Removal of the stomach for cancer nutrition. Diet and proper nutrition after gastric removal - features and recommendations

After removal of the stomach for cancer and other gastrointestinal ailments, all patients noticeably deteriorate in function digestive system. Thus, unprocessed substances penetrate into the small intestine, which leads to poor absorption of beneficial elements.

As a rule, the stomach or part of it is removed after a diagnosis of stomach cancer is made. Surgery can also be aimed at removing a gastric polyp. After surgical intervention After removal of the stomach or part of it, patients must adhere to diet therapy for at least 6 months. the main objective This regimen is to reduce the amount of food consumed so that the patient’s body gradually adapts to the reduction in the size of the gastric pouch. Further in the article we will tell you how and what a patient should eat if a gastrectomy or gastrectomy was performed for any indication.

Features of dietary nutrition

As it became clear during medical research, frequent use in food products plant origin provides positive impact on cell metabolism and prevents the development malignant neoplasms and gastrointestinal diseases. It is fruits and vegetables that help strengthen the immune system and stop inflammation in the human body. When compiling a menu for a patient who has undergone surgery in the stomach cavity to remove it, it is necessary to take into account the following features:

• Patient's age.
• Physiological features.
• Psychological characteristics.
• Stage of the tumor process (in oncology).

A properly developed menu will improve the general condition of the patient, reduce the number and degree side effects from carrying out chemical therapy for cancer. When developing a menu, you need to pay attention to the following recommendations:

• The amount of fat in the total daily energy value should not exceed 30%.
• You need to eat in small portions.
• The diet should contain a lot plant products food, as well as freshly squeezed juices.
• You should give up sweets, pastries and sugar.
• You need to adhere to restrictions on the consumption of starchy foods, such as legumes, potatoes, bananas, etc.
• The amount of salt consumed per day should not exceed 5g.
• The consumption of alcohol and black strong coffee is strictly prohibited.
• As a drink, it is better to use vegetable decoctions, tomato juice only without salt), green teas.

Please note that in case of malignant neoplasms in the stomach, you need to increase the consumption of foods that can slow down growth cancer cells, and also completely exclude those that provoke the development of malignant neoplasms.

What to eat after surgery?

Nutrition after removal of a polyp or part of the stomach should be selected as gentle as possible. On the first day after surgery, you can fast if recommended by your doctor. Considering that after the surgeon’s intervention in the stomach, the stomach’s ability to digest food is slightly impaired, incompletely digested food fragments will penetrate into the intestines, which will bring discomfort in the stomach, nausea, and other negative manifestations. To minimize unpleasant symptoms, you need to eat very small portions and limit fluid intake to 200 ml at a time.

Nutrition after surgery should be structured so that the amount of protein foods and vitamins is increased. But the use of salt and the consumption of carbohydrate-containing foods should be reduced to a minimum. As we have already said, you need to eat often (at least 6 times a day), but in small portions. Gastric resection – serious procedure to remove a part of the stomach that involves intervention in the human body. Before the procedure, careful preparation is required, and after the procedure, a special postoperative regimen is required.

The main indication for such an intervention is stomach cancer and other malignant formations that are not amenable to more humane treatment. After gastric resection, the patient’s life changes dramatically. Because of this, special nutrition after removal of the stomach for cancer is an integral part of the patient’s life.

After resection, food according to digestive tract will pass faster than before, so patients often complain of a feeling of heaviness. The following may also sometimes appear:

• Dizziness.
• General fatigue.
• Drowsiness.
• Dumping syndrome, etc.

Patients who cannot do without resection must be prepared for the fact that after the procedure changes in the functioning of the pancreas and small intestine will be noticed, as a result - weight loss, hypovitaminosis, anemia, etc. Negative consequences. In some cases, patients, especially if resection does not allow success, are prescribed more effective operation- complete removal of the stomach. But such a radical procedure also has its own characteristics and negative consequences, and the mortality rate is lower. early stages postoperative period is about 10-12%.

Prohibited and permitted foods after stomach removal

Prohibited foods after stomach removal:	Allowed products after removal of the stomach:
First courses are made with fatty broths of meat and fish, as well as mushroom decoctions.	Greens (dill and parsley, dill, lettuce).
Seasonings and various dressings.	Sea kale.
Smoked meats, pickles, canned food and pickled foods.	Different types of cabbage: Savoy, Peking, broccoli.
Food with a coarse and hard texture.	Products of plant origin.
Green products of plant origin.	Garlic and cibul.
Alcohol.	Mustard.
Fats of vegetable and animal origin.	Soups.
Fast food products.	Well-cooked porridge.
Semi-finished products.	Pastes made from lean meat or fish.
	Puree boiled vegetables.
Chocolate and sweets containing it.	Boiled eggs and omelettes.
	Low fat cottage cheese.
Carbonated drinks, black strong coffee and tea.	Vegetable oil.
	Green tea.

Please note that before use, products must be thoroughly chopped, and heat treatment use a double boiler or boil them. But drinking too hot is strictly prohibited. It also wouldn’t hurt to mention that you need to avoid products that contain a lot of dyes, flavors, emulsifiers, preservatives and other carcinogens that can cause an increase in tumors and have a detrimental effect on the general condition of the patient.

Dishes for patients with stomach cancer

Sample menu for patients with stomach cancer, it is allowed to choose from such dishes and products as:

• Oatmeal with water or with milk and tea.
• Omelette, tea with biscuits.
• Oatmeal cookies with tea or herbal infusion.
• Pasta casserole, tea.
• Cottage cheese casserole with tea.
• Rice pudding with a cup of green tea.
• Orange juice with croutons.
• Fruit jelly.
• Fruit muesli dipped in milk.
• Soufflé or mousse of fruits and berries.
• Biscuits with juice or compote.
• Pea soup, vegetable stew, compote.
• Vegetable soup, pumpkin puree, juice.
• Milk-rice soup, vegetable casserole, tea.
• Beetroot soup, rice casserole, tomato juice.
• Tea with diet cookies.
• Cottage cheese.
• Baked apples.
• Fruit salad.
• Steamed cheesecakes.
• Zucchini fritters.
• Jelly or soufflé made from fruits and berries.
• Rice porridge with steamed meat, juice.
• Buckwheat, vegetable stew, tea.
• Mashed potatoes with cream cheese sauce ( homemade), compote.
• Baked fish, vinaigrette, juice.

As you can see, a menu can be built even from a very limited list of permitted products, you just have to really want it!

A stomach cancer diagnosis is not a death sentence. Treatment for some types of cancer includes. This can lead to a number of changes in lifestyle and eating habits. A gastrectomy is the removal of part or all of the stomach. Special attention paid to what kind of nutrition is prescribed to the patient after removal of the stomach for cancer. Lack of the main thing digestive organ significantly affects the nutritional pattern.

To solve stomach problems, if other types of treatment do not help, organ removal is used in the following cases:

• benign tumors;
• bleeding;
• inflammation;
• perforation of the stomach wall;
• polyps or growths inside your stomach;
• stomach cancer;
• severe ulcer or duodenal ulcer.

If you have a stomach ulcer, it is necessary to maintain normal stomach acidity. Gastric juice Reduces acidity if you drink cabbage juice and do slow walking after eating.

There are three main types of gastrectomy:

• Partial resection - removal of part of the stomach. As a rule, the lower half of the stomach is removed, the remaining part is connected to the intestines.
• Removal of the entire stomach - the esophagus is connected to the small intestine.
• Removed as part of weight loss surgery – up to ¾ of the stomach can be removed during a sleeve gastrectomy, the remainder is pulled up and stapled together, creating a smaller belly and appetite.

After gastric surgery, the ability to absorb fluids and food products remains. However, you will need to make a few lifestyle changes after the procedure. The diet after surgery is strictly followed.

Some types of surgeries can also be used to treat obesity. By making the stomach smaller, it fills more quickly. This may help you eat less. However, obesity surgery is performed when other options have failed. Less invasive procedures include:

• diet;
• exercise;
• treatment, blood tests to monitor indicators;
• consultation with a nutritionist and attending physician.

How to prepare for surgery

Before surgery, your doctor will order blood tests and imaging tests. This will ensure that you are healthy enough for the procedure. You may have to stop taking some medications before surgery.

The patient should tell their doctor if they have any other medical conditions or pregnancy. The patient must quit smoking.

Smoking adds additional recovery time and can create more complications.

Risks of gastrectomy include:

• acid reflux;
• diarrhea;
• dumping syndrome due to insufficient digestion;
• incision wound infection;
• chest infection;
• internal bleeding;
• stomach leakage;
• nausea;
• vomit;
• stomach acid leaks into the esophagus, causing scarring and narrowing of strictures;
• blockage of the small intestine;
• avitaminosis;
• weight loss.

How is resection performed?

There are two different ways performing a gastrectomy. All of them are performed under general anesthesia. This means that you will be in deep sleep during surgery and you will not be able to feel pain.

Open surgery – involves one large incision.

Laparoscopic surgery – uses small incisions and specialized instruments. It includes less pain and faster recovery time. These are more advanced surgeries with a lower complication rate.

After the operation, the doctor will close the incision with stitches and the wound will be bandaged. The patient will undergo a rehabilitation phase under the supervision of a nurse. After surgery, the patient may remain in the hospital for one to two weeks. During this period, tubes will be passed through the nose to the stomach.

This will allow the doctor to remove any fluids produced by the stomach and will help keep you from feeling nauseous. The patient will have intravenous nutrition for three days. On the fourth day, a gradual feeding of 30-50 grams begins after removal of the stomach for cancer, with a gradual increase in portions.

Swallowing problems

Swallowing problems often occur after gastric surgery. Food usually passes very quickly into the stomach from the esophagus. Food is partially digested, so it must enter the intestines in small quantities. The stomach can hold about 2 liters of food and drink. Without a stomach, food enters the intestines almost undigested, and the intestines will only accept small amounts at a time. This means that you should eat very slowly and in small quantities.

Sometimes the intestines will not accept more and there will be a problem with swallowing. Your doctor may prescribe medications to help speed up the passage of food. They are usually taken before meals. When the body adapts, the problem will be partially solved on its own. But this does not mean that you will be able to eat large amounts of food.

Diet therapy

The first months after surgery, pureed diet No. R is prescribed. Once you return home, you may need to adjust your eating habits. Some changes may include when the stomach is removed:

• chew food thoroughly;
• eat less food during the day;
• gradual increase in portion;
• varied fractional meals;
• pureed food;
• avoid foods with high content fibers;
• eat foods rich in calcium, iron and vitamins C and D;
• take vitamin supplements.

Recovery after gastrectomy can take a long time. Eventually, your stomach and small intestine will gradually stretch. Then you will be able to consume more fiber and eat more sufficient quantity vitamins and minerals.

Stomach oncology; in case of oncology, it is better to eat crushed and jelly-like food. Proper nutrition is always difficult for anyone healthy person, but the diet after removal of the stomach for cancer will be even stricter. Nausea may be a problem. A cancer patient may lose appetite for a while and lose weight.

Weight must be maintained good nutrition. This is not the time to restrict your diet. If you are losing weight or have problems with food, then eat whatever you want pureed. You should eat small meals every 2 to 3 hours until you feel better. In the future, eat 4-5 times a day.

The menu should be varied: dietary meat and fish, buckwheat, oatmeal, cottage cheese, eggs, pureed vegetables and fruit jelly, pureed soups, compotes. Preference must be given meat products: rabbit, chicken, turkey, veal, beef. Exclude: lamb, pork, semolina and millet. Food should not be over-salted.

You can eat bread one month after surgery. You can consult a nutritionist who can give you ideas on how to deal with some of the side effects of treatment.

If part or all of the stomach is removed, you will have to eat less food, but more often. It is recommended to stay in vertical position after eating. Your doctor or nutritionist can help you determine your diet.

When some or all of the stomach is removed, the food that is swallowed quickly passes into the intestines, leading to various post-meal symptoms. Some patients have problems with nausea, diarrhea, sweating and flushing after eating. This is called dumping syndrome. When part or all of the stomach is removed, the food that is swallowed quickly passes into the intestines, leading to various complications.

Sometimes people may need food additives to get what they need nutrients. Individual people may need to be fed through a tube inserted into the small intestine. This is done through a small hole in the skin on the abdomen during minor surgery to help prevent weight loss and improve nutrition. Less commonly, a tube known as a gastrostomy tube or G-tube may be placed in bottom part belly.

After cancer treatment, the patient should receive diet table and set habits healthy eating in place.

Eating healthily and avoiding alcohol and smoking can reduce your risk of a range of cancers, as well as provide many other health benefits.

Informative video

Contents of the article:

Diet after removal of the stomach for cancer is a mandatory part of treatment, since the operation disrupts the function of the gastrointestinal tract. If previously digested food mass entered the small intestine, now it does not undergo the necessary processing, so necessary for the body substances are absorbed much worse.

About the operation

Removal of the stomach is a difficult surgical operation, which is prescribed when there are no other ways to save a person’s life. It's called a gastrectomy. In this case this body removed completely. Even if the operation was successful, there was no serious complications, the patient needs to prepare for long-term rehabilitation. At complete removal stomach, it is important to take vitamins in the form of medications, especially vitamin B12, since it is absorbed in the stomach, and without additional treatment Pernicious anemia may develop.

However, the prognosis is favorable if the patient underwent surgery on time, and then underwent rehabilitation and followed all the doctor’s recommendations. You can easily adapt to new digestive conditions. But with oncology, everything is much more complicated, since much depends on the stage of cancer, general condition sick.

Gastric resection is a similar operation, however, the patient does not have the entire organ removed, but only part of it: from a quarter to 2/3. Then the stump of the stomach is connected to the duodenum. This is also a serious operation, like removing the stomach. To recover from it, you need to strictly follow the doctor’s recommendations, it is especially important to eat right.

Nutrition in the first days

Immediately after gastric surgery, the patient cannot eat, so there is no need to bring anything to the hospital. For the first 2 days he fasts, and on the third day the doctor may allow him to drink a little compote or rosehip decoction, or sweet tea. The patient is given water every 15 minutes, giving him 1 tsp. liquids.
There is something that doctors do not recommend immediately after surgery; the patient will be fed by medical staff clinics. To ensure that the body receives all the necessary nutrients, special mixtures of proteins and amino acids can be administered intravenously. The doctor may also prescribe protein enpit. The patient receives 30-50 ml of this solution. First, it is administered through a probe, then, when it is removed, through the mouth. The patient eats in this peculiar way for about 2 or 3 days. Gradually the amount of protein enpitite obtained is increased.

Nutrition after surgery

After 4 or 5 days, the doctor will switch the patient to a normal diet, provided that he has no bloating and normal peristalsis. But this does not mean that now he will be able to eat dumplings with sour cream or pies. The diet after surgery is very strict, but you cannot break it, because proper nutrition– This is an important part of the patient’s rehabilitation.

After gastrectomy, the patient must eat according to a special diet. There are several types of diet that are prescribed to the patient. You need to adhere to each of them for about 2-4 days, but the doctor can increase or shorten this period, it depends on the patient’s well-being.

Diet No. 0A

Diet No. 0A is prescribed on days 4 or 5. Features of this diet: little salt (no more than 1 or 2 g) and a lot of water (1.8 -2.2 l). The patient should eat at least 7 or 8 times a day, eating no more than 250 g of food. As an addition to the diet, you are allowed to eat 1 or 2 soft-boiled eggs.

What you can eat:

• mucous decoctions to which cream is added;
• light meat broth, no fat;
• fruit or berry jelly;
• juices from vegetables or fruits;
• sweetened drink made from rose hips.

For now, you cannot eat dense foods, even if they are pureed, or drink milk.

Diet No. 0B

This diet is needed on the 6th or 8th day after surgery due to stomach cancer. The patient should take up to 2 liters of liquid, and the amount of salt is slightly increased, to 4 or 5 g. The patient can eat up to 6 times a day, servings - 400 g. What is possible? The menu is the same as for diet No. 0A, but the list of allowed products is longer:

• soups with cereals;
• the patient can already eat pureed porridges made from rice or buckwheat, but only if they are liquid;
• soft-boiled eggs or white omelet are allowed;
• The patient’s menu also includes meat and fish (puree), but only dietary ones.

Diet No. 0B

This diet is usually prescribed for days 9-11. This is a special diet after surgery, when the patient switches to a full diet. The patient should drink up to 1.5 liters of water or other liquid, the amount of salt allowed is 6 or 7 g. The patient eats about 5 or 6 times a day, the following dishes are added to his menu:

• cream soup;
• white crackers, but not more than 75 g;
• pureed vegetables or fruits;
• apples, but not fresh, but baked;
• chopped meat or fish;
• cottage cheese, you can add a little cream;
• various fermented milk drinks.

Dumping syndrome

In approximately 10-30% of patients after surgery on the stomach, dumping syndrome is observed, when food is quickly dumped from the stomach into the intestines and is disrupted. carbohydrate metabolism, balance of gastrointestinal hormones and so on. Such patients complain of weakness, severe dizziness after meal, headache. They feel hot, sweat profusely, and the patient may faint.

To prevent these and other unpleasant symptoms from appearing, especially if a person has stomach cancer, you need to follow a number of simple rules:

1. The patient’s menu should contain a lot of proteins and the amount required for him complex carbohydrates.
2. The amount of easily digestible carbohydrates is limited, that is, you will have to forget about sweets, sugar, cakes, drinks, and canned juices for a while.
3. The amount of fat is reduced, fried foods are also not allowed.
4. Patients should not eat foods that increase bile secretion or that increase pancreatic secretion.

If unpleasant symptoms nevertheless appear, you must report them to the attending physician, who should monitor the patient after gastrectomy or resection. He will choose the right treatment.

Diet 10 days after surgery

What can patients without a stomach eat or those who have had part of their stomach cut off? 9-12 days after surgery, the patient is transferred to dietary table No. 1, but the pureed option is chosen. The patient should eat frequently, eating about 5 or 6 times a day. Portions should be small, about 250 g; if it is liquid, then no more than one glass.

The diet should contain a lot of proteins, so patients need to eat chopped meat or boiled fish, prepare omelettes from proteins, and do not give up fresh cottage cheese. Fats are also necessary, but moderate amount. If the patient feels bad from such food, the amount of fat is reduced. The patient should eat little carbohydrates, especially if they are easily digestible, it is better to reduce their content.
During this period, the patient should not eat strong broths, as well as fatty poultry, meat, all kinds of sausages, ham, smoked products and canned food. Everything fried, bread, flour products, pickles. All vegetables and fruits must be ground before consumption.

Nutrition several months after surgery

If the patient feels well, there is no point in eating only pureed foods. After 3 or 4 months, the patient can begin to eat regular food, but some restrictions still remain. How to eat right? You still need to stick to diet number 1, but not the pureed version. The patient's diet becomes more varied: he can eat meat soups, eating them with dried white bread, fish and meat, chicken. Allowed are boiled vegetables, herbs from the garden, potatoes, buckwheat, rice, fresh fruits, fermented milk drinks and so on.

You can stick to this diet for about 2 or 3 months. If the patient has no complications, he has no problems with the intestines, the functioning of the gastrointestinal tract, then six months after the operation you can eat like everyone else. However, the diet cannot be canceled; it is also important to monitor the chemical composition of the diet.

Allowed

If a patient has stomach cancer, due to which part of the stomach or the entire organ was removed, the menu can still be varied. Here is a list of dishes and foods that can be eaten with this disease:

• slimy soups, to which they added oatmeal, buckwheat, rice, put a little butter or cream;
• you can cook meat dishes, for example, veal, chicken, turkey;
• white bread croutons;
• you need to prepare fish dishes, and these are pollock, hake, cod and pike;
• Porridges are allowed: oatmeal, rice, buckwheat, you can put a piece of meat in them;
• soft-boiled eggs or omelet;
• if there is no intolerance, milk, cream, cottage cheese are allowed;
• Jelly or jelly made from berries are useful.

Prohibited Products

To avoid pain in the abdomen and other unpleasant symptoms, after the tumor has been removed, it is better to exclude some foods from the diet or at least limit their quantity:

• strong broths;
• can't eat fresh bread, various confectionery and flour products;
• Sausages, canned food and all kinds of smoked meats, fatty meat or poultry are not allowed;
• It is worth giving up some cereals: barley, corn, pearl barley and millet;
• pasta;
• You can’t eat fried foods or pickles;
• mushrooms;
• raw vegetables, especially legumes, cabbage, rutabaga, onions, radishes and so on;
• cottage cheese or sour cream, if they are fatty;
• Sauces and spices, all kinds of seasonings are contraindicated;
• you cannot drink soda, coffee, strong tea, alcohol, or juices from the store;
• sweets and jam are also not allowed, as are ice cream, cakes, and chocolates.

Nutrition after removal of the stomach for cancer is an important part of treatment; you must follow a diet, otherwise the body will not be able to recover quickly. Sticking to it is not so difficult, since the basis of nutrition is soups and cereals. If you create a menu correctly, the patient will quickly recover, and over time will be able to expand his diet.

Resection of the stomach or part of it in a number of cases is the only possible method treatment and preservation of the patient's life. Stomach surgery is radical method treatment of extensive malignant neoplasms ( stomach cancer ), not amenable conservative treatment, polyps, stomach bleeding. Despite the progress of medicine, gastric removal remains one of the most difficult surgical operations, and even if it is successful and there are no significant complications, rehabilitation takes a long period time, and nutrition after gastric surgery is the most important component of this process.

Diet after gastrectomy or after removal of part of the stomach

Parenteral nutrition after gastrectomy begins with sequentially prescribed Diet No. 0A , 0B , 0V ( , 1B surgical). Their purpose is to provide the patient with minimum quantity basic food nutrients, unloading and sparing the stomach, preventing intestinal bloating, etc. The diet contains easily digestible foods containing complete proteins, fats, carbohydrates, vitamins and macro/microelements and increased amount free liquid. Salt consumption is sharply limited.

On the first postoperative day, the patient is shown to be hungry; on day 2 - the diet includes 250 ml of warm sweet tea and rosehip infusion (50 ml), which are given after 15-20 minutes per teaspoon; on days 4-5 in the absence of abdominal bloating and normal peristalsis, prescribe Diet No. 0A and 2 soft-boiled eggs; for 6-8 days Diet No. 0B ; on days 9-11 - Diet No. 0B .

• Diet No. 0A . Contains 5-10 g of proteins, 15-20 g of fats and 180-200 g of carbohydrates. The volume of free liquid is 1.8-2.2 l, sodium chloride is no more than 1-2 g. Energy value daily ration varies between 760-1020 Kcal. Food is served in liquid form. Fractional diet - up to 7-8 times a day and the amount of food per meal is no more than 250 g. The diet includes mucous decoctions with cream, light low-fat meat broth, fruit and berry jelly/jelly, sweet rosehip decoction, fruit and berry juices . Dishes with a pureed and dense consistency, drinks containing carbon dioxide, and whole milk are completely prohibited.
• Diet No. 0B . Contains 40-50 g of protein, 50 g of fat and 250 g of carbohydrates. The volume of free liquid is up to 2 l/day, sodium chloride is no more than 4-5 g. The energy value of the daily diet is 1580-1650 Kcal. Food is prepared in liquid/puree form. Diet - up to 6 times a day, portion size should not exceed 400 g. In addition to permitted products Diets No. 0A the diet is expanded by adding mucous cereal soups cooked in vegetable broth, soft-boiled eggs, liquid pureed rice and buckwheat porridges, protein steamed omelettes, pureed dietary meat and fish, sweet berry jelly.
• Diet 0B . It is a diet of a transitional stage to subsequent physiologically complete nutrition. Contains 80-90 g of protein, 70 g of fat and 320 g of carbohydrates. The volume of free fluid is 1.5 l/day. Sodium chloride no more than 6-7 g. The energy value of the daily diet is 2100-2400 Kcal. Food is served in puree form. Diet: 5-6 times a day. The diet additionally includes cream/mashed soups, pureed steamed meat and fish, pureed cottage cheese with cream, fermented milk drinks, baked apples, pureed fruit/vegetable puree and 50-75 g of white crackers.

The duration of each surgical diet is 2-4 days, but, if necessary, the time spent on them can be lengthened or shortened. That is, approximately 9-12 days later, the surgical diet after the operation ends, and the patient is transferred to the standard Pevzner diet (mashed version), which limits the amount of food consumed at one time: no more than 250 g of the first pureed dish or a glass of liquid ( 250 g), and for lunch - only two dishes. Meals are fractional, 5-6 times a day.

The diet contains an increased amount of protein (100-110 g), for which dishes from boiled chopped meat are used, boiled fish, fresh pureed/calcined cottage cheese, egg white omelettes. The amount of fat in the diet is at the level of physiological norms or several times higher (80-90 g). If the patient does not tolerate fats well (and pure form too), which is manifested by bitterness in the mouth, regurgitation, diarrhea, their quantity is limited to 60-70 g. The carbohydrate content is reduced to 300-320 g due to easily digestible carbohydrates.

In some cases, in particular when dumping syndrome manifested by weakness, heartbeat , chills, a feeling of heat, abdominal pain and bloating that appear after eating, it is necessary to completely eliminate foods containing sugar, since the consumption of easily digestible carbohydrates is one of the reasons for its appearance.

To slow down the evacuation of food from the gastric stump, it is recommended to consume viscous and jelly-like foods. You can practice separate meals of dense and liquid consistency, starting with dense ones, as well as eating in a lying position. Eat food in even small portions 6-7 times a day. After eating, you need to lie/recline in bed for 30-40 minutes. You can also practice eating butter before eating carbohydrate foods, which inhibits the removal of food from the gastric stump. At poor tolerance whole milk it is excluded from the diet and replaced with other products.

Strong broths based on meat, mushrooms and fish, fatty red meat and fish, some types of birds (duck, goose) and products based on them (sausages, canned food, ham, smoked meats), fried foods, dough products are completely excluded from the diet. , fresh bread, savory snacks, salty fish and vegetables, solid animal fats, unprocessed raw vegetables and fruits.

At feeling good 3-4 months after the operation, the patient is gradually transferred to the non-rubbed version Diets No. 1 . The diet is physiologically complete, contains an increased amount of proteins and is practically normal amount fats and complex carbohydrates. The limitation concerns simple carbohydrates, in order to prevent the development of dumping syndrome. Culinary methods of processing products are preserved: the products are boiled or steamed, and after boiling, baked or stewed. In terms of the range of products, the diet of this diet option is more extensive, but the rules and restrictions are the same.

It is allowed to consume low-fat meat soups, borscht, cabbage soup (once a week), dried wheat bread, low-fat varieties fish and beef, chicken dishes, savory cookies. It is allowed to eat boiled and raw vegetables, garden herbs, fermented milk products, dishes based on buckwheat and rice, potatoes, mild low-fat cheese, dietary sausages, fresh fruits and berries.

In the absence of complications and satisfactory gastrointestinal function, 6 months after surgery, the patient can switch to a normal diet, but taking into account the diet and characteristics chemical composition diet. It is possible to independently adjust the set of food products in the diet, taking into account individually intolerant foods. With pronounced loss of body weight (10-15%) after gastric resection, especially for cancer, the calorie content of the daily diet should be increased compared to physiological norm by increasing the content of essential food nutrients recommended for the diet.

If complications such as inflammation of the anastomosis or gastric stump occur, peptic ulcer prescribe the pureed option Diets No. 1 , and during exacerbation - sequentially No. 1A And 1B with modifications to them taking into account intolerance to certain products. In general, the nutrition of patients with diseases of the operated stomach must be individualized.

It is advisable to include specially developed dietary nutritional mixtures in the diet after gastric surgery - “ Nutrizon », « Nutridrink », « Berlamin Modular ", which should be administered in small portions, can be diluted with water, with constant assessment of their tolerability.

Dietary nutrition must necessarily include taking vitamin-mineral complex tablets and medications that normalize motor-evacuation function various departments Gastrointestinal tract and preparations containing enzymes to improve digestion processes ( Creon , Mezim-forte ). Complete rehabilitation in patients is long-term and usually occurs by the end of the first year after surgery.

Indications

Gastric resection and complications of the operated stomach.

Authorized Products

Diet after gastric resection when transferring the patient to Diet No. 1 (A , B ) includes slimy cereal soups from rice, buckwheat, oatmeal with the addition of butter, low-fat cream or egg-milk mixture, cream to the finished dish. For second courses, lean types of red meat are used (veal, beef), chicken or turkey, well boiled and minced.

Dishes of white fish (cod, pollock, pike, hake) in the form of steamed or boiled are allowed. Cereal dishes are prepared with milk/water in the form of liquid porridge from buckwheat, oatmeal, and rice, to which butter is added.

If tolerated well, the diet includes milk and dishes based on it, low-fat cream, calcined cottage cheese, milk jelly, chicken eggs in the form of a steam omelette or soft-boiled.

Among fats, preference is given to butter and vegetable oils, added immediately before use to the finished dish. Jelly and jelly made from sweet berries are useful. From drinks - juices from fresh berries, weak tea with cream, rosehip infusion.

Table of permitted products

	Proteins, g	Fats, g	Carbohydrates, g	Calories, kcal
buckwheat (kernel)	12,6	3,3	62,1	313
cereals	11,9	7,2	69,3	366
white rice	6,7	0,7	78,9	344
white bread crackers	11,2	1,4	72,2	331
sugar	0,0	0,0	99,7	398
milk	3,2	3,6	4,8	64
cream	2,8	20,0	3,7	205
cottage cheese	17,2	5,0	1,8	121
boiled beef	25,8	16,8	0,0	254
boiled veal	30,7	0,9	0,0	131
rabbit	21,0	8,0	0,0	156
boiled chicken	25,2	7,4	0,0	170
turkey	19,2	0,7	0,0	84
chicken eggs	12,7	10,9	0,7	157
butter	0,5	82,5	0,8	748
mineral water	0,0	0,0	0,0	-
black tea with milk and sugar	0,7	0,8	8,2	43
juice	0,3	0,1	9,2	40
jelly	0,2	0,0	16,7	68
rose hip juice	0,1	0,0	17,6	70

Fully or partially limited products

The patient's diet after gastric surgery excludes bakery and confectionery products, fresh bread, pastries, and products made from any type of dough. Strong broths based on meat or fish, dishes made from fatty meats and fish, as well as products based on them (canned food, sausages, smoked meats), solid animal and cooking fats, fried foods, pickles, mushrooms, various snacks, vegetables and raw fruits, full-fat cottage cheese, cheese, sour cream, fermented milk products.

You cannot include various sauces, seasonings, and spices in your diet. The consumption of carbonated drinks, strong tea, coffee, concentrated vegetable and fruit juices, and any alcohol-containing drinks is prohibited.

Table of prohibited products

	Proteins, g	Fats, g	Carbohydrates, g	Calories, kcal
Vegetables and greens
vegetables	2,5	0,3	7,0	35
vegetables legumes	9,1	1,6	27,0	168
swede	1,2	0,1	7,7	37
cabbage	1,8	0,1	4,7	27
green onion	1,3	0,0	4,6	19
bulb onions	1,4	0,0	10,4	41
white radish	1,4	0,0	4,1	21
horseradish	3,2	0,4	10,5	56
spinach	2,9	0,3	2,0	22
sorrel	1,5	0,3	2,9	19
Mushrooms
mushrooms	3,5	2,0	2,5	30
Cereals and porridges
corn grits	8,3	1,2	75,0	337
pearl barley	9,3	1,1	73,7	320
millet cereal	11,5	3,3	69,3	348
barley grits	10,4	1,3	66,3	324
Flour and pasta
pasta	10,4	1,1	69,7	337
Bakery products
bagels	16,0	1,0	70,0	336
wheat bread	8,1	1,0	48,8	242
Confectionery
jam	0,3	0,2	63,0	263
candies	4,3	19,8	67,5	453
pastry cream	0,2	26,0	16,5	300
Ice cream
ice cream	3,7	6,9	22,1	189
Cakes
cake	4,4	23,4	45,2	407
Chocolate
chocolate	5,4	35,3	56,5	544
Raw materials and seasonings
mustard	5,7	6,4	22,0	162
ginger	1,8	0,8	15,8	80
ketchup	1,8	1,0	22,2	93
mayonnaise	2,4	67,0	3,9	627
ground black pepper	10,4	3,3	38,7	251
chilli	2,0	0,2	9,5	40
Dairy
sour cream	2,8	20,0	3,2	206
Meat products
pork	16,0	21,6	0,0	259
salo	2,4	89,0	0,0	797
Sausages
dry-cured sausage	24,1	38,3	1,0	455
sausages	12,3	25,3	0,0	277
Bird
smoked chicken	27,5	8,2	0,0	184
duck	16,5	61,2	0,0	346
smoked duck	19,0	28,4	0,0	337
goose	16,1	33,3	0,0	364
Fish and seafood
dried fish	17,5	4,6	0,0	139
smoked fish	26,8	9,9	0,0	196
canned fish	17,5	2,0	0,0	88
Oils and fats
creamy margarine	0,5	82,0	0,0	745
animal fat	0,0	99,7	0,0	897
cooking fat	0,0	99,7	0,0	897
Alcoholic drinks
white dessert wine 16%	0,5	0,0	16,0	153
vodka	0,0	0,0	0,1	235
cognac	0,0	0,0	0,1	239
beer	0,3	0,0	4,6	42
Non-alcoholic drinks
cola	0,0	0,0	10,4	42
sprite	0,1	0,0	7,0	29
tonic	0,0	0,0	8,3	34
black tea	20,0	5,1	6,9	152
energy drink	0,0	0,0	11,3	45

* data is per 100 g of product

Nutrition menu after gastrectomy (Diet)

The menu for the week after gastrectomy should ensure the alternation of various protein and cereal dishes in order to prevent monotony, while strictly observing the permitted methods of culinary processing of products and, most importantly, observing the portion sizes. It must be remembered that meat/fish dishes can be consumed in the form of puree or soufflé once a day. If you are intolerant to milk, it must be replaced with other products or consumed in small portions, as well as diluted with weak tea.

Stomach cancer is one of the most aggressive malignant tumors, developing from the cells of the mucous membrane of the organ. In most cases, adenocarcinoma is diagnosed, less often - other types of disease. In men, the pathology occurs almost 1.5 times more often than in women. Typically, the malignant process develops between the ages of 40-70 years. The main danger with stomach cancer is the absence of symptoms initial stages and rapid metastasis.

Symptoms and causes

The most important factor provoking the tumor process is the presence of gastrointestinal diseases, especially those occurring in a chronic form (gastritis, ulcers, polyps, inflammation). Other predisposing reasons are:

• Helicobacter Pylori infection;
• hereditary predisposition;
• bad habits;
• ionizing radiation;
• long-term use of anti-inflammatory drugs;
• decreased immunity;
• vitamin deficiency (B12 and C);
• working with asbestos, nickel and other carcinogens;
• poor diet with excess fried, fatty and spicy foods.

Absence hazardous factors does not guarantee protection against stomach cancer, but significantly reduces the likelihood of the disease. In people who have increased risk formation of a tumor-like formation, a malignant process does not always appear, but there are more of them among patients with oncological pathologies.

Primary manifestations of gastric cancer are nonspecific and are often ignored by the patient. Main early signs pathological process are:

• general weakness;
• low-grade fever;
• rapid unmotivated weight loss;
• prolonged heartburn;
• change taste preferences(aversion to meat food);
• nausea;
• sleep disorders;
• pale skin;
• bloating;
• dysphagia.

As the disease progresses, other symptoms are added: abdominal pain, stomach rigidity, brown, tarry stools, and vomiting blood. Only the appearance of such manifestations of the disease forces most patients to seek medical help.

Classification

Stomach cancer is divided into many types: according to localization, morphological and histological structure tumors.

Depending on the location, there are cancers of the lower (antral), middle, upper (cardiac) and lateral parts of the stomach. Most common detection malignant pathologies observed in the lower part of the organ.

Based on tumor growth, they are divided into:

• polypoid cancer;
• saucer-shaped;
• infiltrative;
• solid.

Polypoid cancer is a clearly defined, smooth or nodular tumor with a cylindrical base that expands into the lumen of the stomach. The size of the pathology varies between 1-8 cm. The color of the tumor is gray, red. This type of cancer is most often a solitary formation. There is no peristalsis in the affected area.

Saucer-shaped cancer has a tumor shape similar to its name. The bottom in the altered area is covered with a gray-brown coating, deep and uneven. There is no infiltration of the mucous membrane in the pathological area.

Infiltrative cancer accounts for 50% of all cases of malignant processes of the stomach. This is a lumpy, irregularly shaped formation.

Diffuse cancer looks like a poorly defined, eroded area of ​​the mucosa.

Histological tumor types include solid, signet ring cell, glandular squamous, unclassified and undifferentiated carcinoma, adenocarcinoma (95% of cases), gastric lymphoma, and leiomyosarcoma.

Diagnosis and treatment

In 80% of cases, the pathology is diagnosed at stages 3 and 4. The patient experiences significant weight loss up to cachexia due to the inability to eat normally, bowel dysfunction manifested in constipation and diarrhea, pain in epigastric region, constant nausea, heartburn, flatulence, severe weakness.

Most often, fibrogastroduodenoscopy is used to clarify the diagnosis - examination of the stomach using optical instrument, introduced into the esophagus. FEGDS allows you to take a fragment of a damaged area to conduct an analysis confirming or refuting the cancer process. Tests of urine, blood, and stool are also prescribed. occult blood. Additional ways diagnostics are CT, PET, MRI, radiography, ultrasound.

The main method of treating pathology confirmed by examinations is surgical removal neoplasms together with part of the stomach (with resection) or the entire organ (with subtotal or total gastrectomy), the use of chemotherapy, radiotherapy, as well as palliative treatment. The operation usually lasts from 2 to 4 hours. However, removal of pathology is not performed if certain factors are present:

• serious illnesses of cardio-vascular system, kidney;
• cancerous peritonitis;
• severe cachexia;
• hemophilia;
• ascites;
• metastasis to many important organs(liver, lungs, spleen).

Removal of the stomach or part of it along with lymph nodes affected by a malignant process, helps get rid of significant amount changed cells, reducing the risk of further cancer progression.

Diet after surgery

Nutrition after removal of the stomach for cancer changes significantly. The result of surgery is a change in the function of the gastrointestinal tract, since the organs involved in the process of food processing no longer exist.

For several days after gastrectomy or resection, the patient feels nausea, discomfort, and heaviness in the abdomen. However similar symptoms- a normal postoperative phenomenon and should only cause concern when their intensity increases. In this case, you may need another surgical intervention. The patient needs to get used to new dietary rules, as well as some lifelong food restrictions.

On the first day after resection or gastrectomy, eating is not allowed. On the second day, you can drink warm tea and start eating some pureed dishes in small portions, since now the food ends up in the intestines immediately after swallowing. On day 4, diet No. 0a is prescribed. The menu should include porridge - rice, buckwheat, oatmeal, as well as vegetable soups, soft-boiled eggs, steamed omelettes, baked apples, berry jelly.

After a week, the patient is transferred to diet No. 0b. With it, you need to eat up to 6 times a day at equal intervals. One serving of food should be approximately 400 g. The diet after removal of the stomach involves reducing salt intake to a minimum. Alcohol is completely excluded. Drinking after a meal is prohibited; it is better to do it after about an hour. With this diet therapy, the patient is allowed to consume compote, milk porridge, fruit juices and jellies, pureed cottage cheese, berry jelly, tea with lemon, and rice water.

• grape juice;
• citrus fruits, currants, gooseberries;
• whole milk;
• cabbage, sweet red pepper;
• carbonated drinks;
• confectionery;
• dense dishes.

Prohibited products are also mushrooms, sausages, smoked meats, honey, sugar, strong tea, cocoa and coffee, barbecue, flour products, and legumes.

3 weeks after surgery, provided normal recovery period (complete absence diarrhea, regurgitation, bloating) diet No. 1 is prescribed. The patient eats in a standing position and after the meal he needs to lie down to rest. When anemia occurs in limited diet meat, purees and juices from fresh fruits, and liver are introduced. Very useful in postoperative period are vegetable juices– they stimulate tissue restoration and have a pronounced antitumor effect. The diet after gastrectomy or organ gastrectomy in the first 8 weeks prohibits the consumption of broths based on fish and meat.

Upon discharge from the hospital, the patient receives detailed instructions with information about restrictions affecting nutrition after gastrectomy or gastrectomy. No more than 2 dishes and 200 ml of liquid are allowed at one time. Milk must be diluted. Carbohydrate intake should be reduced, as they can provoke dumping syndrome (appearance of tachycardia after eating, increased sweating, general weakness).

3 months after treatment, you can include unprocessed food in your diet.

In the period from 6 months to 1 year, the patient, with the permission of the doctor, switches to good nutrition, however, the amount of carbohydrates and coarse fiber the menu remains limited.

The patient’s physiological recovery begins one year after treatment.

Survival prognosis

Survival depends greatly on the stage of the malignant process at which the patient was operated on, the accuracy of the person's diet, and general health. According to statistics, in people with stomach cancer it does not exceed 20%.

After the operation, it is prohibited to visit baths and saunas. Relaxation in specialized sanatoriums is recommended. It is important to follow a daily routine and physical activity without excessive muscle strain, and also adhere to a diet with a reduced intake of carbohydrates and fats and increased content proteins.

Stomach cancer is a formidable oncological disease with disappointing survival statistics due to late diagnosis. An important factor, affecting the effectiveness of treatment is timely contact with a specialist and removal of the stomach tumor along with part or all of the organ.