Rafał Mulek

Preoperative period:

 

Diet and work with a dietician

 

Each patient who decides to undergo surgical treatment of obesity has had numerous attempts to reduce body weight using various diets. Of course, most of them fail, otherwise the patient would not be looking for new solutions. So when he hears that he is to resume working with a dietician before surgery, he often reacts with surprise and opposition. However, this procedure is not without sense, because dietary treatment before surgery is a re-entry to the right "dietary track". Thanks to this, the patient has a chance to reduce his body weight before the operation, and he will enter the treatment phase after the operation more gently, without the element of surprise. This period of treatment is for the patient what building up before the competition is for the athlete. It should also be borne in mind that the lower the patient's weight on the day of surgery, the easier the operation will be for the surgeon, and this is associated with a reduction in the risk of the surgical procedure, and after all, it is the patient himself who should be most interested in reducing the risk.

 

A healthy diet is primarily a varied and balanced diet, which includes proteins, fats and carbohydrates. In other words, it cannot be a diet based on one type of products, such as pasta or the famous pork neck.

 

A healthy diet also means regular meals. By maintaining constant time intervals between meals (2-3 hours on average), there is no overwhelming feeling of hunger before the next meal, which we satisfy by eating much more than we actually need. Eating regularly, we take in a smaller amount of food each time than when we eat twice a day, of which the first meal is usually symbolic, and the real feast takes place at the end of the day, after returning home late. By eating smaller portions of food regularly, we also prevent the stomach from stretching, and this is of great importance. The stomach sends a nervous impulse informing about satiety only when it is full. The math is simple - a large stomach needs more food to send a message of satiety.

As a consolation, I will add that after surgery, thanks to the reduction of the stomach volume, it is much easier for the patient to comply with the recommendations regarding "reasonable" volumes of food intake, because the volume of the "new" stomach is on average several times smaller than originally.

 

Postoperative period:

 

The period immediately after surgery is the time of discovery. The patient must rediscover their digestive tract and learn how to eat and drink to feel comfortable. In the first days after surgery, the stomach tissues are swollen, and the volume of the stomach is therefore smaller than it will be on the 3-4th day. On the first day after surgery, the patient may only take water. The patient should drink a sip or a maximum of 2 sips of water at a time, after which they should wait a few minutes to ensure that the volume of fluid ingested is not too large. If too much water is taken, at best the patient will feel discomfort in the epigastrium, there may also be a feeling of fullness in the esophagus and even pain. Only slow but systematic intake of water guarantees a feeling of comfort and, at the same time, quenching thirst.

 

Usually, from the second day after surgery, the patient can take a liquid diet. The principle of taking a liquid diet is exactly the same as taking water. A teaspoon or two of soup should be followed by a few minutes break, during which the patient can see if his stomach is full or if he can take another spoonful of soup. It should be remembered that liquid foods are those which, after tilting the cup or plate, flow freely out of the dish and do not require engaging teeth while eating. A liquid diet should be used for 6 weeks after surgery.

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• for the first 2 weeks it should be based on broths and clear soups, in the following weeks it can be gradually thickened, which means that soups can be in the form of creams
• only from the fourth - fifth week, you can start using pure mash.
• after 6 weeks, the patient can try to return to the normal consistency of food, such as before the operation.

 

In the first days after the operation, eating should be very careful, so that the patient does not feel discomfort while eating due to taking too much food at one time. In the following days, when the patient is able to predict how much food he can take at one time, food can be taken at fixed intervals. Aim to eat five meals a day, 2-3 hours apart.

It is very important that when taking both liquid and solid diets, do not forget to drink water between meals.

 

Once you start using a solid diet:

• start eating meat in pieces, cut the meat into small pieces and chew them carefully, start with veal or chicken, because they are easier to chew,

• try eating higher fiber vegetables, but still be careful with asparagus, leafy spinach, cauliflower, broccoli stalks, green beans, leeks and cabbage

• stop eating as soon as you feel full, even if it means leaving food on your plate

• try to eat fruit cut into small pieces

• avoid foods high in fiber (long, coarse-fiber meat, especially beef, fruit skins, vegetable peelings) and other fibrous foods, such as: leafy, coarse-grained or wholemeal cereal products - they can get stuck in the stomach even after careful chewing and because the fibers contained in them can swell

 

If you experience vomiting, indigestion or nausea after eating, ask yourself:

• did I eat too fast?

• did I chew my food well enough?

• Did I eat too much or were the bites/spoons too much?

• did i eat a meal?

• did I start drinking too soon after eating?

• did I go to bed too early after eating?

   

What to do when you feel that food is stuck in the esophagus/stomach?

Stop eating immediately and try to drink something (in small sips). If, in the next few hours, you feel that the fluids are not going down either, contact your doctor.

 

You should contact your doctor when you experience:

• repeated, frequent vomiting after meals

• repeated passing of black, loose, foul-smelling stools

• suddenly appearing emerging_abdominal pains abdominal vomiting

 

 

 

 

Food selection recommendations

 

Vegetables

• Asparagus, leeks - very difficult to chew, it is good to cut them into pieces

• Beans - beans - do not forget to chew them well

• Broccoli, cauliflower - the stalks are difficult to chew well, it is better to cut them off

• Cabbage, lettuce - chew carefully, eat in small bites

• Leaf spinach - contains long fibers. Don't forget to chew it well. Eat in small bites

• Mushrooms - they are easy to swallow whole, the stalks are difficult to chew; chew piece by piece

 

Fruit

• Bananas - large pieces that are easy to swallow, chew well, eat in small bites

• Cherries - they have pits, make sure you don't swallow the pits

• Nuts - be careful not to swallow them whole, chew them carefully

 

Meat and sausages

• Meat - be very careful with raw meat - it is difficult to chew and small pieces are easy to swallow; especially beef should be chewed thoroughly

• Raw ham - can be difficult to chew and is generally swallowed in large chunks; this can be avoided by careful chewing

 

Seafood

• Fish - cooked, grilled, baked fish meat is generally soft and easy to chew. Do not swallow large pieces

• Oysters, shrimp, squid, lobster - eat in small bites, chew them thoroughly, because their flesh can be quite tough

 

Bread

• Wholemeal bread - it should be chewed well, paying special attention to the crust

• White bread - usually soft, but do not forget about its proper chewing