Esophagectomy Diet - UWMC Health On-Line - University of ...

Page 12Food and Nutrition ServicesEsophagectomy DietPatient EducationFood and Nutrition ServicesQuestions?Your questions areimportant. Call yourdoctor or healthcare provider if youhave questions orconcerns. UWMCclinic staff are alsoavailable to help.Dietitian/DietTechnician:________________Important Points to Keep in Mind• Eat 5 to 6 meals a day. At first, youmay be able to eat only small amountsat a time, about ½ cup.• Cut your food into small pieces andchew it well.• Focus on eating high-calorie, highproteinfoods.• Eat and drink slowly.• If you have symptoms of dumpingsyndrome (diarrhea, nausea, bloating,weakness, and sweating), you mayneed to avoid foods that are high insugar, fat and lactose (the sugar thatnaturally occurs in dairy products).• Try not to drink anything 30 minutesbefore or after a meal to help preventdumping syndrome.• Drink 8 to 10 cups of liquid each day.One cup equals 8 ounces.• Avoid lying down right after a mealto help prevent reflux. Wait at least30 minutes before reclining. Thiswill give your food time to settle.• If you lose weight for more than1 week after discharge, call thedietitian or diet technician.EsophagectomyDietNutrition guidelinesBecause you had an operation to removeyour esophagus (the tube that carries foodand drink from your mouth to your stomach),you will not be able to eat and drink normallywould for the first 4 to 6 weeks after youroperation.The diet guidelines in this booklet will helpyou get enough calories. It is common tohave difficulty swallowing and to quickly feelfull after an esophagectomy. You may alsohave dumping syndrome, when food movesthrough the intestines too quickly, causingdiarrhea or discomfort.Food and Nutrition ServicesBox 3560571959 N.E. Pacific St. Seattle, WA 98195© University of Washington Medical Center11/2007 Rev. 03/2011Reprints on Health Online: http://healthonline.washington.edu

Page 2 Page 11Food and Nutrition ServicesEsophagectomy DietFood and Nutrition ServicesEsophagectomy DietWhen yourdoctor saysyou are ready,you will start aclear liquiddiet, and thenwork up tomoist, softfoods.Getting StartedAfter your surgery, you will take a bariumswallow test to make sure there are no leaksin the surgery site. When your doctor saysyou are ready, you will start a clear liquiddiet. After that, you will work up to moist,soft, solid foods. The steps below explainwhat foods to start with and how your dietwill progress.Step 1: Clear Liquid Diet• Jell-O• Apple juice• Broth (chicken, beef, or vegetable)• PopsiclesSample MenusBreakfast 1½ cup cookedcereal½ cup milkSnack 11 oz. thinly slicedturkey breastLunch 1½ cup pea soup1 cup milk or fruitjuiceBreakfast 21 scrambled eggwith 1 oz. cheeseaddedSnack 2½ banana½ cup yogurtLunch 2½ cup tunacasserole1 cup milk or fruitjuiceBreakfast 3Fruit smoothie with½ cup yogurt andblended peaches orbananaSnack 31 thin slice of cheeseLunch 3½ cup macaroni andcheese1 cup milk or fruitjuice½ cup applesauce• Tea (without milk)Step 2: Full Liquid Diet• Milk (skim, 1%, 2%, or whole)• Puddings and custards• Yogurt (without chunks)• Ice cream and frozen yogurt as tolerated• Creamy soups (without chunks)• Smoothies (use fruits without seeds)• Nutritional supplements such as EnsureHigh Protein, Boost High Protein, orGlucerna• All clear liquids in Step 1 aboveSnack 11 deviled eggDinner 1½ chicken breastmarinated interiyaki sauce½ cup cookedcarrots1 cup milk or fruitjuiceSnack 1½ cup cottagecheese½ cup canned fruitSnack 21 pudding cupDinner 2½ cup pasta withmeat sauce1 Tbsp. gratedparmesan cheese½ cup cookedzucchini1 cup milk or fruitjuiceSnack 21 can Glucerna orEnsureSnack 36 oz. to 8 oz. yogurtDinner 32 oz. meatloaf½ cup mashedpotatoes1 teaspoonbutter/margarine1 teaspoon sourcream1 cup milk or fruitjuiceSnack 3½ cup dry cereal orinstant oatmealmade with milk½ cup milk or yogurt

Page 10 Page 3Food and Nutrition ServicesEsophagectomy DietFood and Nutrition ServicesEsophagectomy DietUse foodswithout addedsugar if youhave dumpingsyndrome.Basic Banana Smoothie(1 serving)- 1 cup vanilla 2% low fat yogurt- 1 frozen banana- 3 ice cubesBlend all ingredients until smooth.Per serving: 300 calories, 12 grams protein(2 protein servings)Yogurt Shake(8 oz. per serving)- ½ cup whole milk or milk mixture- ¼ cup fruit yogurt- ¼ cup soft fresh or canned fruitBlend all ingredients until smooth.Per serving: With whole milk: 225 calories,8 grams protein (1 protein serving); withMilk Mixture: 310 calories, 13 gramsprotein (2 protein servings)Peanut Butter Smoothie(1 serving)- 1 cup 2% low fat milk- 2 tablespoons peanut butter- 1 frozen bananaBlend all ingredients until smooth.Per serving: 415 calories, 17 grams protein(2½ protein servings)Step 3: Soft Esophagectomy DietOnce you leave the hospital you should be readyto begin following a Soft Diet. You will followthis diet for the next 4 to 6 weeks, or longer ifneeded. If moist soft solid foods become toohard to swallow or cause nausea and abdominaldiscomfort, go back to the Full Liquid Diet(Step 2) until you are ready to try moist softfoods again.Remember to eat slowly and to stop eating whenyou feel full.Soft Esophagectomy DietFood TypeMeats andMeatSubstitutes(2 to 3 oz.portions)OK to Eat andDrinkTender, moist fish,shellfish, andpoultry; groundmeat with gravy orsauces; cannedchicken, deli turkey,deli ham, tuna,cottage cheese,tofu, soft-cooked orscrambled eggs,sliced hard boiled ordeviled eggs; moistcasseroles withallowed ingredients,tuna or egg saladwithout coarseingredients; moistmacaroni andcheese, plain orflavored yogurt;thinly sliced cheeseDo NOT Eator DrinkRoast beef,pork or lamb,steak orchops; salami,pastrami, hotdogs,sausage,bacon,casseroleswith rice,crunchycasseroles,cheese cubes(OK if meltedin foods),sandwiches,peanut butter,nut butters,yogurt withberries, pizzaRemember toeat SLOWLYand to stopeating whenyou feel full.

Page 4 Page 9Food and Nutrition ServicesEsophagectomy DietFood and Nutrition ServicesEsophagectomy DietEat fruits andvegetablesthat are softenough tomash with afork.Food TypeBreadsandCerealsStarchesOK to Eat andDrinkSoft pancakesmoistened withsyrup and butter;cooked cereal ordry cereal withmilk i.e., creamof wheat, creamof rice, instantgrits, Cheerios,Rice Krispies,Special KWell-cooked,moist potatoes;potatoes insauces (withoutskins), wellcookedpasta insauces cut intosmall piecesVegetables Vegetable juices;soft, well-cookedvegetables (suchas carrots, beets,squash, or greenbeans) that canbe mashed with aforkFruitsFruit juices,cooked orcanned fruitswithout seeds orskin (peaches,pears, mandarinoranges); ripebananas, melon,mango, papayaDo NOT Eat orDrinkAll breads, rolls,crackers; wholegrain,high fiberdry or cookedcereals; oldfashioned orsteel cutoatmeal; cerealswith dried fruits,nuts or seedsPotato chips,potato skins,fried potatoes,rice, corn, beanswith skins (pinto,black, kidney)Raw or friedvegetables,whole kernelcorn, peas, driedbeans, spinach,celery, gasformingvegetables suchas broccoli,cabbage,Brussels sproutsAll other fresh,frozen, or driedfruits or fruitswith seeds orskins (apples,berries,pineapples,oranges,pomegranate)Breakfast in a Glass(10 oz. per serving)- ½ cup whole milk or milk mixture- ¼ cup orange or pineapple juice- ¼ cup liquid egg substitute- ½ banana- 1 teaspoon sugarBlend all ingredients.Per serving: With whole milk: 210 calories,10 grams protein; with Milk Mixture: 270 calories,15 grams protein (2 protein servings)Egg Nog(10 oz. per serving)- 1 cup whole milk or milk mixture- ¼ cup liquid egg substitute- ½ teaspoon sugarBlend all ingredients.Per serving: With whole milk: 210 calories,14 grams protein; with Milk Mixture:320 calories, 25 grams protein (3½ proteinservings)High-Protein Shake(12 oz. per serving)- ½ cup whole milk- 1 cup ice cream- 1 package Carnation Instant BreakfastBlend all ingredients until smooth.Per serving: 340 calories, 10 grams protein(1½ protein servings)

Page 8 Page 5Food and Nutrition ServicesEsophagectomy DietFood and Nutrition ServicesEsophagectomy DietRECIPEMilk MixtureAdd 1 cup skimmilk powder to aquart of wholemilk. Blend andchill. Makes1 cup (8 oz.).Use this mixturein cooking aswell as fordrinking.Boosting ProteinHere are some tips to add protein to your diet:• Use milk, Milk Mixture (see recipe at left),evaporated milk, or cream instead of waterfor cooking hot cereal. Also use theseliquids instead of water to make instantcocoa, canned soups, custards, and pudding.• Add pureed or chopped meat to scrambledeggs, omelets, or soups. For example, addchicken to cream of chicken soup, ham tosplit pea soup, or beef to tomato soup.• Add chopped, hard-cooked eggs to sauces,soups, casseroles, or chicken or tuna salad.• Add grated cheese to cooked vegetables,sauces, soups, and casseroles.• Cottage cheese with avocado or cannedfruit makes a good snack.Special DrinksThese drinks may be prepared at home tosupplement your diet. The flavors may bechanged to suit your own tastes.If you are lactose intolerant, try soy milk, ricemilk, or almond milk instead of cow’s milk.Milk Mixture(Makes 4 servings, 8 oz. each)- 1 quart regular whole milk- 1 cup powdered milkBlend and chill well. Use in place of regularmilk for cooking or in special drinks.Per serving: 265 calories, 18 grams protein(2½ protein servings)Food TypeBeveragesDrink64 ouncesa daySoupsDessertsAvoid thesefoods if theycausedumpingsyndromeFatsSweetsAvoid thesefoods if theycausedumpingsyndromeOK to Eat andDrinkAll allowedexceptcarbonatedbeveragesSoups made withallowedingredients thatare easy to chewi.e., chickennoodle, tomato,blended creamsoup, blendedsplit pea soupPudding, custard,ice cream,sherbet, fruit ice,frozen yogurt,gelatin made withallowed food,popsicles,milkshakes,smoothiesButter,margarine, saladdressing,mayonnaise,gravy, sourcream, whippedtoppings, oilsSugar, syrup,honey, jelly, plainchocolateDo NOT Eat orDrinkCarbonatedbeverages:soda pop,sparkling water,beerAvoid soupswith rice orlarge chunks ofmeat orvegetablesCookies, pies,or any dessertwith a crust orcontaining nuts,coconut, ordried fruit;bread or ricepuddingAll fats withchunks added,such as saladdressings withseeds, fruit, orvegetables;cream cheesewith fruit orvegetablepiecesNuts, coconut,chewy candysuch ascaramels,licorice, hardcandyEatingenoughcalories andprotein helpswith woundhealing.

Page 6 Page 7Food and Nutrition ServicesEsophagectomy DietFood and Nutrition ServicesEsophagectomy DietEat a varietyof foods fromeach foodtype.Food TypeOtherCommercialProteinDrinksOK to Eat andDrinkMild spices,ketchup,mustard,barbeque sauceEnsure, Boost,Glucerna,CarnationInstantBreakfast,SlimfastCalorie and Protein NeedsDo NOT Eat orDrinkPickles,popcorn, stickyfoods, hot spicyfoodsIf dumpingsyndrome is aproblem, usingproductsdesigned forpeople withdiabetes maybe helpful• You need to eat ______ calories a day• Every day, you will need: ____ grams ofprotein, which equals _____ servingsHigh-Quality Protein FoodsBelow is a list of common foods rich in highqualityprotein. Each food amount listed is equalto 1 protein serving (7 grams).• 1 oz. cooked fish, poultry, or lean ground meat• 1 egg or ½ cup liquid eggs substitute• 1 oz. cheese (melted)• 1 cup milk (skim, 1%, 2%, or whole)• 1 cup yogurt• ½ cup canned tuna or salmon• 1 cup pudding• 3 oz. tofuBoosting CaloriesAfter surgery, the body needs more caloriesand protein for healing. Eating small, highcaloriemeals throughout the day can helpyou meet those needs.Here are a few ways to add calories to yourdiet:• Eat smaller meals more often, or dividemeals in half. For example, have an eggfor breakfast and then have some cannedfruit and cooked cereal for a midmorningsnack.• Add butter or margarine to hot cereal,eggs, cooked vegetables, mashed potatoes,pasta, and soups.• Use gravies and sauces on meats andvegetables. A variety of sauce mixes areavailable at the grocery store.• Use sour cream to top fruits, meats, creamsoups, and baked potatoes. It can also beadded to sauces, scrambled eggs, andomelets.• Use mayonnaise or salad dressing onmeats and eggs.• Eat avocados plain or make guacamole totop egg dishes, meats, cooked vegetables,or cottage cheese.• Use whipped cream on canned fruit,pudding, or Jell-O.