Diet After Nissen Fundoplication Surgery

After surgery, you will have swelling where the esophagus connects to the stomach. The swelling will make it hard for you to swallow or burp because the opening will be about the size of a straw. The feeling of tightness and trouble swallowing will go away over the next 3 to 12 weeks. Follow these diet guidelines to prevent problems from surgery.

Eating and drinking are key to getting enough calories and other nutrients to help you heal. To protect the area, prevent more swelling and to promote healing, follow a diet of soft, easy-to-swallow and easily chewed foods for at least 4 to 6 weeks after surgery. Follow this diet to prevent problems that could occur from swallowing food chunks that are too large or too rough to pass through your swollen tube. This diet will also help to control nausea, extra gas, diarrhea or problems swallowing.

Avoid stretching your stomach

Because the top of your stomach was wrapped around the bottom of your esophagus, your stomach will not be able to hold large amounts of food. Over-stretching your stomach could put stress on the site and cause you to have nausea, retching or pain.

  • Eat 5 or 6 small meals each day instead of 3 large meals.
  • Eat slowly and eat in a calm and relaxing placeDrink at least 6 to 8 cups of liquid each day, but limit your liquids to 4oz or 1/2 cup with meals and 8oz or 1 cup with snacks. Drink the rest of your liquids to between meals and snacks.
  • Drink at least 6 to 8 cups of liquid each day, but limit your liquids to 4oz or 1/2 cup with meals and 8oz or 1 cup with snacks. Drink the rest of your liquids to between meals and snacks.
  • Eat sweet foods and desserts at the end of your meals as these food make digestion occur more quickly.

Avoid problems swallowing

  • Sit upright when eating and for at least one hour after eating
  • Take small bites and chew all of your food to baby food consistency before swallowing. If your food cannot pass through a straw, it cannot be swallowed.
  • Eat only foods that you can tolerate. If you have trouble swallowing or you feel pressure or food getting stuck, stop eating and give the food time to pass. After the food passes, begin to eat again and chew more food and add more liquid to moisten the food. If soft food continues to cause problems, go back to pureed or liquid diet for a few days.
  • Keep food soft, well-cooked and moist. Avoid gummy foods, such as breads, green bananas and peanut butter, that can be hard to swallow.
  • Do not eat dry bread products. These foods can swell with your saliva or other liquids and could form a ball in your esophagus and cause blockage.
  • Do not eat meat for at least the first 2 weeks. No large or tough pieces of meat after that as they can be hard to pass through the esophagus into the stomach.
  • Do not eat raw, crunchy fruits or vegetables. These foods can have sharp edges that could irritate and cause more swelling.

Avoid gas and bloating

  • Avoid liquids that are either hot or very cold as they can cause spasms and pain in the esophagus
  • Avoid talking during meals, drinking from a straw or bottle, and do not chew gum or tobacco.
  • Limit or avoid foods that cause stomach gas or bloating. These may include milk and other dairy products, sugar, broccoli, cauliflower, cabbage, onions, and beans or legumes
  • Avoid carbonated beverages, including beer for at least 3 to 4 weeks. After that, be sure to pour the carbonated drink into a cup or glass to allow some of the fizz or carbonation to escape.

Diet after surgery

You will be on a full liquid diet, then advance to a pureed or blenderized diet and then advance to a soft diet. You will go back to eating your normal diet in about 6 weeks. Foods for each phase of your diet are listed.

Remember: Any time you have trouble swallowing, increased pain, or you feel like food is stuck, return to a full liquid diet for a day or two.

Full liquid diet

The first 14 days after surgery require special attention to prevent irritation to the surgery site. Your doctor will place you on full liquid diet during this time.

You may have:

  • Water
  • Milk or cream.
  • Fruit or vegetable juice without pulp, such as grape or tomato
  • Nectars, grape and cranberry juices have more calories than citrus or vegetable juices.
  • Prune juice or apricot nectar may be effective in easing constipation.
  • Decaf coffee or tea.
  • Drinks from powdered mixes.
  • Instant breakfast drinks, like Carnation.
  • Boost or Ensure or other nutrient drinks.
  • Creamed soups without chunks.
  • Yogurt without fruit chunks.
  • Broth.
  • Cream of wheat or cream of rice cereal, thinly prepared.
  • Smoothie drink without fruit chunks or seeds.
  • Pudding or custard.
  • Ice cream, sorbet, frozen yogurt or milkshakes without fruit pieces, nuts or candies added.
  • Jell-o without added fruit or other things.
  • Eggnog that is alcohol-free.

Soft diet: day 15 to 6 weeks after surgery

You can continue any of the foods that you have been eating from full liquid and pureed diets and add these items:

Drinks

  • Regular tea or coffee in small amounts to limit caffeine.
  • Avoid alcohol
  • Avoid carbonated beverages until at least 3 weeks after surgery.  After that, pour into glass to allow carbonation to escape.
  • Breads, grains and starches
  • Soft cooked oatmeal, thinly prepared. After 4 weeks, you can try:
  • Finely chopped pasta.
  • Fluffy, soft rice.
  • Soft-cooked potatoes with sauce or gravy.
  • Avoid any bread or bread products, dry cereals, pancakes, waffles, crust and baked goods.
  • Avoid any deep fried chips and fries, popcorn, crackers and other hard or crunchy snack foods.
  • Vegetables
  • Remove all skins, seeds and peels.
  • Chop or dice in small pieces and steam or cook vegetables well to “mashable” texture, such as carrots, squash and zucchini.
  • Add salad dressing, mayonnaise, or cheese sauces over soft-cooked vegetables for added calories.
  • Avoid all raw or deep fried vegetables.
  • Avoid coarse, fibrous vegetables, such as beets, cabbage, spinach, corn, Brussel sprouts, greens, celery, asparagus, lettuces and peas.
  • Avoid gas-causing vegetables, such as broccoli, cauliflower, onions, cabbage, beans and legumes.

Soups

  • Blenderized soups or stews with soft cooked meats and vegetables.
  • Add cream or half and half to increase calories.
  • Avoid soups with whole kernel corn, large chunks of vegetables or meat.

Fruits

  • Remove all skins, seeds or peels.
  • Blenderized fruit.
  • Soft, cooked or canned fruit.
  • Soft, ripe bananas.
  • Blenderized fruit with milk or yogurt to create smoothies.
  • Avoid Juices with pulp.
  • Avoid fresh fruits, such as oranges, pineapple, apples, coconut, raisins, prunes, kiwi, strawberries, grapes, peaches and nectarines.
  • Avoid dried fruits and green bananas.

Meats or other protein foods

  • Wet scrambled eggs moistened with milk or other liquid to make thin.
  • Ground, minced poultry, fish, beef or pork mixed with gravy or sauce.
  • Tender, flaky fish.
  • Small bits of shrimp meat.
  • Soft tofu scrambles.
  • Avoid large or tough pieces of meat or meat substitutes, such as garden burgers or fish.
  • Avoid fried eggs, hot dogs and sausages.
  • Avoid nuts and chunky peanut or other nut butters.
  • Avoid textured vegetable protein or firm tofu.

Milk and milk products

  • Sour cream.
  • Cottage cheese.
  • Cream cheese.
  • Melted grated cheese.
  • Avoid hard cheeses unless melted for sauce

Desserts and snacks

  • Tapioca.
  • Avoid any bread or bread products, pies, cakes and cookies.
  • Avoid hard candies, licorice, taffy and any products that contain nuts or dried fruit chunks.

Condiments and spices

  • Ketchup.
  • Mustard, not spicy.
  • Mild sauces or dressings.
  • Oil and vinegar.
  • Salt or salt substitutes.
  • Finely ground pepper.
  • Spices in moderation, such as onion powder, garlic powder or paprika.
  • Avoid coarse pepper, chili powder, curry, ginger, hot peppers and hot sauces, such as spicy barbeque sauce, taco sauce and Tabasco.

Fats and oils

  • Butter or margarine.
  • Cooking oils.
  • Mayonnaise.
  • Mild-flavored salad dressings.
  • Oil and vinegar.
  • Whipped topping.
  • Avoid deep-fried foods.