Gastrectomy Nutrition Guidelines

What is a Gastrectomy?

  • A gastrectomy is the removal of some or all of your stomach that holds food at the beginning of digestion. After surgery, your stomach will hold much less food. Your food will also not stay in your stomach as long. It is very common to have symptoms of dumping syndrome.

What is dumping syndrome?

  • Dumping syndrome is a condition where your food leaves your stomach too quickly. This causes food to “dump” into the small intestine.
  • Up to one half of people have dumping syndrome after a gastrectomy.
  • You can have either early or late dumping syndrome. Early dumping syndrome is caused by a shift of fluid in the small intestine. Later dumping syndrome is caused by a drop in blood sugar.

How do I know if I have dumping syndrome?

  • You may have early dumping syndrome if half an hour after eating you experience the following: nausea, vomiting, abdominal pain, cramping, diarrhea, dizziness, burping, fatigue, or rapid heart rate.
  • You may have late dumping syndrome if four hours after eating you experience the following: sweating, fatigue, dizziness, shakiness, anxiety, rapid heart rate, fainting, confusion, diarrhea, or low blood sugar.

How should I eat after a gastrectomy to prevent dumping syndrome?

  • Eat smaller meals 5-6 times a day.
    • Your stomach cannot hold as much food after surgery.
    • Eat no more than 1 cup of food at each meal or snack.
    • Add new foods slowly to lower side effects of dumping syndrome.
  • Chew food really well.
  • Eat protein at every meal.
    • Proteins include chicken, turkey, beef, pork, fish, cheese, eggs, nuts, seeds, and soy foods.
  • Choose low fiber grains.
    • Low fiber grains are often grains from white, refined flour.
    • Read the food labels and do not eat food with more than 2g of fiber per serving.
  • Do not eat a lot of sugar.
    • Avoid sweets such as cakes, candy, pies, and cookies.
  • Limit carbohydrates.
    • If you are experience dumping syndrome, limiting carbohydrates might help.
    • Avoid, bread, cereal, rice, pasta, crackers, potatoes, corn, peas, squash, fruit, and fruit juices.
  • Avoid foods with natural laxatives.
    • Do not eat prunes, figs, licorice, caffeinated foods/drinks, and sugar alcohols.
  • Do not eat or drink very hot or very cold foods.
  • Drink only unsweetened drinks and do not drink a lot with meals.
    • Do not drink with snacks and meals.
    • Wait 30 to 60 minutes after a meal before drinking.
  • Avoid alcohol.
    • Alcohol increases the risk of cancer recurrence and does not provide the body with any nutrients.
  • Rest after eating.
    • Lie down for 20-30 minutes after eating.

What else do I need to know?

  • A gastrectomy may cause lactose intolerance. Avoiding dairy products such as milk, creamy soups, ice cream, yogurt and cheese may help. You may still be able to eat yogurt. Try yogurt with “live, active cultures” on the label.
  • You may need to take fiber, calcium, iron, or vitamin B-12 supplements. Iron can prevent anemia, calcium prevents osteoporosis, and fiber supplements may lessen symptoms of dumping syndrome. Your body may not be getting enough nutrients from food alone. Ask your surgeon and a registered dietitian what is best for you.
  • If you experience rapid weight loss, talk to your surgeon or a registered dietitian immediately. Losing more than 1-2lbs per week is rapid weight loss. Rapid weight loss is dangerous even if you are overweight. Your body may not be getting the nutrients it needs.

What food should I choose and avoid eat after a gastrectomy?

  • Milk and Dairy
    • Choose buttermilk, evaporated milk, 1% or skim milk. Eat plain yogurt without added sugar, powdered milk, low fat cheese, and no sugar added ice cream.
    • Avoid chocolate milk. Avoid any milk product with added sugar.
    • If you are lactose intolerant, try lactose-free milk or soymilk.
  • Meat and Protein
    • Choose tender meats cooked without added fat including chicken, turkey, beef, pork, and lamb. Eat soy based meat products, eggs, fish, and smooth nut butters.
    • Avoid fried meats. Avoid processed meats like salami, bologna, bacon, sausages, or hot dogs. Avoid tough or chewy meats. Avoid beans, peas, lentils, nuts, or chunky nut butters.
  • Grains
    • Choose white breads and cereals made with white flour.
    • Avoid high fiber grains and cereals or foods with more than 2g of fiber per serving.
  • Vegetables
    • Choose cooked vegetables without seeds or skin. Eat potatoes without the skin. Eat lettuce. Drink strained vegetable juice.
    • Avoid vegetables except iceberg lettuce. Avoid cooked vegetables with seeds or skin. Avoid beets, broccoli, cauliflower, cabbage, brussels sprouts, collard greens, mustard, greens, turnip greens, and corn.
  • Fruits
    • Choose canned and soft fruits without added sugar. Choose bananas and melons.
    • Avoid any fruits except bananas and melons. Avoid dried fruits such as raisins and prunes. Avoid fruit juices. Do not eat canned fruit in syrup with added sugar.
  • Fats
    • Choose oils, butter, trans fat free tub margarine, cream, cream cheese, and mayonnaise. 
  • Drinks
    • Choose water, decaf coffee and decaf tea and diet, sugar free, and caffeine free soft drinks.
    • Avoid caffeinated tea, coffee, or sodas. Avoid alcohol. Avoid fruit juice. Avoid sweetened drinks that contain sugar, corn syrup, or honey.
  • Sweeteners
    • Use stevia as a natural artificial sweetener.
    • Avoid any foods made with artificial sweeteners. Saccharin, aspartame, sucralose, and acesulfame potassium are artificial sweeteners. Avoid food with sugar, honey, syrup, sorbitol, or xylitol listed as one of the first 3 ingredients.

For a quick reference, check out the Gastrectomy Food Chart.