Eating After Your Esophageal Surgery
After your esophageal surgery, you can expect some difficulty swallowing. If food sticks when you eat, it is called “dysphagia.” This is due to swelling around your surgery site and will most likely resolve in a few weeks. It is normal to feel “tight” for up to 10-12 week, but you should be able to advance your diet slowly. If your diet is not progressing by the time of your post-operative clinic visit, your doctor may suggest an outpatient procedure to help things along (outpatient endoscopy with esophageal dilation).
To help you through this temporary phase, we start you out on a pureed diet. Full liquid diet means essentially anything that you can pour and pureed is usually a little bit thicker. You should have been given at least a full liquid diet by the time you left the hospital. We ask patients to stay on pureed diet for the first two weeks to avoid anything getting “stuck” near your recent surgery. At the end of this packet are some suggestions for your diet in the first few weeks after your surgery (level 1-4). Don’t be alarmed if your ability to swallow doesn’t progress according to this plan. Everyone is different and some take longer or shorter to heal after surgery. Use common sense, if you are having trouble swallowing a particular food then avoid it. If food is sticking when you advance your diet, go back to the previous diet for a day or two.
In general, some simple rules to follow are:
Maintain an upright position (as near 90 degrees as possible) whenever eating or drinking.
Take small bites, only ½ to 1 teaspoon at a time at first.
Eat slowly. It may also help to eat only one food at a time.
Avoid talking while eating.
Do not mix solid foods and liquids in the same mouthful and do not “wash foods down” with liquids, unless you have been instructed to do so by your surgeon. If you do feel that your meal is a bit “sticky,” a small amount of warm liquid may help, but avoid drinking too much, or you may feel uncomfortable.
Eat in a relaxed atmosphere, with no distractions.
Following each meal, sit in an upright position (90-degree angle) for 30 to 45 minutes.
Avoid carbonated (bubbly) drinks — they will make you feel bloated.
If food does stick, don’t panic. Try to relax and let the food pass on its own. Sipping strong, hot black tea or warm broth can also help.
Staying Hydrated
It is important to avoid dehydration, so drink lots of fluids, at least 64 oz. of liquids daily. Cold beverages may cause painful esophageal spasms; room temperature or warmer liquids are often easier to drink. A daily multivitamin is also recommended. Most people will lose 5 – 10 pounds after surgery, depending on what they choose to eat.
Smoothies
Smoothies or nutrition shakes are always a good choice throughout your recovery but especially in the first few weeks. There are multiple store bought options such as Ensure®, Carnation® instant breakfast, Boost® and even Gatorade® nutrition shakes. These choices are often expensive, but they are convenient. Many people prefer to make their own nutritious drinks with their favorite fruits, protein powder, yogurt, and vitamin supplements. Feel free to experiment. You can hide a lot of healthy vegetables in a fruit smoothie without ruining the taste (examples are avocado, sweet potatoes, even leafy vegetables such as spinach or kale). Try to supplement with at least 50 grams of protein each day for the first few weeks (about 2-3 scoops of most powdered brands). If you need ideas, there are recipes on the internet (Opens in a new window).
This information has been approved by Emily Speer, MD (January 2017).