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Diet and eating after esophagectomy

Description

You had surgery to remove part, or all, of your esophagus. This is the tube that moves food from the throat to the stomach. The remaining part of your esophagus was reconnected to your stomach.

What to Expect at Home

You will probably have a feeding tube for 1 to 2 months after surgery. This will help you get enough calories so that you start to gain weight. You will also be on a special diet when you first get home.

Self-care

If you have a feeding tube that goes directly into your stomach (gastrostomy tube) or intestine (jejunostomy tube):

• Usually, you need to use it only at night or for periods during the day. You can still go about your daytime activities.

• A nurse or dietitian will teach you how to prepare the liquid diet for the feeding tube and how much to use.

• Follow instructions on how to care for the tube. This includes flushing the tube with water before and after feedings and replacing the dressing around the tube. You will also be taught how to clean the skin around the tube.

You may have diarrhea when you are using a feeding tube, or even when you start eating regular foods again.

• If specific foods are causing your diarrhea, try to avoid these foods.

• If you have too many loose bowel movements, try psyllium powder (for example, Metamucil) mixed with water or orange juice. You can either drink it or put it through your feeding tube. It will add bulk to your stool and make it more solid.

• Ask your health care provider about medicines that may help with diarrhea. Never start these medicines without first talking to your provider.

What you will be eating:

• You will be on a liquid diet at first. Then you may eat soft foods for the first 4 to 8 weeks after surgery. A soft diet contains only foods that are mushy and do not need much chewing.

• When you are back to a normal diet, be careful eating steak and other dense meats because they may be hard to swallow. Cut them into very small pieces and chew them well.

Drink fluids 30 minutes after you eat solid food. Take 30 to 60 minutes to finish a drink.

Sit in a chair when you eat or drink. Do not eat or drink when you are lying down. Stand or sit upright for 1 hour after eating or drinking because gravity helps food and liquid move downward.

Eat and drink small amounts:

• In the first 2 to 4 weeks, eat or drink no more than 1 cup (240 milliliters) at a time. It is OK to eat more than 3 times and even up to 6 times a day.

• Your stomach will stay smaller than it was before surgery. Eating smaller meals throughout the day instead of 3 larger meals will be easier.

References

Rajaram R, Spicer JD, Dhupar R, Kim JY, Sepesi B, Hofstetter W. Esophagus. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 42.

Wilder FG, Yang SC. Management of esophageal cancer. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:54-65.

Review Date: 1/28/2025

Reviewed By: John Meilahn, MD, General Surgeon, Wyndmoor, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.