Dietary advice following anti-reflux surgery

Following your surgery you may find that your ability to swallow is affected for six weeks or slightly longer after surgery as people recover at different rates. You are advised to avoid very hot or very cold beverages within the first week after your surgery to allow healing.

We also advise you to eat minced, moist food that is easy to swallow. You are advised to eat small portions regularly (six small meals a day) and to chew your food well. There are certain foods that we advise you not to have because of the potential of them becoming stuck (causing an obstruction) such as; large chunks of gristly tough meat or deep fat fried meat.

In addition; a known side effect of your surgery is difficulty burping therefore we advise you to avoid fizzy drinks (alcoholic and non-alcoholic) or gas forming vegetables as they might cause you problems with bloating and abdominal discomfort.

Below is a list of food options that would be suitable to try. This list is not exhaustive and is provided only as a guide as not everything will work for all people but the main principle is minced, moist and easy to chew. We have also provided a list of unsuitable options for guidance.

Suitable options

Breakfast and cereals

• Weetabix
• porridge
• scrambled eggs

Meat and alternatives

• minced or finely chopped, very tender meat in gravy
• fish in sauce (no bones)
• mashed pulses
• soft or melted cheese eg cottage cheese or cheese sauce
• eggs, eg scrambled, poached, omelette

Starchy foods

• mashed potatoes
• inside of jacket potato (no skin)
• pasta / spaghetti in a sauce - spaghetti hoops, macaroni, carbonara, ravioli

Fruit and vegetables

• stewed fruit eg apples or pears
• mashed fruit eg banana
• puréed or mashed vegetables
• mashed sweet potato

Puddings

• yoghurt
• smooth ice cream
• soft puddings with custard
• mousses
• egg custard
• crème caramel
• trifle
• jelly
• ‘dunked’ biscuits

Miscellaneous

• puréed soup

Unsuitable options

Breakfast and cereals

• bread
• toast
• pastries and cakes
• biscuits
• dry or crunchy cereals with nuts
• crumpets

Meat and alternatives

• large pieces of red meat
• fried meat
• sausages, pies
• sausage rolls
• hard cheese

Starchy foods

• chips

Fruit and vegetables

• all fruit containing pips, seeds or skin
• vegetables with skin eg peas, broad beans, sweet corn
• salads, raw vegetables
• stringy fruit or vegetable eg rhubarb or celery
• gas forming vegetables eg Brussels sprouts, broccoli, cauliflower, beans

Puddings

• dry pastry
• muffins

Miscellaneous

• tinned soups with ‘bits’
• nuts
• crisps
• popcorn

What to do if you experience:

Difficulty swallowing

Given time, your swallowing will improve but if you find the first weeks challenging try the following:

• Add extra sauces to your food or Blend (liquidise) food in a sauce.
• Eat slowly and chew your food well – up to 20 chews before swallowing.
• Drink fluids slowly.
• Drink small amounts of water with your food.
• Concentrate more on nourishing drinks, for example have milk or milky drinks such as Ovaltine, Horlicks, or less acidic fruit juices such as apple juice.

If you are unable to tolerate more than a litre and a half of fluid in 24 hours contact your clinical nurse specialist (CNS).

Excessive wind

• Use a straw when drinking.
• Reduce your intake of gas forming drinks, vegetables such as onions, brassicas such as sprouts, cabbage and legumes such as peas, beans and lentils.
• Stop taking pain killers as soon as you no longer need them as some pain killers can slow your bowels.
• Ensure your bowels are working and if they are not working well speak to your pharmacist or GP and seek advice on which laxatives to use.
• Drink plenty of warm fluids.
• Try peppermint tea/ water or over the counter remedies such as Wind-Eze or Deflatine.

Abdominal pain

It is not uncommon to experience pain after surgery for the first week or two after surgery. Take pain killers that you were given on discharge as directed. If your painkillers are not providing adequate cover, or the pain is getting worse contact your CNS for advice or see your GP if out of hours.

Reflux symptoms

Some people experience symptoms that might mimic reflux. Avoid taking any medications for reflux soon after surgery or before your first review. Please see your GP or contact your CNS team for advice.

Losing weight

Most people can lose up to a stone in weight after surgery. If you are concerned about your weight loss; try the following:

• Eat small meals often, eat snacks between meals.
• Avoid ‘light diet’, low fat or low sugar food options.
• Fortify your meals by adding extra calories from butter, margarine, oils, full fat milk, cream, cheese, crème fraiche or coconut cream to savoury foods, or sugar, honey and jam to desserts
• Drink nutritious drinks between meals, eg warm or cold milky drinks, soups, yoghurt based drinks, or smoothies.
• Meritene Energis (Build up) or Complan milkshakes/ soups can be helpful and are available from most chemists or supermarkets.
• If you are continuing to lose weight, inform your CNS or speak to your GP and request fortified drinks.

Your CNS team are available Monday to Friday between 08:00 (8am) and 16:00 (4pm) on 01223 596383. Please contact them for advice or leave a message on their voicemail and they will respond back as soon as possible. Alternatively, if urgent, you can contact the Upper GI secretaries:

• 01223 217421 (Mr Hardwick, Mr Safranek, Mr Gourgiotis)
• 01223 348024 (Mr Hindmarsh, Mr Sujendran, Mr Bennett, Mr Oneill, Miss Noorani).

Out of hours, contact your GP or 111.

References

IDDSI (International Dysphagia Diet Standardisation Initiative) April 2019