Nissen Fundoplication Dietary Modifications

Immediately after your surgery, you will not be drinking anything. That is why you are in the hospital receiving intravenous fluids. The second reason you are in the hospital is to prevent/treat nausea to avoid vomiting. When you are likely to not get nauseated or after your wrap has been studied with an x-ray test, you will be started on clear liquids. When you go home from the hospital, you will be on full liquids and "blenderized" foods for the first 2-3 weeks. At that point you can advance to a soft diet. Below you will find a sample menu as well as some Nissen dietary modifications.

The main problems that we are trying to avoid in the first 4-6 weeks after your surgery is dysphagia (dis-fa-gea). This symptom is the sensation that food is getting stuck in your chest and will not reach your stomach. Trying to wash food that is stuck down will likely result in everything coming back up. We want to avoid gagging or vomiting. To some degree or another, everyone will experience more gas (flatulence) and some will experience diarrhea.

Some "dos and don'ts"

Eat small frequent meals. Avoid drinking more that 4 fluid ounces with meals and 8 fluid ounces with snacks. Drink the bulk of liquids between meals. Cold liquids will cause more esophageal spasm and increase dysphagia. Drink room temp or slightly warm liquids.

Take smaller bites and chew the food very well.

Avoid gummy foods such as bananas, breads (sandwich materials), deep dish pizza dough as these can be hard to swallow. Sometimes even noodles and pasta can cause dysphagia so start out with small amounts and chew.

Avoid gulping liquids or drinking through a straw. - it promotes air swallowing. People who have lived with GERD by habit swallow air to initiate a swallow to clear their esophagus. It takes time to unlearn this habit.

Don't chew gum or tobacco--promotes air swallowing

Avoid foods that cause gas: corn, dried beans, peas, lentils, onions, broccoli, cauliflower, and any food from the cabbage family.

Avoid caffeine, carbonated drinks (beer or soft drinks), citrus, and tomato products. Avoid drinking very hot or very cold liquids.

Don't try to eat steak or dense meats for about 4-6 weeks from surgery then you must chew them very well.

Clear liquid diet: apple juice, cranberry juice, grape juice, chicken broth, beef broth, Jell-O, decaf tea. Avoid carbonated drinks for 6-8 weeks after surgery and then try them in small amounts.

Full liquid diet: milk (not chocolate), cream of wheat or rice, strained creamed soups except tomato or broccoli, vanilla and strawberry ice cream, sherbet, yogurt (no strawberry or raspberry because of seeds), Carnation Instant Breakfast (except chocolate). Remember that some folks get diarrhea after dairy products anyway and this may be worse after Nissen fundoplication.

Sample menu

Breakfast	1/2 cup canned fruit, 1/2 cup cereal, 1 small pancake, 1/2 cup milk
Mid morn snack	3 graham crackers, 1 Tbs peanut butter, 1 teaspoon jelly, 1 cup decaf tea
Lunch	3 oz beef patty (finely ground-no gristle), 1/2 cup mashed potatoes, 1/2 cup canned peaches, 1/2 cup fruit juice,
Mid afternoon snack	6 saltine crackers, 1 Tbs cream cheese, 1 cup 2% milk
Dinner	3 oz finely ground chicken, 1/2 cup rice, 1/4 cup carrots, 1/2 cup canned pears, 1/2 cut decaf tea
Evening Snack	1/4 cup cottage cheese, 1/2 cup applesauce, 1 cup milk

Remember to drink extra fluids throughout the day---best room temp or slightly warm.

 

Nissen Soft Dietary Modifications

Drinks	reg milk, decaf tea, powdered drink mixes, non citrus juices(apple, grape, cranberry)	Avoid chocolate milk, drinks containing caffeine, decaf coffee, carbonated drinks, alcohol, citrus juices like orange, grapefruit, lemonade
Breads	pancakes, French toast, waffles, crackers, toast	Avoid gummy breads, pizza dough, sweet rolls, coffee cake or donuts
Cereals	cream of wheat or rice, box cereals	Avoid coarse cereals such as bran, any cereal with fresh or dried fruit, coconut, seeds or nuts
Desserts--start after the first week post op	plain cakes, cookies, pies, pudding and custard, ice cream (may cause esophageal spasm if too cold), yogurt, sherbet,	Avoid desserts containing chocolate, coconut, nuts, seeds, fresh or dried fruit, peppermint or spearmint
Eggs	soft scrambled	Avoid fried eggs or Mexican omelettes
Fats	butter, margarine, mayonnaise, veg oil, mildly seasoned salad dressings, plain cream cheese	Avoid highly seasoned salad dressings, cream sauces, gravies, bacon, ham fat, lard, fried foods, nuts
Fruits	any canned or cooked fruit or fruit juice except as listed in avoid	Avoid all fresh and dried fruit, fruits with seeds or skin such as berries, figs, and raisins, all citrus fruits and juices, bananas
Meats, Fish, Poultry, & Cheese--you may begin these 7-10 days after surgery	finely ground lean beef, lamb, pork, veal, poultry and fish (not fried). cottage and ricotta cheeses smooth peanut butter mild cheese such as American, mozzarella, and baby Swiss	Avoid tough meats with a lot of gristle, fried meats, highly seasoned meats or sausage, bacon, ribs, brisket, sardines, anchovies, duck, goose. Chili Shellfish Sharply flavored cheeses esp those with peppers Nachos Crunchy peanut butter Yogurt with nuts, seeds, coconut, strawberries, or raspberries
Potatoes/Starches	white potatoes, rice watch chewing spaghetti, macaroni and noodles as they can sometimes gum up and cause dysphagia	Avoid fried potatoes sweet potatoes (yams--cause flatulence) fried rice popcorn
Soups	meat broths and some cream soups	Avoid highly seasoned soups and tomato soup
Sweets	sugar, syrup, honey, jelly, marshmallows, plain unfilled hard candies	Avoid jam, marmalade, preserves chocolate candy containing nuts, coconut, seeds, peppermint, spearmint or dried or fresh fruit
Vegetables	cooked veggies without seeds or skins	Avoid raw veggies, tomatoes, tomato juice, tomato pasta, tomato sauce, and V-8 juice, gas producing vegs such as broccoli, brussels sprouts, cabbage, cauliflower, onions, corn, cucumber, green peppers, rutabagas, turnips, radishes, and sauerkraut, dried beans, peas, and lentils.
Comments	Eat slowly, chew completely, drink sparingly with meals and make it room temp or warm you will have early filling or satiety you will probably lose weight (8-10 lbs) but your clothes may still feel tight because your abdominal muscles don't hold your tummy in and you may have more gas to distend you.	Avoid gulping, eating fast, drinking cold beverages with meals Don't try meats like steak or prime rib for 4-6 weeks after surgery.