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How do I eat after digestive tract surgery?
Perhaps you have had surgery for chronic diverticulitis, cancer of the digestive tract, a Whipple procedure, bariatric surgery, or maybe even gallbladder surgery. Surgeries of the digestive tract typically alter the way our bodies process food as they change our digestive landscape. I discovered this after my second surgery on the upper digestive tract. After this surgery (and nearly a week in the hospital), well-meaning friends brought me food, which I certainly appreciated. However, the food they brought me were salads, fresh fruit and vegetables, cream-based soups, and casseroles. All of which made me feel terrible. It turned out my problems stemmed from what I was eating. So, what should I have been eating instead of these foods? It was a time of trial and error for me. I spent a lot of time finding which foods were “safe” and which foods were “triggers” and would cause digestive difficulties.
After major surgeries of the digestive tract, many hospital systems have a registered hospital dietitian meet with you before discharge and provide instructions on the best way to eat. This was not my experience. I did, however, request a referral to a dietitian several months after surgery.
Let's sit around the table and share our tips on the eating plan that worked best for you after your surgery and talk about the kinds of foods that were (and still are) the easiest to digest. We are all different in our responses to surgery, but we will undoubtedly find common ground.
I look forward to learning together. Share your ideas, recipes or cooking methods that have helped you.
Here are a few questions to get us started:
- If you have had a consultation with a dietitian, what did you learn?
- What foods did and didn't work for you?
- What about the quantity of food at each meal, as well as the timing of meals?
- Have your cooking methods changed?
- Do you still use spices the same way?
- Have you kept a food diary to track any foods that might be triggers for digestive difficulties?
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Thank you @linda82 and (@hopeful33250 for your feedback. I will definitely try your suggestions. I had thought about a food journal and will definitely start doing that. It’s funny you talk about soups because that’s one thing I still make. As it makes a lot for just one person, I usually have single servings in my freezer. I try to use a lot of vegetables. I seem to be able to tolerate smaller salads and some fresh vegetables, but if I eat too much of that I spend the next day in the bathroom. So that’s one area I’m trying to figure out because I know I’m probably not getting enough fiber. The only way I can describe the tightness is that it feels like my gut has been pulled tight. And maybe that’s exactly what it is. I had 12 inches of bowel removed and then hooked back together. I started having this feeling around the 4 month mark.
The stomach discomfort is right in the middle of my gut and typically comes on suddenly and usually midday. I’m guessing something I ate brings it on but I don’t really know. And if it is I haven’t figured out what foods trigger it.
I have a follow up appointment with my surgeon this week and will talk to her about this stuff but I’m wondering if it’s time to make an appointment with my GI for additional help.
I guess I had high expectations that when I had the bad part of my bowel cut out I’d be normal again. And while my quality of life is way better than a year ago I still haven’t figured out my new normal. It helps so much to read what others who have had similar experiences are dealing with.
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6 ReactionsI am glad this discussion has helped you, @foxj. If possible, you might ask for a referral for pelvic floor therapy as well as a referral to a registered dietitian.
Please continue to post any questions you have and I'd love to hear from you again after your appointment next week with your surgeon.
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3 ReactionsThis is so true Teresa!
Soup allows you to get protein as well as easy to digest fiber (vegetables) chicken-based soup with rice and veggies works
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2 ReactionsHello @linda82,
I find it interesting that you said that your biggest meals are either breakfast or lunch and that you don't like to feel full in the evening. I feel the same way about the timing of meals. In the evening, I really need to eat lighter than the rest of the day.
Are there others in the group who also feel better when they eat a lighter meal in the evening?
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2 ReactionsHi Teresa,
My symptoms are normal and expected for Low Anterior Resection Syndrome (LARS) after rectal resection and radiation therapy.
I coped with these symptoms from surgery in 1986 until becoming a flight attendant in 2016 (30 years), then discovering that I could not do the job I had intended if continually faced with accidents and unplanned bathroom dependence
My research into LARS and experimentation with eating alternatives, pelvic therapy, and two over the counter medications (Loperamide and Dulcolax) showed me that I could develop control that I had been able to avoid for 30 years.
While not perfect and still subject to occasional accidents, it has provided dramatic improvement over my status quo
My symptoms are direct result of pathophysiology due to LARS that anyone with similar surgery/radiation could expect.
While I am still learning, I am anxious to promote the belief that these symptoms are expected and that recovering patients have more control than we may have experienced post surgery/radiation and greater ability to change with a positive result
I hope my comment may be helpful to other LARS recoverees like me.
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5 ReactionsHi, Teresa. we all appreciate your initiative on the impact of surgery on our digestive tract, especially on how to deal with nutrition that comes mainly from what we eat and drink. I don't think my experience will be widely useful, given my unusual surgical escape from colon cancer.
The surgeons removed most of my colon, starting with its beginning where my appendix was, up my right side, across the top of my abdomen, and down my left side to within six inches of my rectum. As a result, I lost almost all of the large intestine where foods not already digested in the small intestine are harvested by a crowd of bacteria and absorbed from them into my metabolism. In short, I lost a lot of nutritional material that used to be collected in my colon, and the customary waste that remained was clogging what was left of my colon and in my rectum. Over more than a year of recovery, it became clear that fiber-bearing foods were a major factor in the poor mobility of a digestive system that had no colon to handle it.
I found relief last month from a expert nutritionist. To deal with the bulky and fibrous foods, we cut high-fiber cereal from my daily breakfast and other carbohydrate food. Then we spread my meals out to four per day, reducing each to about two-thirds of their former size. She recommended that I make special effort to chew my food more to make it easier to digest in my stomach and small intestine. And starting each day with a glass of water and adding more during the day, along with nutritious drinks, has helped move the digesting food along more readily. And maybe most important, more exercise at a moderate rate for longer periods encourages everything to move along as it should.
On the whole, the content of my diet is not markedly different than before, just less fibrous, more spread out, and more liquid. Martin
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5 ReactionsThanks for your post, Martin. While I've only had three small resections in the upper digestive tract, it was enough to slow down the digestive system. Similar to you, I also had a consultation with a registered dietician who told me much the same thing.
Small meals are very important with an emphasis on easy to digest sources of protein. I also avoid high fiber foods, especially raw fruits and veggies. Everything I eat needs to be well cooked in order not to cause gastric issues of one type or another. Water as well as moderate exercise has also been important for me.
Could you give us an example of some of the items you might eat on a regular basis?
Yes, your comments are very helpful, @jimdiehl. You mentioned pelvic floor therapy (PFT). I also found this very helpful. Abdominal massage as well as working with a TENs unit were some of the lessons I learned from PFT.
Any particular gems that you learned?
Will look up abdominal massage and working with a TENs unit
One thing I have seen no one write about is the value of Fasting to avoid Gastrocolic Reflex, an autonomic response that starts when solid food is ingested and often leads to diarrhea with someone like me with LARS.
Once you eat solid food, you can expect a bowel response within about two hours. This allows you to plan timing of food ingestion to a place where you will have some control, like a hotel room. Taking food value from liquid, like apple juice does not create the reflex response
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1 ReactionSo my day starts between 9 and 10 AM with a full glass of water, a medium bowl of corn chex, a small glass of mixed protein drink, and a half cup of coffee. For lunch two hours later, I finish the protein drink with a few turmeric corn chips and a cup of sport water with a modest amount of electrolytes and some sugar in it, topped off with one or two small fig newtons. Mary Ann fixes "dinner" (my third meal) at mid-afternoon; it features salmon or crab cakes or a variety of chicken dishes over brown rice or mashed potatoes with a mixture of plain sweet corn and peas on the side. For dessert, we share a special small salad of chopped celery, onion, carrots, red and green peppers with a touch of honey-mustard dressing (giving me my chewing exercise for the day). In the evening when others are having "dinner," I feast alone on whey protein powder in 10 ounces of water to wash down a thin slice of sprouted wheat bread garnished with a teaspoon of almond butter and a few drops of organic grape jam. That and my special diuretic keeps my supply of potassium up where it belongs to fend off my hypertension. Hope you can avoid feeling sorry for me with this kind of diet menu on a regular basis.
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