struggling with my food intake and have lost a lot of weight. My doctor wants me to “get into the calorie intake” but I see in your list of “not to eat” milkshakes and ice cream…. How do I get the calories needed so that I don’t keep on losing more weight? I make great soups with lots of vegetables and when I eat them I add mashed potatoes, rice and the sort for calorie intake….
    Very confusing and very frustrating. I am lucky because my cancer did not spread -so far so good-
    Thank you for your advise. By the way, I am a 71 yr old woman and have always been very active and strong…

    • Anonymous says:

      Hi
      I had my stomach removed 4 years ago to prevent stomach cancer. The one thing I learned is that you have to turn what you know about eating totally around. Try to eat frequent, small meals, and less filling food. I did not eat fruits, vegetables, or any soup for a year after my removal because those foods made me too full too fast without adding many calories to my day. Try to eat food that gives you calorie bang for your buck. I ate eggs every day, toast with peanut butter, quiche, and cereal for the vitamins. Try to eat foods with the most calories for now, not necessarily the ones that are most nutritious, until you gain weight. I know that’s hard because you can’t eat a lot of sugar, but that’s why you have to eat frequently. Keep snacks with you all the time so you can eat as often as possible. I carried baggies of CheezIts and Nuts all the time and snacked, even on just a few at a time, as often as I could, because every calorie counts! Good luck,
      Julie

      • Maynard says:

        I too had my stomach removed 2 years ago and i find that what your saying is bang on. Stay away from sugars and do as you say.. Small amounts. I start with toast in the morning and eat slowly to minimize the dumping syndrome. DO NOT.. start with a full breakfast as it will make you sick most likely, is the advise i would strongly suggest to others. Sugars and anything with starches I found is a NO NO.
        Nuts works well through the day and just concentrate on grazing.. stay away from the larger meals.. They wont work.
        Maynard

Leave a Reply

Return to Top
Contribute Now

Be Our Guest

Share your experience. Learn how you can become a guest contributor to the NSFC Blog.        

Categories