Eating after your operation

After surgery for stomach cancer, your body will need time to adjust. Certain foods may cause you problems. Your doctor, nurse or dietitian will give you advice on managing these.

Short-term problems usually improve with time:

  • If you feel full quickly, try to have several (6 to 8) small meals a day.
  • If you have weight loss, high-calorie or meal replacement drinks can help.
  • If you have dumping syndrome (food passing into the small bowel too quickly), you may feel faint or dizzy. Resting for 15 to 30 minutes after a meal can help.

Other problems can include indigestion, diarrhoea or vomiting. If you have these, tell your doctor as they can prescribe medicines to help.

Occasionally some people find it too difficult to eat enough food. They may need to be fed through a tube for a short time.

Some people have later problems after surgery. This can include not being able to absorb certain vitamins as well as before. You can have these vitamins as tablets or injections.

Eating after surgery

If you’ve had part of your stomach removed, the remaining stomach won’t be able to hold as much food as before. You’ll feel full even after smaller meals. Over several months, your stomach will gradually stretch. Eventually, most people are able to eat the way they did before the operation.

If you had all of your stomach removed, the food you eat will go straight from your gullet into the small bowel. This won’t affect being able to digest food but the small bowel won’t hold as much as your stomach could. Your body will gradually adjust so that you’ll be able to eat more at each meal.

People can have different types of eating problems after stomach surgery. These can generally be divided into:

  • early problems that happen straight away or soon after the operation
  • late problems that happen a few weeks or months after surgery, such as not being able to absorb certain vitamins and minerals from your food
  • problems swallowing after surgery, which can be an early or late problem.

Because I don't have a stomach I can only eat very small portions so I snack a lot in between meals.

Donna


After your operation

You’ll feel full quite quickly when you eat or drink. You may not feel like eating and it’s common to lose some weight. You might find certain foods make you feel sick, or give you indigestion or diarrhoea. This should settle down when you know more about the foods that upset you. Keep a note of foods that regularly cause you problems so you can limit or avoid them. This also helps your doctor or dietitian to know if you have a particular problem. It can take a couple of months to start eating a full range of foods again. Try to eat as well as possible. This will help with your recovery. Here are some tips:

  • Softer foods are easier to eat for the first few weeks after your operation when you have swelling or bruising.
  • Eat several (6 to 8) small meals a day and have snacks with you when you go out.
  • Take your time to eat – relaxing while you eat and chewing food well will help with your digestion.
  • Avoid drinking half an hour before your meal and during it, because this will fill you up. Avoid fizzy drinks for the same reason.
  • Have nourishing drinks instead of water, tea or coffee to give you more calories.
  • Add new foods to your diet one at a time to find out how you tolerate them.


Diarrhoea and vomiting

Diarrhoea can happen in short episodes for a few days or weeks after surgery, before the bowel returns to normal. Taking an anti-diarrhoea drug called loperamide (Imodium®) regularly in the morning can sometimes help.

People find they have stomach pain and feel full when they wake up in the morning. This may be relieved after vomiting clear fluid, which has some dark brown fluid (bile) in it. This can be distressing, but it may only last for a short time. Some drugs that affect the digestive system may help control this vomiting.

If the diarrhoea and vomiting are due to the surgery, it may not be possible to reduce them by changing the foods you eat. But if you find that some foods regularly make the symptoms worse it may help to avoid them. Let your doctor or specialist nurse know if the symptoms don’t improve or your appetite is affected, as they will be able to give you advice or other treatments.


Indigestion

Indigestion or reflux (a backward flow of bile into the gullet) can happen after any stomach surgery. This can cause soreness and inflammation of the lining of the gullet. This can be reduced by antacid medicines, which your GP or cancer specialist can prescribe for you.

Take your time to eat, try to relax and chew foods well – this will help with your digestion. Avoid fizzy drinks, alcohol and spicy foods if you notice they make your symptoms worse.

Indigestion can also be caused by wind trapped in the digestive system. Wind can be reduced by drinking peppermint water or taking charcoal tablets. These are available from pharmacies.

Eating after stomach cancer surgery

Specialist dietitian Claudia Rueb talks about what to expect when you have had stomach surgery.

About our cancer information videos

Eating after stomach cancer surgery

Specialist dietitian Claudia Rueb talks about what to expect when you have had stomach surgery.

About our cancer information videos


Boosting your weight

To begin with, it’s not unusual to find it hard to keep your weight steady. You might never regain all the weight you lose. But in time, most people find their weight gradually becomes steady.

You’ll usually see a dietitian who will talk with you about the effects the surgery has had on your diet. They’ll give you advice about eating a balanced diet and putting on weight. To gain weight, you need to find ways to add more energy (calories) and protein to your diet.

You can do this by:

  • eating high-calorie foods, or adding more calories to your food by using things such as cream, butter or cheese
  • having nutritious, high-calorie food supplements or meal replacement drinks
  • adding energy or protein powder to food – these are available on prescription.

I have lost weight. The good side is that I can eat anything as long as I have small portions. It is best to graze and eat little and often.

Donna


Dumping syndrome

After stomach surgery, food may pass too quickly into the small bowel. This can cause a group of symptoms called dumping syndrome. There are two types of dumping syndrome: early and late.

Early dumping syndrome happens within 30 minutes of a meal. You may feel dizzy or faint, and your heart may start to beat faster. Some people also have tummy cramps and diarrhoea.

The symptoms are caused by food entering the bowel quickly and may last for about 10 to 15 minutes. Things you can do to help are:

  • have small, frequent, dry meals
  • eat slowly
  • have drinks 30 to 60 minutes after food
  • avoid meals high in added sugar, such as sugary cereal
  • eat meals high in protein, such as fish, meat, eggs or tofu
  • eat starchy carbohydrates such as pasta, rice, bread and potatoes
  • rest for 15 to 30 minutes immediately after meals.

Early dumping syndrome often gets better on its own after a few months.

Late dumping syndrome can happen a couple of hours after a meal, or when you’ve missed a meal. This is caused by low blood sugar levels. You may suddenly feel faint, sick and shaky. If you have this, follow the same advice as for early dumping syndrome. Taking glucose tablets and a small snack when the symptoms happen may also help. If late dumping syndrome doesn’t improve or your symptoms are severe, your doctor may prescribe a drug called octreotide or another similar drug to help.

You may suffer nausea or other symptoms following your operation as this is usually caused by "dumping syndrome". Because you don't have a stomach the food can pass into your small bowel too quickly but as time goes on you will learn which foods to avoid as everyone seems to be different.

Donna


Getting the vitamins and minerals you need

After surgery, you may not be able to absorb certain vitamins and minerals from your food as well as before. You need these to keep healthy, so you may need to have them as an injection or as tablets.

Vitamin B12 is important for making healthy red blood cells. You need a chemical called intrinsic factor to absorb vitamin B12 from food. Intrinsic factor is made in the stomach. If all of your stomach was removed, your GP practice nurse will give you B12 injections every few months. If only part of your stomach was removed, your doctor will do a blood test to check your levels of B12 from time to time.

The stomach also helps to absorb other nutrients, such as folate (vitamin B9) and iron. These are important for making red blood cells and calcium, which we need for strong teeth and bones.

Ask your dietitian for advice if you’re worried about your diet or your weight. If you don’t have a dietitian, your doctor or nurse can arrange for you to see one.


Problems swallowing

When the whole stomach is removed, the lower end of the gullet (oesophagus) is joined to the upper end of the small bowel. The join is called an anastomosis. Occasionally this join can become narrow, which can make it difficult to swallow food. This is known as a stricture.

It’s a good idea to see your specialist as soon as possible, so that they can do an endoscopy to look into your gullet. If you have a stricture, the doctor may be able to stretch it or, rarely, put a tube (stent) into the narrowing to keep it open.

If you are having problems swallowing, you may find you begin to lose weight quite quickly. It can help to try eating soft or puréed foods and have nourishing drinks. Rarely, you may need to have food through a tube (enteral feeding) for a short time. Your doctor, specialist nurse or dietitian will give you more information about this.

Back to Surgery explained

After your operation

The nurses and doctors will monitor you carefully after your operation. You may be in hospital for 10–14 days.