Nutritional guidelines following partial or total gastrectomy: sample dietary regimen

Surgical removal of the stomach is performed under general anesthesia. Due to interference with the gastrointestinal tract, digestive and absorption disorders may occur postoperatively. During the first 24 hours, intravenous nutrition is applied, and the patient's mouth is moistened with boiled water. On the second day, bowel sounds and peristalsis should appear, allowing the administration of 500 ml of unsweetened tea throughout the day (about 15 ml or one tablespoon at a time). In the following days, the fluid volume is gradually increased. By the fourth day, a bland, semi-liquid diet is introduced (e. g., rice gruel, soaked rusks). Over the next three days, fruit and vegetable purees are added. After 7 days, the patient should transition to a soft, easily digestible diet. The postoperative diet must include: Adequate protein intake of 1.5 to 2 g per kilogram of body weight, with over half coming from high-value animal protein sources (lean meat, fish, eggs, dairy). Easily digestible fats such as butter, cream, olive oil, and vegetable oils. In cases of fat malabsorption, MCT oils can be utilized. Heavy fats like lard, bacon, and tallow must be avoided. Fruits and vegetables should be peeled, cooked, and pureed to reduce fiber content. Fine-grain cereal products such as semolina, white rice, and wheat bread are recommended. The daily menu should consist of 5 to 7 small meals, initially 100 to 150 ml in volume, gradually increasing. Fluids should be consumed half an hour before or after meals to avoid diluting digestive juices. Resting in a recumbent position for 20 minutes after eating is advised. Flatulent foods (legumes, garlic, onion, cabbage) and long-digesting items (fried, spicy, baked foods) should be strictly avoided. Meals should be steamed, boiled, stewed, or baked in foil. Beverages such as coffee, strong tea, cocoa, and alcohol should be limited.

The procedure of complete removal of the stomach is performed primarily in cases of gastric cancer. The surgeon initially ligates the blood vessels and removes the diseased organ. Continuity of the gastrointestinal tract is then restored by connecting the jejunum or duodenum directly to the esophagus. Digestion after total stomach resection is significantly altered because the stomach's reservoir function is completely lost, and food passes directly from the esophagus into the small intestine. Careful dietary management is essential to prevent malabsorption and dumping syndrome.

Breakfast: wheat pastry with cream cheese and mild jam. Second breakfast: soft-boiled egg, wheat rusks. Lunch (with a 3-hour interval between courses): strained vegetable soup, mashed potatoes with butter and dill, poultry meat cooked in broth. Afternoon snack: semolina cooked on milk with pureed banana. Dinner: white rice cooked in water with soft carrots, steamed fish with parsley and butter. Stomach resection is a serious surgical procedure that requires proper nutrition, as the stomach is partially or fully excluded from digestion. Diligent adherence to dietary guidelines is necessary to facilitate nutrient absorption and prevent undue strain on the gastrointestinal tract.