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The following are diet guidelines to follow after gastric bypass surgery. You will go home on a liquid diet for 3 weeks. You will then progress to soft foods and gradually add regular consistency foods over the next 1-3 months. Included here are suggestions for making this a safe and smooth transition as you learn to eat differently with your new gastric pouch. You will also receive further instructions when you come to your clinic appointments after surgery.

IN THE HOSPITAL:
On the day after surgery, if your swallow study is OK, you will start on sips of clear liquids (1 oz. per hour of water, diluted juice, tea, coffee, broth). Please do not use straws or drink carbonated beverages, as these will cause gas. You will start with small amounts of these liquids because you will feel full quickly and you don’t want to tear your sutures. If you tolerate clear liquids, the next day you will be advanced to 2 oz. (60cc) per hour of full liquids. You may also take small sips of water or low calorie beverages in between to quench your thirst. If you do not get Boost High Protein or Instant Breakfast, ask your nurse for them.  These are really not the best you can do, Boost High Protein or Instant Breakfast, as they contain to much sugar, but since hospitals don't carry the others this will have to do. Once discharged please be sure and read the supplement facts, join a help group, and make lifelong changes in the way you look at your nutrition.

WHEN YOU GO HOME: Starting on the day you go home from the hospital, you should drink 4 oz. (120cc) of liquids every hour, alternating the High Protein Liquids (22grams per 3 Tablespoons) with the low calorie liquids. These liquids should not be taken all at once. Sip slowly and avoid drinking more than 2 oz. every 30 minutes. You need to get a total of 6-8 cups of fluid each day to avoid getting dehydrated. This will take some effort on your part because you may not feel hungry or thirsty at first. 

FOCUS ON PROTEIN: Try to consume at least ..25 (1/4) gram of protein per pound of bodyweight per day. Protein will help you heal from your surgery and keep you healthy as you lose weight. It may also help you avoid the hair loss that can happen with rapid weight loss. Optimum Nutrition Pro Complex is an excellent Protein for this just use 1 scoop per serving will supply 27 grams high quality protein with added glutamine and vitamins.

TAKE YOUR VITAMINS AND MINERALS: You will need to take a complete vitamin/mineral supplement every day for the rest of your life. This is due to a combination of eating less food and decreased absorption of some vitamins and minerals after Roux-en-Y gastric bypass. Due to the large size of adult vitamin/mineral supplements, we suggest you start with 2 chewable children's vitamins with minerals for the first 1-2 months (ex: Flintstones Complete, Bugs Bunny Complete). After that you can change to an adult complete multiple vitamin/mineral (ex: Solaray Spectro 3 or Optimum Nutrition Opti-Men or Opti-Women). If possible it would be better for you to do a Liquid Multi Vitamin as it is much better on your system but a little more expensive. I really feel the cost is well worth for your overall recover and continued recovery. You can take generic equivalents - just compare the contents to the recommended vitamins to make sure they have adequate nutrients. Also, if you don't drink milk, you need to take a Calcium Supplement each day to get adequate calcium. It is also very important to supplement your Essential Fats to keep a healthy balance.

Beginning 3 weeks after your surgery, you will slowly begin adding soft, easily tolerated solid foods to your diet. Please do not begin this stage until your physician or dietitian tells you it is OK. Remember to focus on high protein foods and avoid foods that are high in fat ,sugar or fiber. You will probably need to still get some of your protein from milk or supplements until you are able to eat enough solid food to meet your nutritional needs. Getting enough protein in your diet will help you stay healthy and maintain your muscle mass as you lose weight. Eat the high protein foods first; making sure you fit them in. Remember to add only one new food at a time and observe your reaction to it. If you did not tolerate a food well, the problem may be the food you ate, how you prepared it, or the way you consumed it. See the next section for tips on making your diet progression and weight loss successful.

1. Eat slowly and be aware of when you feel full. When you feel full, stop eating! If you try to continue to eat, you may vomit. You may only be able to eat a few bites of food at a time.
   
   

2. CHEW, CHEW, CHEW! You need to make sure you chew your food very well before you swallow it. This makes it easier to digest and pass from your gastric pouch to your small intestine.
   
   

3. Avoid drinking fluids 30 minute before and with your meals. If you fill up your small gastric pouch with liquid, you won't have room for your food. If you need to, take only small sips of liquids while eating.
   
   

4. Drink enough fluid between meals to meet your fluid requirements. You need 6-8 cups of fluid per day to avoid dehydration. You may need to carry a water bottle with you and sip on low calorie liquids throughout the day to get enough fluids.
   
   

5. Avoid sticky foods. These foods can stick together and form a ball in your gastric pouch, causing nausea and sometimes vomiting. Sticky foods include white bread, rolls, buns, pasta (especially if overcooked and large pieces), rice that clumps together, grits, macaroni and cheese, peanut butter.
   
   

6. Avoid crunchy, hard to digest foods for the first 2 months.
   Crunchy and hard to digest foods include: raw vegetables, nuts, popcorn, chips, coconut, olives, pickles, tough fruit/vegetable skins (such as apple, cucumber skin), dried fruit, corn, iceberg lettuce.
   
   

7. Avoid tough or rubbery meats. Avoid steak, pork chops, ham, and other tough meats for the first few months. Meat is a great source of protein, but it needs to be soft and tender for you to digest it. Try a slow cooking method to make your meat tender, such as a crock-pot, boiling or cooking at a low temperature over a long period of time.
   
   

8. Avoid food/beverages high in sugar. High sugar foods can cause "dumping syndrome." After gastric bypass surgery, some people feel light-heated, sweaty or faint soon after consuming sugar. See page 12 of booklet for description of dumping syndrome.
   
   

9. Avoid extremes in the temperature of your foods and beverages. Some patients experience spasms or cramps with very hot or cold food/beverages.
   
   

10. Limit high fat foods. These foods may make you feel nauseated. They are also high in calories and will slow down your weight loss. Try changing to a fat-free comparable product. If you don't like the fat-free product, try the light product. Below are lists of foods allowed and to avoid for stage 2 of your diet progression. The foods on the avoid list are there because most patients don't tolerate them for the first 2-3 months after surgery. Some patients do tolerate these foods, but it is best to start with the foods on the allowed list. Once you have learned how to eat with your new gastric pouch and have healed from surgery, you can start to add other foods one a time over the next few months. If you follow these suggestions you should transition to solid foods and lose weight successfully!
    
    

    RECOMMENDED FOODS FOR STAGE 2: SOFT DIET: High protein foods Powders: Eggs (cooked with minimal fat) Protein Powders Light Yogurt Low fat Cottage cheese Soft fish (baked, boiled, grilled) Tuna fish (fat-free mayo is OK) Baby shrimp, scallops, crab Chicken (cooked so it is tender and cut into small pieces) Bean and lentil dishes and soups Fat-free refried beans Low fat luncheon meats (turkey, roast beef-sliced thin) Shredded or soft low fat cheeses (avoid melted cheese) Tofu (soy) mixed in soup or vegetables Other foods: Oatmeal, Cream of wheat Softened cold cereal Cooked, soft vegetables Soft fruits without skin or light canned fruits Crackers and pretzels chewed well Potatoes Low fat Soups Very dry toast Soft lettuce (green leaf or Boston bib) with fat-free dressing

    AVOID ON SOFT DIET: Sticky foods: Bread (may tolerate if toasted) Sticky rice Pasta (especially overcooked or large noodles) Grits Macaroni and cheese Peanut butter Crunchy foods: Raw vegetables Fruit/vegetable skins Nuts Popcorn Chips Coconut Iceberg lettuce Tough or rubbery foods: Tough meat (ex: steak, pork chops, ham, hot dogs) High fat foods: Butter, margarine, oils Sour cream Cream cheese Mayonnaise Gravy Fat back, bacon Sausage Whole milk Salad dressing Hard cheeses Fried foods Bologna, salami Chips Desserts

    Remember, your gastric bypass surgery is a crutch to help you lose weight, but it is not magic. If you overeat on high calorie foods or beverages this will reduce the amount of weight you lose. Try to eat nutrient-dense foods to get the most nutrition from the smaller amount of foods you will be eating.