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Post-Esophagectomy Nutrition Guidelines
Nutrition is very important for healing and to prevent weight loss after esophageal surgery.
Remember, because of the surgery, your esophagus may not be able to move foods as easily from your mouth to your stomach. Certain foods can block the esophagus or are difficult to swallow. Some people complain of food “sticking” or have midsternal (behind the breastbone) pain. Your surgeon may ask you to avoid solid foods entirely for the first several weeks at home. The guidelines below will ensure optimal diet tolerance after surgery.
The Diet Progression after Esophageal Surgery
Step 1: Clear Liquid Diet—Follow for ____________ days
Broth, bouillon Clear juices (apple, cranberry, grape, etc) diluted with water, Coconut Water (no pulp), Gatorade/G2, Tea (green tea, herbal teas are best) Jello, sugar-free Jello Nutrition Beverages like Boost Breeze® or Ensure Clear ®
Step 2: Full Liquid Diet—Follow for ____________ weeks
Everything on a clear liquid diet, plus: Hot Cereal—cream of wheat, cream of rice, malt-o-meal Milk, smooth yogurt, reduced fat smooth ice cream (vanilla, chocolate, etc), sherbet, pudding Milkshakes and Malts (made with reduced fat ice cream and milk) Strained or pureed smooth soups (not tomato-based) Nutrition Beverages like Ensure®, Boost®, Orgain®, Premiere Protein®, Muscle Milk®
Step 3: Soft Solid Diet—Follow for ___________ weeks
Everything on a clear liquid and full liquid diet, plus:
Food Group Better Tolerated Foods Less Tolerated Foods
Breads & Cereal Hot cereals, dry cereals softened with milk or lactose free milk Soft cooked pasta or rice; plain crackers
Fresh or “doughy” breads, rolls, granola, bagels, sweet pastries, popcorn, and foods containing dried coconut, nuts (whole or pieces), seeds, or dried fruit
Food Group Better Tolerated Foods Less Tolerated Foods
Fruits Unsweetened canned fruits, applesauce Fresh fruits (with pits/seeds and skins removed) e.g. banana, peach, melon, ripe pear, apple, etc. Fruit juices (diluted with water)
Canned fruit in heavy syrup Dried fruits Stringy fruit such as rhubarb, pineapple Citrus fruits, if having reflux
Vegetables Soft cooked vegetables, such as: zucchini, winter squash, carrots, potatoes (peeled), sweet potatoes (peeled), asparagus tips, green beans, turnips Vegetable juices, if not tomato based
Raw, tough, stringy, or difficult to chew vegetables; deep fried vegetables Gas-producing vegetables: broccoli, Brussels sprouts, cabbage, corn, cucumber, bell peppers, onion, radish Tomato juice/paste/sauce
Meats/ Alternatives Chopped or ground meats, boneless fish Moist casseroles and stews Soups prepared with soft foods Eggs, all preparation except fried Cheese, Tofu Soft cooked lentils, like in soup Smooth/creamy nut butters
Overcooked meat that is tough, gristly, dry, or stringy; Highly seasoned or very fatty meats Chili and other spicy foods Deep fried foods
Dried beans Crunchy/chunky nut butters
Dairy
(If not lactose- intolerant after surgery)
2% or less fat milk or lactose-free milk Soy milk, Rice milk, almond milk, coconut milk Low fat yogurt Reduced-fat ice cream, frozen yogurt Puddings, custards
Yogurt with muesli/granola or dried fruits Ice cream with whole nuts or scratchy foods like pretzels and popcorn Chocolate or other flavored milks
Miscellaneous Small portions of cookies, cakes (no frosting), pies, or other desserts
Teas—green, herbal, weakly brewed black teas “Light” juices, low sugar beverages
Dried coconut, nuts (whole or pieces), seeds, sugary candies or desserts, crisp or sharp foods such as corn chips, nachos, hard pretzels Coffee and caffeinated sodas; peppermint tea; sugary beverages Alcohol
