Post Fundoplication Diet

Robert A. Catania, MD, FACS

Department of General Surgery

Naval Medical Center Portsmouth

General Information:

After surgery, normal post-operative swelling will prevent you from eating a regular diet.  Your diet will be advanced over an 8 week period, and at that point you will be able to eat most of the items in your regular diet.  Careful adherence to this diet will minimize post-operative pain and maximize the likelihood of long term success after your operation.

-Your diet will progress slowly in stages, from just liquids to a normal diet.

-You will probably loose weight for the first few weeks.

-You should eat small, frequent meals (6-8 per day).  Start with six ounces of food per meal.  If you do not have any problems, increase each meal by one ounce every two to three days.

-Take liquid drugs as prescribed.  You may take a daily liquid multi-vitamin as well.  You may use chewable or crushed medications after week two.

Activities That Will Aid Digestion:

-Eat only until you feel full.  This may occur after only a small meal is consumed.

-Drink plenty of fluids with meals.  Try switching bites of food with sips of fluids.

-Eat slowly and chew your food well.

-Sit upright when eating or drinking.

-Remain in an upright position for 20 minutes after eating.  Do not recline.

-Adjust the temperature of the food for your comfort.

-You may use spices as tolerated.

-Walking will improve digestion of food and help alleviate gas.

To Avoid Swallowing Air:

-Avoid smoking, caffeine, and carbonated beverages.

-Sit upright when eating or drinking.

-Do not use a straw.

-Do not chew gum.

-Do not eat dry, hard foods (e.g. pretzels)

It is important to progress with the diet as outlined below.  If discomfort occurs, go back to the previous stage for a few days.  Not all patients will progress through the stages at the same rate.

WEEK 1

Clear Liquid Diet

- The first week you will remain on clear liquids with no caffeinated or carbonated beverages.

- Clear liquids include: water, lemonade, apple, grape, or cranberry juice, Crystal-Lite, Kool-Aid, broth, popsicles, Jell-O, decaffeinated tea and coffee (without cream).

- You can get extra calories and protein from high protein clear liquid supplements available in many health food stores.

WEEK 2

Liquid and puree foods.  Foods can be pureed in a blender.

- Cream of wheat, cooked oatmeal (puree), Pureed pasta, Pureed vegetables, vegetable juice, baby food, moist mashed potatoes, Fruid juice without pulp or seeds, pureed fruit, smooth applesauce, baby food, Pureed meat, baby food, Smooth puddings and custards, milk, milkshakes, ice cream, yogurt, pureed cottage cheese, Sherbet, pureed soups, flavored fruit drinks, instant breakfast drinks, Ensure, Boost

WEEK 3-8

Soft foods

- Hot cereals, cold cereals that soften with milk, crackers and biscuits that soften with liquid, Cooked, finely chopped pasta, Soft cooked, finely chopped vegetables, Soft canned fruit (no pineapple), soft peeled ripe fruit (e.g. bananas), Moist minced meat with gravy, soft cooked scrambled eggs, canned fresh or frozen fish without bones, Cottage cheese, shredded soft cheeses

FOODS NOT ALLOWED UNTIL AFTER WEEK 8

- Bread, rolls, muffins, bagels, granola, shredded wheat, pancakes, waffles, Rice, Raw vegetables, corn, coleslaw, salads, baked potato with skin, Fruits with seeds, nuts, peanut butter, raisins, dates, hard fruit with skin, dried or candied fruit, Unchopped meat, dry meat, fish with bones, Yogurt with fruit or nuts, un-grated hard cheeses, Coconut, popcorn, pickles, carbonated drinks, caffeinated drinks, chips, alcohol

Modified from the University of Maryland Medical Center Department of General Surgery Laparoscopic Nissen Fundoplication Diet Guidelines, June 2004.