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Coping - Problem Foods

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Coping With Problem Foods

Right after Gastric Bypass Surgery, patients often have problems with many foods. This is because their new smaller stomach, which is only about 3% of it's original size, is still tender from the surgery. In addition, their small intestines have been reduced to help produce malabsorption of food (especially foods high in sugar and fat). It takes a little while for healing to take place and for their body to adjust to it's new plumbing. This is why all gastric bypass patients are placed on liquid diets for several days right after surgery. Then they are advanced to a Pureed Consistency Diet for the first few weeks following surgery.
 
The Pureed Diet consists of pureed meats (except red meat), pureed fruits and vegetables, pureed starchy vegetables, and strained cereals.
 
Patients are encouraged to have two ounces of food from the meat group, one ounce from the starchy vegetable group, one ounce from the fruit group at breakfast.
 
At lunch and dinner patients should have two ounces from the meat group, one ounce from the starchy vegetable group, one ounce from the vegetable group, and one ounce from the fruit group.
 
During the evening, patients are encouraged to have one ounce from the meat group as a snack.

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Patients get full very soon during meals. Therefore, they are encouraged to eat their meat first at meal times to help ensure that they are taking in enough protein, which is necessary for wound healing and tissue repair. To help ensure that patients are getting adequate protein, patients should use a protein shake of their choice. Liquids can only be taken up to 30 minutes before meals and can not be resumed till at least 30 minutes after meals. Liquids which are tolerated fairly well include diluted fruit juices (two parts water to one part juice), skim milk treated with the enzyme lactase, non-carbonated/sugar-free/caffeine free beverages (e.g. crystal light lemonade), strained soups, broths, and especially water. Patients are encouraged to take in a minimum of 40 ounces of fluid per day.
 
After the first five weeks, patients are placed on a soft textured diet up to six months from their date of surgery. This includes soft textured fruits, vegetables, starchy vegetables, and well chopped meats (excluding red fibrous meats). Fluids should still not be taken up to 30 minutes before eating, during meals, and should not be taken until a minimum of 30 minutes after eating. Fibrous red meats and raw fruits and vegetables should be avoided for up to six months following surgery, as well. After the first six months following surgery patients can try regular textured foods. They should try one new food each day, by itself, to see whether or not they tolerate it.
 
Nausea, feedback, and diarrhea may occur from making unwise food selections. Sometimes, patients take themselves off the Puree Diet too soon and the coarser texture foods irritate their new stomach. Red meats, which are fibrous like steak, can irritate the pouch as well. Patients will often try well chopped meats (which are fibrous) too soon after surgery. This may cause stomach irritation and inflamation. Once this occurs, it may take a week or two for the irritation to clear up. Patients may be placed on a liquid diet for several days when this happens. After that, they advance to puree foods, then soft and finally regular texture foods.
 
Dumping Syndrome can also occur after eating high sugar and high fat foods or beverages - like high fat meats, colas, cakes, pies, pastries, chips, and fried foods; or after drinking fluids at the same time solid foods are eaten. Right after consuming these type foods/beverages, a patient may feel queasy and light headed. Their heart rate may become rapid and they can experience cold clammy sweats. Finally, they experience a violent bout of diarrhea.