Eating after Upper Gastro-Intestinal surgery

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Why do I need to change my diet after surgery?
Surgery can cause swelling and bruising, making swallowing difficult temporarily. To avoid food getting stuck in the oesophagus, a special diet is recommended after surgery. This usually improves over several weeks.

What does the diet involve?
There are three stages:

• Liquid diet
• Puree diet
• Soft/fork-mashable diet

Most patients start on liquids, then progress to purees, then soft foods, and finally return to a normal diet.

How long will I follow each stage?
The duration depends on your surgery type. Your surgeon will advise when to move to the next stage and when you can return to your normal diet.

General tips

• Eat smaller, more frequent meals (6-8 per day) rather than three large meals
• Choose moist foods with sauces or gravy
• Take your time eating and drinking
• Chew food well and carefully
• Sit upright while eating and for 30 minutes afterward

Foods to avoid
Avoid dry or lumpy foods that can get stuck and cause discomfort, sometimes requiring hospital visits. Examples:

• Dry or tough meats, fish with bones, crispy batter
• Hard cheeses, grilled cheese toppings, nuts, dried fruit
• Fried eggs, undercooked beans or peas
• Soups with large lumps
• Wild rice, hard cereals (All Bran, muesli, shredded wheat)
• Bread, toast, dough-based foods (pizza, chapatti, naan), cakes, crumpets
• Raw vegetables and salads, stringy or gas-producing vegetables (celery, cabbage, onion, sprouts)
• Hard fruits, fruit skins, seeds, and pips
• Hard sweets, toffees, popcorn, crisps, chewing gum, biscuits, crackers

Preparing for surgery and diet

• Consider having a blender, food processor, and sieve ready at home
• Prepare and freeze some pureed and soft meals before surgery
• Stock up on suitable foods to have ready after discharge

What if swallowing does not improve?

• If struggling at any diet stage, revert to the previous stage temporarily
• If unable to swallow liquids, contact the hospital immediately

Medication advice

• Some may take medications normally; others may need crushed tablets or liquid forms
• Your surgeon or pharmacist will advise based on your surgery

Details on each diet stage

Liquid diet

• Foods must be smooth, lump-free, and eaten with a spoon or drunk
• Should not be possible to eat with a fork
• Stay hydrated and maintain nutrition—fortify drinks with milk or cream if needed
• Examples: fruit juice, smoothies, strained soups, milkshakes, ice cream, yoghurt (no seeds), custard, jelly, hot chocolate

Pureed diet

• Smooth, moist foods that hold their shape on a spoon, no chewing required
• Use a blender or sieve to achieve correct texture
• Examples: pureed casseroles, stews, vegetables, curries, macaroni cheese, soft fruits, smooth puddings

Soft/fork-mashable diet

• Foods easy to mash with a fork, served with gravy or sauce
• Meat and fish must be minced or finely chopped
• Examples: well-cooked pasta, minced meat, poached fish (no bones), soft lentils/beans, mashed vegetables, soft ripe fruits

When can I eat normally?
Your surgeon will advise when to return to a normal diet. Introduce firmer foods gradually, chew well, and take your time.

Ready-made meals
Available from:

• Wiltshire Farm Foods: 0800 066 3549 (Level 4 pureed, Level 5 soft meals)
• Oakhouse Foods: 0333 370 6700

Weight loss after surgery

• Losing around 3 kg (½ stone) is common
• If weight loss continues beyond six weeks, contact your doctor for dietitian referral