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Diet After Nissen Fundoplication Surgery

This diet information is for patients who have recently had Nissen fundoplication surgery to correct reflux disease or to repair various types of hernias such as hiatal hernia, intrathoracic stomach. The diet will help control diarrhea, excess gas, and swallowing problems which may occur after this type of surgery.

Keeping Your Stomach from Stretching

  • Eat small, frequent meals (six to eight per day). This will help you get the majority of the nutrients you need without causing your stomach to feel full or extended.
  • Drinking large amounts of fluids with meals can stretch your stomach. You may drink fluids between meals as often as you like, but limit fluids to 1/2 cup (4 fluid ounces) with meals, and one cup (8 fluid ounces) with snacks.
  • Sit upright while eating and stay upright for 30 minutes after each meal.  It is important that you do not lie down after eating. Sit upright for 2 hours after your last meal or snack of the day.
  • Eat very slowly. Take your time when eating.
  • Take small bites and chew your food well to aid in swallowing and digestion.
  • Avoid crusty breads, sticky, gummy foods (such as bananas), fresh doughy breads, rolls, and doughnuts. These types of foods are hard to swallow.  Toasted breads tend to be better tolerated.
  • Sometimes after this surgery you may experience a symptom called Dumping Syndrome or rapid emptying of stomach. Sweetened beverages, candy, sweets and desserts move more rapidly and dump quickly into the small intestine. This can cause symptoms of nausea, weakness, cold sweats, cramps, diarrhea and dizzy spells.  Since sweet foods tend to cause digestion quickly, eat sweet foods and desserts at the end of your meal.

Avoiding Gas

  • Avoid drinking through a straw and do not chew gum or tobacco. These actions cause you to swallow air, which produces excess gas in your stomach. Chew with your mouth closed .
  • Avoid any foods that you know cause stomach gas and distention. These foods include corn, dried beans, peas, lentils, onions, broccoli, cauliflower and any food from the cabbage family.
  • Avoid caffeine, carbonated drinks, alcohol, citrus and tomato products.

When will I be able to eat a soft diet?

After Nissen fundoplication surgery, your diet will be advanced slowly. Although, this depends on your progress and your tolerance for food.  Generally, you will be on a clear liquid diet for the first three days after your surgery. Then you will advance to the full liquid diet for three days unless otherwise specified by your surgeon. After this, you will advance to the Nissen soft diet depending on your progress.

Please be aware that everyone’s tolerance for food is different. Your doctor may have you advance more slowly, depending on your progress.

Clear Liquid Diet

  • Apple juice
  • Cranberry juice
  • Grape juice
  • Chicken broth
  • Beef broth
  • Vegetable broth (no tomato)
  • Flavored gelatin (Jell-O®)
  • Decaf tea
  • Popsicles
  • Italian ice

Carbonated drinks (sodas) are not allowed for the first six to eight weeks after surgery. After this time you can try them again in small amounts.

Full Liquid Diet

The full liquid diet you will follow contains anything on the clear liquid diet, plus:

  • Milk (no chocolate milk)
  • Cream of wheat or cream of rice
  • Strained creamed soups (except tomato or broccoli)
  • Vanilla and strawberry ice cream
  • Sherbet
  • Blended vanilla yogurt, custard style without fruit or seeds
  • Pudding (no chocolate or coconut pudding)
  • Nutritional drinks including Ensure®, Boost®, Carnation Instant Breakfast® (except chocolate- flavored)

Note: Dairy products, such as milk, ice cream, and pudding, may cause diarrhea in some people just after surgery. You may need to avoid milk products at first and try them in small amounts as you advance your diet.

Nissen Soft Diet

Food Category

Foods to Choose

Foods to Avoid

Beverages
  • Regular Milk, 2%, 1%, and non-fat milk or skim (no chocolate)
  • Decaf tea
  • Powdered drink mixes (in moderation)
  • Non-citrus juices (apple, grape, cranberry, or blends of these)
  • Fruit nectars
  • Nutritional drinks including Boost®, Ensure®, Carnation Instant Breakfast®
  • Chocolate milk, cocoa or other chocolate-flavored drinks
  • Drinks containing caffeine, such as coffee or tea
  • Decaf coffee
  • Carbonated drinks
  • Alcohol
  • Citrus juices like orange, grapefruit, lemon and lime
Breads
  • Pancakes, french toast and waffles
  • Crackers (saltine-type, round butter type, graham)
  • Toast
  • Fresh bread, untoasted bread and products including bagels, Kaiser rolls and hard rolls
  • Crackers with nuts, seeds, fresh or dried fruit, coconut, or those that are highly seasoned, such as garlic or onion-flavored crackers
  • Sweet rolls, coffee cake or doughnuts
Cereals
  • Well-cooked oatmeal (plain or flavored, no dried fruits, raisins, or nuts)
  • Cold cereal (Cornflakes®, Rice Krispies®, Cheerios®, Special K® - plain)
  • Very coarse cereal such as bran
  • Any cereal with fresh or dried fruit, coconut, seeds or nuts

Desserts

Eat in moderation, and do not eat desserts or sweets by themselves.

  • Plain cakes, cookies and cream-filled pies
  • All pudding and custard flavors except those in the AVOID column
  • Ice cream, ice milk, frozen yogurt and sherbet
  • Gelatin made from allowed foods
  • Fruit ices and popsicles
  • Desserts containing chocolate, coconut, nuts, seeds, fresh or dried fruit, peppermint or spearmint
Eggs
  • Poached, hard boiled, or scrambled
  • Fried eggs and highly seasoned eggs (deviled eggs)

Fats

Eat in moderation.

  • Butter and margarine
  • Mayonnaise and vegetable oils
  • Mildly seasoned cream sauces and gravies
  • Plain cream cheese
  • Sour cream
  • Highly seasoned salad dressings, cream sauces, and gravies
  • Bacon, bacon fat, ham fat, lard and salt pork
  • Fried foods
  • Nuts
Fruits
  • Any canned or cooked fruit or fruit juice except those listed in the AVOID column
  • All fresh fruits, especially citrus fruits and dried fruit
  • Fruits with seeds such as berries, kiwis and figs
  • Canned pineapple
  • All citrus fruit juices and pineapple juice
  • Ripe bananas
Meat, Fish, Poultry, and Cheese
  • Meats can be ground, minced, or chopped to ease swallowing and digestion
  • Tender, well cooked, and moist cuts of beef, chicken, turkey, fish, and pork
    (NOTE: meats, poultry and fish should be prepared any way except fried. Try baking, broiling, boiling, stewing, or simmering)
  • Cottage and ricotta cheeses
  • Mild cheese such as American, brick, mozzarella and baby Swiss
  • Creamy peanut butter
  • Plain custard or blended fruit yogurt
  • Moist casseroles such as macaroni and cheese, tuna noodle casserole
  • Grilled/toasted cheese sandwich
  • Tough meats with a lot of gristle
  • Fried, highly seasoned, smoked, and fatty meat, fish, or poultry, such as frankfurters, luncheon meats, sausage, bacon, spare ribs, beef brisket, sardines, anchovies, duck and goose
  • Chili and other entrees made with pepper or chili pepper
  • Shellfish
  • Strongly flavored cheeses such as sharp cheese, extra sharp cheddar, cheese containing peppers or other seasonings
  • Crunchy peanut butter
  • Any yogurt with nuts, seeds, coconut, strawberries or raspberries
Potatoes and Starches
  • Peeled, mashed, or boiled white or sweet potatoes
  • Oven-baked potatoes without skin
  • Well-cooked white rice, noodles, barley, spaghetti, macaroni and other pastas
  • Fried potatoes, potato skins and potato chips
  • Fried, brown or wild rice
  • Popcorn
Soups
  • Mildly flavored meat stocks
  • Cream soups made from allowed foods
  • Highly seasoned soups and tomato based soups, cream soups made with gas producing vegetables, such as broccoli, cauliflower, onion or cabbage

Sweets and Snacks

Use in moderation and do not eat large amounts of sweets by themselves.

  • Sugar, syrup, honey, jelly and seedless jam
  • Plain hard candies and plain candies made with allowed ingredients
  • Molasses
  • Marshmallows
  • Other candy made from allowed ingredients
  • Jam, marmalade, and preserves
  • Chocolate in any form
  • Any candy containing nuts, coconut, seeds, peppermint, spearmint, or dried or fresh fruit
  • Popcorn, chips, tacos, hard pretzels
Vegetables
  • Well cooked soft vegetables without seeds or skins such as asparagus tips, beets, carrots, green and wax beans, chopped spinach, tender canned peas, squash and pumpkin
  • Raw vegetables, tomatoes, tomato juice, tomato sauce and V-8® juice
  • Gas-producing vegetables such as broccoli, brussel sprouts, cabbage, cauliflower, onions, corn, cucumber, green peppers, rutabagas, turnips, radishes and sauerkraut
  • Dried beans, peas and lentils
Miscellaneous
  • Salt and spices in moderation
  • Mustard and vinegar in moderation
  • Fried or highly seasoned foods
  • Nuts, coconut and seeds
  • Pickles and olives
  • Chili sauces, ketchup, barbecue sauce, horseradish, black pepper, chili powder, and onion and garlic seasonings
  • Any other strongly flavored seasoning, condiment, spice or herb not tolerated well
  • Chocolate
  • Carbonated drinks
  • Anything with caffeine
  • Alcoholic beverages

 

Sample Menu

 

Breakfast
  • ½ cup canned fruit (non-citrus)
  • ½ to ¾ cup cereal
  • 1 small pancake
  • 1 tsp. margarine
  • 1 tsp. jelly
  • ½ cup 2% milk
  • 1 tsp. sugar
Mid-Morning Snack
  • 2 graham crackers
  • 1 T creamy peanut butter
  • 1 tsp. jelly
  • 1 cup decaf tea
Lunch
  • ½ cup tuna salad (no raw vegetables)
  • 3 to 4 saltine crackers
  • ½ cup canned peaches
  • ½ cup fruit juice (non-citrus)
  • 1 tsp. margarine or vegetable oil
Mid-Afternoon Snack
  • 4 saltine crackers
  • 1 T cream cheese
  • 1 cup 2% milk
Dinner
  • 3 oz. roasted chicken (finely ground) with sauce
  • ½ cup white rice
  • ¼ cup cooked carrots
  • ½ cup canned pears
  • 1 tsp. margarine
  • ½ cup decaf tea
  • 1 tsp. sugar
Evening Snack
  • ¼ cup cottage cheese
  • ½ cup applesauce
  • ½ cup 2% milk

 

Revised September 2013

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