Diet after gastric bypass

Gastric Bypass surgery reduces the intake of the stomach by more than one tenth of its original capacity. Immediately after a gastric bypass surgery, the patient cannot take bulk or voluminous food. It is imperative for patients to understand the volume of the new digestive system. The new and smaller stomach needs certain levels of conditioning before being introduced to heavy or solid foods. A gentle and careful gastric bypass diet progression can only ensure proper healing of the stomach and allow time for your body to adapt to the new eating patterns.

Diet after Gastric bypass

Typically it is common to have a certain degree of malabsorption after gastric bypass surgery. Patients who undergo gastric bypass surgery may also be devoid of certain vitamins and minerals since they cannot take enough food to meet the daily requirement. Hence, it is mandatory to add multivitamin/mineral supplements for better absorption of food.

Try foods that are rich in Protein and Calcium and low in fat

Calcium and proteins must form an essential part of your diet after a gastric bypass surgery. Proteins help with wound healing, muscle and skin re-growth, and repair as well as prevent hair-loss, whereas calcium is required for the strength of bones. Doctors suggest a daily protein goal of 60-70 grams per day after gastric bypass surgery.

Remember to have a low fat diet especially after gastric bypass surgery, since your new digestive system may not tolerate food that is rich in fat. Hence, stay away from fried foods, fast foods or snack foods. However, small amounts of fats such as those found in lean meats and fish or low fat dairy products can be consumed. Eating a sensible low fat diet can help sustain weight loss after gastric bypass surgery.

Foods rich in Protein and low in Fat

Consider adding any of the following foods to your diet after gastric bypass surgery.

• Fish (flounder, Sole tuna, crab and salmon)
• Lean cuts of beef.
• Lean cuts of pork loin or leg.
• Skinless chicken or turkey (preferably white meat)
• Dry beans and legumes
• Eggs and egg whites
• Low fat milk or milk products
   

Consider a diet that is low in added sugars

Most patients who undergo gastric bypass surgery experience dumping syndrome, especially after eating concentrated sweets, fatty foods or after drinking fluids with meals. Dumping syndrome is a condition where the food exits the stomach pouch and dumps into the intestine resulting in diarrhea, nausea, lightheadedness, flushing and stomach cramps.

Hence, after gastric bypass surgery, avoid eating sugar and foods that contain real sugar. It is also better to avoid any food, which has ingredients like maple syrup, honey, molasses, corn syrup, corn sweeteners, glucose, lactose, maltose, dextrose, sorghum, sorbitol or mannitol. However, it is fine to use artificial sweeteners as substitutes since they are not heavy and contain very few calories.

Gastric Bypass Nutrition

The new digestive system formed after the bypass surgery will have low levels of tolerance, and hence cannot accept any heavy foods. The postoperative digestive system requires certain levels of conditioning before adapting to any eating patterns. Keeping this in mind, doctors prescribe a four-stage standard gastric bypass diet.

Stage I - Liquid Diet: Immediately after surgery, while you are still in the hospital, doctors will test your eating tolerance by providing sips of clear liquids like water, broth, unsweetened juices, diet Jell-O and other diet drinks. This might be your diet for the next one or two days. Once you and your stomach tolerate the liquid foods, doctors will add pureed foods to your diet.

Stage II - Puree Diet: For the next 2-3 weeks following your surgery, your surgeon will ask you to eat food in liquid or semi-liquid form. Do not take solid foods at this stage, as chewing the same can put pressure on the staple line. Ensure that the food you eat during this stage is thin in consistency, and smooth like yogurt or applesauce. Try eating 4-6 meals per day. Foods that can be considered during this stage are

• Pureed fish, tuna, poultry or pork
• Low fat cottage cheese, or non-fat cheese
• All types of baby-food meats
• Pureed tofu, egg or egg substitute
• Blended low fat casseroles with soft vegetables
• Skimmed or 1% milk
• Sugar free or low fat yogurt
• Applesauce, pureed banana or other fruits and vegetables, mashed potato
• Oatmeal, grits and cream of wheat
• Sugar free gelatin or popsicles
• Sugar free and fat free pudding or custard.
   

Blend the meat in the blender by adding skimmed or low fat milk. Avoid eating crunchy peanut butter, chocolate, sweetened or condensed mil**** cream, vegetables or fruits with hulls or seeds, crunchy cereals, bread, chewing gum and sweets during this stage. If you feel any trouble taking any of these puree foods, consult your doctor. He might advise you to slower the pace of eating while decreasing the amount of food.

Stage III - Semi-solid or Soft Diet: Once you are comfortable with pureed diets, doctor will advise you to try semi-solid or soft food portions of the diet. This might happen probably after 3^rd or 4^th week of the gastric bypass surgery. However, the decision to start semi-solid or soft diet is purely dependent on the postoperative patient's capability to consume food. Include 4 meals a day and remember not to exceed 4-6 ounces per meal. Understand that you are re-engineering your stomach for eating patterns and hence eat and drink slowly. Take small bites and chew very well. Try the same foods suggested in the stage II. However, this time you need not blend the meats instead try consuming them directly. Nevertheless, ensure the meat is lean, soft and moist or the ones that can be mashed with fork.

Try avoiding dry, tough or chewy meats. Also do not experiment yourself with red meat, it is too heavy to tolerate at this stage. Avoid fried eggs, chocolate, sweetened, condensed or whole mil**** cream, salads, raw crunchy fruits especially the ones with tough skins or seeds, bread, cereals, chewing gum and sweets.

Stage IV - Solid Foods: Following the tolerance of semi-solid foods by your stomach, you may try some solid foods on your diet. Since this is still a testing phase, try eating one at a time. As you progress with your solid diet, try reducing the number of meals to three per day. Try consuming about 60 grams of protein per day and be as regular as possible with your meals.

Apart from the semi solids suggested in stage III, try eating fresh, canned, frozen or cooked fruit, well-toasted bread, crispy low fat crackers or baked tortillas, boiled, mashed or baked potatoes, well cooked whole wheat pasta or rice. Try limiting or avoiding foods like

• Tough meat or meat with gristle
   
• Avoid fruits that are dry and have tough skins
   
• Limit fried or breaded vegetable products and meat products
   
• Limit sweet breads, doughnuts or pastries
   
• Have limited versions of instant noodle dishes, fried salty snack foods and creamed soups
   

Drink considerable amount of fluids. In order to avoid dehydration, gastric bypass patients must drink at least 4 cups of low calorie liquids between meals, especially for the first month. Remember to drink the fluids 30 minutes either before or after your meal, because drinking while eating can overfill the stomach pouch and cause vomiting or nausea. Avoid carbonated beverages until you stomach attains full tolerance to all food varieties. Try low calorie beverages like

• Skim milk
• Diluted juice
• Flavored water
• Fat free cappuccino
• Decaf Coffee
   

Be patient while adding food varieties to your diet. Make healthy choices on what to eat. Trial and error would be the best choice to identify whether your stomach has developed tolerance towards food varieties. If you are not able to tolerate certain diet varieties, do not worry, as it is normal with gastric bypass patients.