Diet After an Esophagectomy

An esophagectomy (ee-soff-uh-JEK-tuh-mee) is surgery to remove the esophagus. After this type of surgery, it is common to have some problems eating for a few months.

What can I expect after surgery?

For the first few months after surgery, you may have problems such as:

  • Weight loss
  • Dumping syndrome (nausea, diarrhea, abdominal cramping, light-headedness)
  • Excess gas
  • Trouble swallowing

Your diet plan after surgery is designed to lessen your discomfort and allow you to enjoy eating.

What type of diet will I have?

You will have several types of diet. Your diet will change slowly based on your rate of recovery and how well you can tolerate food. The amount of liquids that you are permitted to have at one time will vary based on your doctor's recommendation. In general, your diet plan will advance as follows:

  1. Clear liquid diet, for the first few days after surgery
  2. Full liquid diet
  3. Soft diet

Each person tolerates food in a different way. Your doctor will advance your diet plan based upon your progress after surgery. 

How can I help myself?

Follow the tips below to make eating more comfortable and enjoyable.

To reduce discomfort

  • Eat small, frequent meals (6 to 8 per day). This helps you get all the nutrients you need.
  • Take small bites and chew your food well. This helps you to swallow and to digest your food.
  • Drink most of your liquids between meals. Limit liquids with meals to ½ cup (4 ounces). Limit liquids with snacks to 1 cup (8 ounces).
  • If you eat sweets, eat them at the end of your meal. Sweets are digested more quickly than other foods. Eating sweets first could lead to low blood sugar or hypoglycemia.
  • Choose foods that are soft and moist because they can be easier to digest. Avoid gummy foods, such as bananas, untoasted bread and bread products.
  • Sit up straight when you eat. This way, gravity can help food move through your digestive tract. After you eat, continue to sit for 30 to 60 minutes.
  • Eat your last meal or snack at least 2 to 3 hours before you go to bed.

Avoid the following foods and beverages if they produce reflux:

  • Alcoholic drinks
  • Caffeine
  • Citrus and tomato products

To avoid gas

Do not use a straw, chew gum, or smoke because these activities make you swallow air. Keeping extra air out of your digestive tract helps to reduce gas.

Avoid the following foods that produce gas:

  • Broccoli
  • Cabbage
  • Cauliflower
  • Corn
  • Dried beans, dried peas
  • Lentils
  • Onions
  • Sodas (carbonated drinks)

Clear liquid diet

Right after surgery, you will follow a clear liquid diet, which includes:

  • Clear juice (apple, grape, and cranberry)
  • Clear broth (chicken, beef, and vegetable)
  • Flavored gelatin (such as Jell-O®)
  • Tea and coffee

Make sure to check with your doctor for the amount of liquids you are permitted at one time.  The amount varies from patient to patient, based on your recovery from surgery. Sodas (carbonated drinks) are NOT allowed for 6 to 8 weeks after surgery. After this time, you can try sodas in small amounts. Caffeinated beverages can be introduced at this time as tolerated.  

Full liquid diet

A full liquid diet contains all the liquids of the clear liquid diet in addition to:

  • Blended yogurt (vanilla or custard style without fruit or seeds)
  • Cream of wheat or cream of rice cereal, and grits
  • Ice cream (no chocolate and without fruits, nuts or seeds)
  • Frozen yogurt (no chocolate and without fruits, nuts or seeds)
  • Instant breakfast drinks and nutrition supplements, i.e. Boost®, Ensure® (no chocolate flavors)
  • Milk (no chocolate)
  • Pudding (no chocolate, rice, or coconut flavored)
  • Sherbet
  • Strained cream soups (NOT tomato or broccoli)

Note: Dairy products may cause diarrhea right after surgery. Dairy products include milk, ice cream, and pudding. You may need to avoid milk products at first. Then try them in small amounts as you advance your diet. You can also try products that are lactose reduced or lactose free.

 

Soft diet

A soft diet consists of bland, low fiber, lower-fat, soft foods and drinks.

 Food

Foods to Choose

Foods to Avoid

 Breads
  • Pancakes, waffles, and french toast
  • Crackers (i.e. saltines, graham crackers, Ritz®)
  • Toasted bread
  • Untoasted bread, bread products (i.e. bagels, hard rolls, Kaiser rolls), and crackers that contain nuts, seeds, fresh or dried fruits, or coconut, and highly seasoned (i.e. garlic or onion flavored) crackers
Cereals
  • Cream of Wheat®, grits, oatmeal, and other cooked cereals (plain or flavored without raisins, dried fruits, or nuts)
  • Cereals including Rice Krispies®, Cheerios®, Corn Flakes®, plain Special K®
  • Coarse cereals such as bran, Grape Nuts®, and granola
  • Any cereals with fresh or dried fruit, coconut, seeds, or nuts
Potatoes and Starches
  • Cooked, peeled white or sweet potatoes
  • Rice and barley
  • Pastas, such as enriched noodles, spaghetti, and macaroni
  • Fried potatoes and potato skins
  • Fried, brown, or wild rice
Soups
  • Mildly flavored meat stocks
  • Cream soups made with allowed ingredients
  • Highly seasoned soups and tomato-based soups
Vegetables
  • Cooked vegetables without seeds or skins, such as asparagus tips, baby peas, beets, carrots, chopped spinach, green and wax beans, and winter squash
  • All raw vegetables
  • Vegetables with seeds or skins
  • Tomatoes, tomato juice, tomato sauce and vegetable juice (i.e. V-8®)
  • Gas-producing vegetables such as broccoli, brussel sprouts, cabbage, cauliflower, corn, cucumbers, green peppers, onions, radishes, rutabagas, sauerkraut, and turnips
  • Dried beans, peas, and lentils
 Fruits
  • Any canned, cooked fruits or fruit juice, (except those listed as foods to avoid)
  • All fresh and dried fruits
  • Fruits with seeds or skin, such as berries, figs, and raisins
  • All citrus fruits and juices
  • Bananas
  • Pineapple (fresh, juice, and canned)
Eggs
  • Any style prepared eggs (except those listed as foods to avoid)
  • Fried eggs
  • Highly seasoned eggs, such as deviled eggs
Meats, Fish, Poultry, and Cheese
  • Finely round lean beef, lamb, pork, veal, fish, and poultry prepared any way except fried
  • Cottage and ricotta cheese
  • Mild cheeses such as american, brick, baby swiss, or mozzarella
  • Smooth peanut butter
  • Vanilla and peach blended yogurt (no pieces of fruit, nuts or seeds)
  • Casseroles and stews prepared with allowed ingredients
  • Grilled cheese sandwiches
  • Tough meats with gristle
  • Fried, highly seasoned, smoked and fatty meats, fish, or poultry such as frankfurters, lunch meats, sausage, bacon, spareribs, beef brisket, sardines, anchovies, duck, and goose
  • Chili and other spicy foods
  • Shellfish
  • Strongly flavored cheese such as sharp cheese and cheese that contains peppers or other seasoning
  • Crunchy peanut butter
  • Any yogurt that contains nuts, seeds, coconut, or pieces of fruit
Sweets

(Eat in moderation and with a meal.)
Note: If dumping syndrome occurs, you may need to avoid these.
  • Sugar, syrup, honey, jelly, and seedless jam
  • Unfilled hard candies and plain candies made with allowed ingredients
  • Molasses
  • Other candy made with allowed ingredients
  • Jam, marmalade, and preserves
  • Marshmallows
  • Any candy that contains nuts, seeds, fresh or dried fruit, coconut, peppermint, or spearmint

Desserts

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

  • Plain cakes, cookies, and creamed 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 that contain chocolate, coconut, nuts, seeds, fresh or dried fruit, peppermint, or spearmint
Beverages
  • Milk
  • Tea or coffee
  • Powdered drink mixes
  • Non-citrus juices such as cranberry, grape, apple, or blends of these
  • Nectars
  • Caffeinated beverages as tolerated
  • Sodas and other carbonated drinks
  • Alcoholic drinks
  • Citrus juices such as orange, grapefruit, lemon, and lime
  • Drinks that contain herbal ingredients, such as St. John's Wort or ginseng.
  • Any chocolate flavored beverage
Fats

(Eat in moderation.)
  • Butter and margarine
  • Mayonnaise and vegetable oils
  • Mildly seasoned salad dressings made with allowed ingredients
  • 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
Other
  • Salt, flavored extracts, condiments, spices, and herbs (depending on how your body reacts to them)
  • Mustard and vinegar (in moderation, depending on how your body reacts to them)
  • Cheese Nip® crackers, plain Goldfish® crackers
  • Fried or highly seasoned foods
  • Nuts, seeds, and coconut
  • Pickles and olives
  • Chili sauce, barbecue sauce, horseradish, ketchup, black pepper, chili powder, and onion and garlic seasonings
  • Any other strongly flavored seasoning, condiment, spice or herb not tolerated
  • Popcorn
  • Potato chips
  • Hard pretzels
  • Any food not tolerated.

Sample Menu

Breakfast
  • ½ cup canned fruit (no pineapple or citrus)
  • 2 small pancakes
  • 1 teaspoon margarine
  • 1 teaspoon jelly or syrup
  • ½ cup milk
Mid-morning Snack
  • 3 graham crackers
  • 1 tablespoon peanut butter
  • 1 teaspoon jelly
  • 1 cup tea
Lunch
  • 2 - 3 ounces beef patty (finely ground)
  • ½ cup mashed potatoes
  • ½ cup canned peaches
  • ½ cup milk
  • 1 teaspoon margarine
Mid-afternoon Snack
  • 4 - 6 soda crackers
  • 1 tablespoon cream cheese
  • 1 cup milk or ½ cup fruit juice (non-citrus)
Dinner
  • 2 - 3 ounces roast chicken (finely ground)
  • ½ cup rice
  • ½ cup cooked carrots
  • ½ cup canned pears
  • 1 teaspoon margarine
  • ½ cup tea
Evening Snack
  • ¼ cup cottage cheese
  • ½ cup applesauce
  • 1 cup milk

Revised February 17, 2014

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