What should I pay attention to in my diet after total gastrectomy

For some patients with advanced gastric cancer, if the condition is too serious, then total gastrectomy should be considered.

After total gastrectomy, food directly enters the duodenum. At the same time, because the vagus nerve is cut off, the time of bile and pancreatic secretion is inconsistent with the time of food entering and the secretion function is reduced, which hinders the digestion and absorption of protein and fat. In addition, due to the removal of the cardia, the reflux of intestinal juice, bile, and pancreatic juice can easily cause reflux esophagitis, so the following points should be noted in dietary care.

1. For patients whose weight has dropped significantly due to reduced food intake (significantly less than that of subtotal resection), they must follow the principle of eating small and frequent meals. Eat less at each meal, 4 to 5 meals a day. Do not overeat, and try to eat more easily digestible and nutritious foods.

2. To prevent reflux esophagitis, in order to protect the esophageal mucosa, take milk and acidic foods (such as chewing small pieces of apples, kelp, and crushed carrots) and avoid eating high-fat, high-concentration viscous liquid food. To prevent food reflux, take a semi-sitting position after meals, and fast before going to bed to keep the upper digestive tract empty.

3. After gastrectomy, gastric acid decreases and the peristalsis of the upper small intestine accelerates, disrupting the digestive physiological function, thereby affecting the absorption of protein and iron, and iron deficiency anemia is prone to occur. For this reason, patients can eat some lean meat, fish and shrimp, animal blood, animal liver and kidney, egg yolk, soy products, as well as dates, green leafy vegetables, sesame paste and other foods rich in protein and iron.

4. Due to the weakened physiological function of the stomach, do not eat raw, cold, rough and hard food, and avoid eating spicy and irritating condiments such as pepper, mustard, etc.