Eating Smart After Nissen Fundoplication: Your Guide to a Smooth Recovery

What can I eat after my Nissen (or Toupet) Fundoplication?

For the first 6 weeks after this surgery you may experience:

• Difficulty swallowing (dysphagia)
• Abdominal bloating and flatulence
• Pain after eating

The following dietary advice will help to minimise these symptoms and should be followed until you see your consultant.

Your diet for the first six weeks after surgery

• Week 1: Clear fluids progressing to a soft 'sloppy' diet
• Weeks 2 - 3: Soft 'sloppy' diet
• Weeks 4 - 5: Soft diet progressing to a normal diet
• Week 6: Normal healthy diet (as agreed with your consultant)

Clear fluids

You should start having clear fluids on the night of your surgery. You will be able to drink water 3 hours after surgery. Have small meals of clear liquids, making sure you drink them slowly.

Suitable fluids are:

• Water
• Squash
• Apple, cranberry, grape and pomegranate juices
• Smooth soups
• Decaffeinated tea
• Ice cream (allow this to melt in your mouth before swallowing)

Avoid:

• Very hot or cold fluids
• Fizzy drinks (these can cause bloating and gas and should be avoided for 6 weeks)
• Alcohol
• Caffeine
• Citrus juices, e.g. orange juice

Soft 'sloppy' diet

You should start having a soft 'sloppy' diet the morning after surgery and continue with this for 4 weeks.

What is a soft 'sloppy' diet?
A soft sloppy diet is where you only eat foods which:

• are soft and moist
• have plenty of liquid
• can be broken into pieces with a fork
• do not require a lot of chewing

Suitable foods are:

• Weetabix softened with milk
• Milky porridge
• Pureed meat, fish and other foods (you may find a blender useful)
• Smooth soups without lumps

If you have any problems with eating these foods, drop back to having clear fluids and build up to a soft, sloppy diet.

Avoid:

• Solid lumps of food (these may get stuck in the oesophagus)
• Bread
• Crackers
• Hard biscuits
• Pastry
• Dry meats such as cold cuts and steak

Limit the following foods which may cause gas or irritation:

• Onions
• Citrus fruits and juices
• Tomatoes and tomato products
• Beans
• Highly spiced and fatty foods
• Caffeine and alcohol
• Fizzy drinks

General tips to help with eating after a fundoplication:

• Sit upright at mealtimes and for half an hour after eating.
• Relax and eat your meals slowly.
• Drink fluids with meals to keep foods moist.
• Have plenty of gravy/sauce
• Avoid eating for 2 hours before going to bed.
• Sleep propped up with an extra pillow.

Soft-normal diet

You should be able to progress to a soft-normal diet 4 - 6 weeks after surgery.

What is a soft-normal diet?
A soft-normal diet involves gradually introducing more solid textures to your diet.
Suitable foods (in addition to the ones in a soft-sloppy diet) are:

• Soft minced meat
• Flaked fish without bones
• Well-cooked pulses
• Well cooked pasta
• Rice and vegetables with plenty of sauce

While you are having a soft-normal diet you should avoid the same foods you were advised to avoid on page 4.
If you have any difficulties with certain foods discuss this with your consultant or dietitian. At your 6 week follow-up appointment with your consultant you may agree with him/her that you should start a normal diet with more challenging textures.

Having a balanced diet

It is important to have a well-balanced diet to give your body the right amount of energy, protein, vitamins and minerals to function properly. Choosing a variety of different foods will help you to get all the nutrients you need for good health. You also need to make sure your diet contains enough energy and protein as you may be eating less than usual. Sometimes dietary changes can cause diarrhoea or constipation but this should settle once you are having a normal healthy diet. If you feel you are losing weight contact your hospital dietitian or ask your GP or practice nurse to refer you to a community dietitian.

Meal and snack ideas for your soft diet

Breakfast

• Weetabix, porridge or instant oat cereal made with milk or soya milk or scrambled eggs made with milk and low fat spread
• Apple juice/smoothie or soft fruit e.g. ripe banana, stewed apple/pear
• Decaffeinated tea

Mid-morning

• Yoghurt, mousse or soft fruit/ fruit puree
• Water or squash

Lunch

• Minced/tender meat, chicken with sauce or flaked fish in parsley or cheese sauce with mashed potato and mashed/finely chopped vegetables or pureed meat/ lentil and vegetable curry or pureed homemade soup made with pulses/meat, potatoes and vegetables
• Water or squash

Mid-afternoon

• Soft fruit or mashed tinned fruit
• Yoghurt
• Decaffeinated or herbal tea Dinner Similar to lunch meal.

Dessert

• Ice cream
• Jelly
• Crème caramel
• Rice pudding
• Semolina
• Lassi
• Instant whip
• Mashed or tinned fruit with custard

Evening

• Milky drink such as malted milk drink or hot chocolate