Adult Gastroenterology Associates
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Anti-Dumping Post-Gastrectomy Diet Purpose This diet helps to prevent a condition called "dumping syndrome," which occurs in some patients who have undergone stomach surgery. The symptoms include bloating, nausea, diarrhea, dizziness, weakness, sweating, and rapid heartbeat. They may occur 30 to 60 minutes after eating a meal and then again, 2 to 3 hours after eating. The early symptoms are caused when concentrated sugar passes too rapidly from the stomach into the intestine. The body dilutes this sugar mixture by bringing fluid from body tissues into the intestine, giving a sense of fullness, cramping, and occasionally, diarrhea. The loss of water from tissues can produce a temporary drop in blood pressure, with resulting weakness and faintness. The later symptoms are caused by the rapid absorption of sugar into the bloodstream, which raises the amount of blood sugar. A high level of blood sugar signals the body to produce more insulin. The excess insulin, in turn, drives blood sugar levels down. The low blood sugar (hypoglycemia) produces the weakness, hunger, and rapid heart rate that may occur about two to three hours after eating. This diet is really a regular diet with frequent small meals and reduced simple sugars. Nutrition Facts Depending upon individual tolerances and food selection, the Anti-Dumping or Post-Gastrectomy Diet is adequate in all nutrients according to the National Research Council's Recommended Dietary Allowances (RDA). Depending on the type and extent of gastric surgery performed, poor absorption of nutrients, vitamins, and minerals may occur to a significant degree. Some patients may become deficient in iron, calcium, folate, and B-12. The physician may prescribe vitamin/mineral supplementation and B-12 injections. Special Considerations Eat six small meals daily to avoid overloading the stomach. Limit fluids to 4 oz (1/2 cup) during mealtimes. This prevents the rapid movement of food through the upper gastrointestinal tract and allows adequate absorption of nutrients. Drink liquids 30 to 45 minutes before eating and 1 hour after eating, rather than with meals. Rest or lie down for 15 minutes after a meal to decrease movement of food from the stomach to the small intestine. This decreases the severity of symptoms. Avoid sweets and sugars. They aggravate the dumping syndrome. Avoid very hot or cold foods or liquids, which may increase symptoms in some patients. Stomach surgery is performed for different reasons, so calorie requirements may vary from patient to patient. For example, a patient who has had surgery for severe obesity will need to be on a weight reduction program. A very thin patient who has had ulcer or cancer surgery will need extra calories. Food Groups Group Recommend Avoid Milk & milk products (2 or more cups daily) as tolerated: butter-milk; low fat, skim, or whole milk; creamed soups; low calorie pudding; plain or low-calorie, artificially sweetened yogurt; cheese cocoa mixes; ice cream; malted or chocolate milk; sweetened custard and pudding; sweetened, fruited, or frozen yogurt; milkshakes Vegetables (3 or more servings daily) all none Fruits (2 or more servings daily) fresh fruit, fruit canned in natural juice, unsweetened fruit juice dried fruits, canned or frozen fruits in syrup, sweetened juice Breads & grains (4 or more servings daily) crackers, pasta, plain breads and rolls, pretzels, rice, unsweetened cereals sugar-coated cereals (including granola), doughnuts, sweet rolls Meats & meat substitutes (5 to 6 oz daily) eggs, seafood, beef, poultry, pork, peanut butter none Fats & oils (servings depend on caloric needs) butter, margarine, oils, salad dressings none Sweets & desserts (servings depend on caloric needs) artificial sweeteners, low-calorie jelly, low-calorie gelatin, low-calorie popsicles popsicles, cakes, pies, cookies, jellies, jams, gelatin, high sugar desserts, sherbet Beverages (limit fluid with meals to 4 oz per meal) sugar-free beverages, water regular soft drinks, sugared drink mixes, lemonade, Kool Aid, Gatorade, sugared ice tea, Snapple or similar drinks Sample Menu Breakfast Lunch Dinner unsweetened orange juice 1/2 cup poached egg 1 toast 1 slice margarine 1 tsp low-calorie jelly 1 tsp sugar substitute salt/pepper beef patty 3 oz on bun mayonnaise or ketchup 1 Tbsp broccoli 1/2 cup margarine 1 tsp skim milk 1/2 cup salt/pepper chicken breast 3 oz mashed potatoes 1/2 cup green beans 1/2 cup margarine 2 tsp coffee 1/2 cup non-dairy creamer sugar substitute salt/pepper Mid-Morning Snack Mid-Afternoon Snack Evening Snack unsweetened cereal 1/2 cup skim milk 1/2 cup bread 1 slice turkey 1 oz mayonnaise 1 Tbsp lettuce low-calorie pudding 1./2 cup cottage cheese 1/4 cup fresh peaches 3/4 cup This Sample Diet Provides the Following Calories 1550 Fat 62 gm Protein 87 gm Sodium 2327 mg Carbohydrates 119 gm Potassium 2372 mg