Esophagectomy - diet; Post-esophagectomy diet

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

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.

You may be using a feeding tube when you go home. You will probably use it only at nighttime. The feeding tube will not interfere with your normal daytime activities.

• Your doctor or dietitian will teach you how to prepare the liquid diet for the feeding tube and how much to use.
• Flush the tube with water before and after feedings. You can use seltzer to clean out any dried material that is stuck to the tube.
• Clean all of the equipment with warm soapy water after each feeding.

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

• Notice if any specific foods are causing your diarrhea. Try to avoid these foods.
• If you have too many loose bowel movements, try psyllium powder (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 doctor about medicines that may help with diarrhea, such as loperamide (Imodium). Never start these medicines without first talking to your doctor.

What you should be eating:

• You will be drinking liquids at first. Then you will eat soft foods for the first 4 to 8 weeks after surgery. A soft diet contains only foods that are mushy and don’t need much chewing.
• When you are back to a normal diet, avoid steak and other dense meats because they may be hard to swallow.

Drink fluids 30 minutes after you eat solid food, and take 30 - 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 anything because gravity helps your food move downward.

Eat small meals.

• In the first 2 weeks, eat or drink only small amounts -- no more than 1 cup at a time. It is okay to eat more than 3 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.

Maish M. Esophagus. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 41.