How do I eat after digestive tract surgery?

@hopeful33250
Thanks, Teresa, for the tip. Right now, I am taking a lot of other meds and supplements that I am not adding any more to my diet. I do take Gabapentin at night for some residual pain and melatonin. However, I'll check it out.
Take care.

@projfan
I have been sneezing lately after I start eating. Why is this?

I've posted before about my eating experience after bariatric surgery, but to sum it up:
-- If you haven't explored the instructions given to bariatric surgery patients for how to eat for the first several months after surgery, you might want to do that just to see if there are any tips you might find useful. A lot of work has gone into building this guidance over the years, so you might as well benefit from those studies.
-- If you can't eat a balanced diet, it isn't the end of the world. Prioritize protein (make your own protein shakes if necessary, which gives you total control, and consider tossing in whole frozen fruit or green vegetables if you can handle them). Consider the key supplements: iron, calcium+D, multivitamin, B12, and B1. (Don't take iron and calcium at the same time, since they fight each other.) Ask your PCP to order blood tests for all of those several months after the surgery, and make sure you keep asking for updates to guide your supplement choices over time.
-- There were many foods that triggered nausea for me during the first year or so, but most of them have become gradually less problematic. If you find you can't eat something, try again with a small amount in six months, a year, etc.
-- Consider going through a FODMAP exclusion diet if you are really having difficulty pinning it down. Importantly, it doesn't actually have to be a FODMAP problem (turned out that it wasn't for me) for the diet to be helpful, because it gives you a systematic way to identify challenging foods. The FODMAP exclusion diet is not for everyone, though, since it's very disciplined and takes a long time to get through.
-- I lost the ability to handle garlic, but shallots are fine and make a reasonable substitute. That problem appears to be permanent, but my ability to handle chilis seems to be returning, although it's taken about a decade. It really helps to explain to the wait staff in restaurants that the issue is NOT an allergy and is just a strong preference, because kitchen staff these days are trained to panic about allergies and my issues won't actually kill me, which is very different.
-- Insurance reimbursement rates for dieticians are so low that it's hard to find them. If you do, make sure that they have experience with patients who have had your specific procedure or are have dealt with your specific symptoms.
-- You may find that smaller meals are better, which means multiple snacks instead of full meals. I now manage meal sizes by when I start sneezing; apparently it's a vagus nerve thing, and I know that if I try to push past it, I'm guaranteed to head to nausea and potentially vomiting. I'm not saying sneezing will happen to you (pretty sure it happens to almost nobody), but you can absolutely watch for the earliest signs that enough is turning into too much, and just rigorously stop there.
-- Don't let yourself get dehydrated, which will make it all worse. Track whether you are better off drinking with meals or between meals, since this might impact your symptoms.

Hope something here helps!

THANKSGIVING EATING TIPS

With Thanksgiving upon us, those with Exocrine Pancreas Insufficiency (EPI) can take a few measures to prevent discomfort when eating large meals. There will be many ingredients that can challenge one’s digestive tract. Meals containing lots of fats, sugar, protein, carbohydrates, high-fiber vegetables and beans composed of complex carbohydrates called oligosaccharides will be encountered.

To enjoy the Thanksgiving meal, I have found the following tips helpful:

Don’t skimp on taking extra capsules of pancrealipase (Creon, Zenpep, etc).

Take small portions of items and a pancrealipase at the start.

Eat slowly and chew all ingredients thoroughly.

Take an extra capsule for items of higher fat content and stagger taking additional capsules throughout the meal. Each time you refill your plate, take another capsule.

Take a pause before going back for extra helpings. Spread out the servings and avoid overeating.

By slowing down my ingestion, smaller meal portions spread out over time and taking an ample amount of pancrealipase has been very effective for me without any digestive discomfort during and after Thanksgiving. I generally take 6-10 capsules of Creon throughout the Thanksgiving meal with satisfactory results.

Vegetables such as corn, peas, asparagus, broccoli, cauliflower, cabbage, Brussels sprouts, beans, etc., are composed of oligosaccharides. They require the enzyme alpha-d-galactosidase to be digested. This enzyme is not blended into any Rx or OTC pancrealipase capsule. It is available as the OTC product Beano. Taking a capsule of Beano with vegetables and beans will digest food items without the formation of gas, bloating or cramping.

Should gas and bloating form after the meal, simethicone-based OTC medications Phazyme and Gas-X will break up pockets of gas making it easier to expel.

To help in optimizing the dosage of capsules needed based on quantity and ingredients, there is an online dosing calculator at pertcalculator.org

THANKSGIVING EATING TIPS

With Thanksgiving upon us, those with Exocrine Pancreas Insufficiency (EPI) can take a few measures to prevent discomfort when eating large meals. There will be many ingredients that can challenge one’s digestive tract. Meals containing lots of fats, sugar, protein, carbohydrates, high-fiber vegetables and beans composed of complex carbohydrates called oligosaccharides will be encountered.

To enjoy the Thanksgiving meal, I have found the following tips helpful:

Don’t skimp on taking extra capsules of pancrealipase (Creon, Zenpep, etc).

Take small portions of items and a pancrealipase at the start.

Eat slowly and chew all ingredients thoroughly.

Take an extra capsule for items of higher fat content and stagger taking additional capsules throughout the meal. Each time you refill your plate, take another capsule.

Take a pause before going back for extra helpings. Spread out the servings and avoid overeating.

By slowing down my ingestion, smaller meal portions spread out over time and taking an ample amount of pancrealipase has been very effective for me without any digestive discomfort during and after Thanksgiving. I generally take 6-10 capsules of Creon throughout the Thanksgiving meal with satisfactory results.

Vegetables such as corn, peas, asparagus, broccoli, cauliflower, cabbage, Brussels sprouts, beans, etc., are composed of oligosaccharides. They require the enzyme alpha-d-galactosidase to be digested. This enzyme is not blended into any Rx or OTC pancrealipase capsule. It is available as the OTC product Beano. Taking a capsule of Beano with vegetables and beans will digest food items without the formation of gas, bloating or cramping.

Should gas and bloating form after the meal, simethicone-based OTC medications Phazyme and Gas-X will break up pockets of gas making it easier to expel.

To help in optimizing the dosage of capsules needed based on quantity and ingredients, there is an online dosing calculator at pertcalculator.org

@hopeseeker22 highly processed foods are very hard on digestive system, especially after surgery ! Wishing you healing !

I wish I knew more of the symptoms you face other than feeling bad. Are you anemic perhaps? Are iron, magnesium, calcium and more at normal levels? The last 18” of my terminal ileum was removed in ‘93 due to Crohn’s. This hardly absorb A, D, K & most of all B-12. So Dr. let’s me self-inject B-12 2x per month. Goes right to target instead of trying to be absorbed by missing ileum. My GB removed. All such surgery results in scaring and perhaps narrowing digestive tract which along w/ CD damage resulting in episodic severing cramping. Finally figured out that was caused by my diet. Too figured. I cut out all fruit, veggies, (even canned) nuts, fries, yes bananas, pulpy products, In-In-Out Burgers, fast food generally, That leaves meat, fish, poultry, eggs and a lot of processed junk Twenty plus years now but maybe 4-5 cramping episodes. It’s a mechanical matter. Ping pong ball no fit down garden hose. Hey, why do so many GI doctors - after a first visit - want to get you on the cutting board?

@azsunshine7 some people add the protein high calorie drinks, which can have added nutrients…personally hated them… smoothies are another way to eat while in recovery…each person finds what they like as well as tolerate well….it can’t be overemphasized that it’s important to limit highly processed foods… avoid bacon, salami etc….my system doesn’t do well with red meat…i got some useful info from better websites like Mayo Clinic, Cleveland clinic, MSK, any major cancer center as well.