Nutrition Intake After Bariatric Surgery

• The success of bariatric surgery depends on your post-development diet plan. Post-surgical nutrition has two goals that are listed below,
• To ensure post-operative tissue healing and the preservation of the lean muscle mass during excessive weight loss is the provision of adequate energy and nutrients.
• After surgery, it is the consumption of the nutrients consumed in a way that does not create a reflux, early satiety and pumpings syndrome.

The nutrition program after bariatric surgery consists of 3 stages;

1. Clear liquid period (2 weeks)

2. Puree period (2 weeks)

3. Solid Diet

In order to protect the patient after being discharged from the hospital, the person starts to their food consumption with liquid diet after the last leakage test. The liquid diet applied during the first 14 days post-operation, all the patient drinks should be in liquid form, dairy products and carbonated drinks should not be consumed. Carbonated beverage is prohibited for life in patients who have undergone sleeve gastrectomy.

The reason for this is that carbonated drinks dilate the stomach pouch and incurable halitosis (bad breath) . The free consumption within the clear-liquid diet can be shown as water, herbal tea, beef broth, chicken stock, vegetable juice, 100% organic fruit juices, wishy-wash black tea and homemade sugar-free compote.

The puree period can start in a controlled manner after the completion of the 2 weeks liquid diet period.The determinant here is the weight and the diet of the patient, before the operation. Since the feeling of hunger is prevented, the patient receives the calories his/her body needs with a small portion of food and does not feel hungry.

During the puree period, a program that can be implemented life-long is provided. İnclusive of 5 meals as 3 main meals and 2 snacks is given. Patients start a puree diet planned by a dietician starting the second week post- operation till the end of the fist month. This period is the sensitive in terms of which the food consumed must pass through the blender, milk and dairy products can be consumed without lactose.

Protein intake is a significant factor after sleeve gastrectomy operation. Adequate vitamin, mineral and protein intake plays an important role in this process and its continuation. Individuals that have undergone the operation, when the food consumption is not carefully planned and nutrition is not regulated as it should, hair loss, nail breakage and non-growth problems and dryness of the skin are seen. For the reasons listed, eggs, meals containing minced meat and protein powder are used in the pure phase. As of the 10th day, the protein powder that will be used until the 3rd month is also crucial for the benefit of the patient.

Another important element planned in the nutrition of the patient is the solid-liquid separation aimed to be made for life. There are 3 important reasons for this practice, which aims to put half an hour between each liquid and solid food;

• Protein deficiency,
• Enlargement of the stomach pouch
• Dumping syndrome.

In the patient’s already restricted food intake, when both liquid and solid are consumed together, enough protein intake cannot be provided, solid foods swell together with liquids would enlarge the stomach by taking up more space in the stomach pouch, and solid and liquid foods combined will come to the intestine faster and sugar is absorbed faster than normal.

Patients who have completed their puree period without any problems and that are entering the 1st month of solid period post-operation. For the duration of the solid period, food consumption must be planned to prevent blosiveness and within the high protein content and rich in nutrients as well. The foods prohibited for this period can be simplified as all meat and chicken, bread and bread products, flour products, and types of rice. Prohibition of these nutrients is primarily to protect patients, rather than the calorie intake. Since all meat and chicken are very rich in fiber, they strain the stomach pouch. The rest of the prohibited foods such as flour products and rice, on the other hand, swell in the stomach and cause discomfort in the stomach pouch of the patient who is already full within small portions. If patients were to consume these foods during this period, they may experience complaints of pain or vomiting.

It is recommended that patients who completed and passed the first month on their diet should be educated about snacking, and be advised not to consume snacks and instead, consume it as a meal.

For example, the patient who wants to eat nuts should consume it in the form of a meal until he/she doesn't feel the sense of hunger, instead of eating it periodically. As of the 3rd month, these prohibitions are lifted and the only remaining ones can be defined as the solid-liquid separation and gas-based beverages.

Patients who have completed their periods now continue their lives in a healthy way with the rules they will pay attention to for a lifetime. In between the 3rd and 12th month post operation within blood tests, vitamins and minerals are checked, and nutritional and supplementary vitamins are given in case of any deficiency.

Nutrition Recommendations After Surgery

• Do not consume solid and liquid foods and beverages together at meals.
• Fluids should be taken 30 minutes before or after meals. Liquid consumption during meals fills the small stomach pouch and can cause vomiting.
• Although your stomach is reduced in volume, frequent consumption of high-calorie foods can cause weight gain rather than weight loss.
• Alcohol contains high calories and encourages your appetite, so it should be avoided.
• Foods should be consumed slowly, with small bites and chewing well. A meal should last 30-45 minutes on average.
• If the food is not chewed enough, it may cause pain, discomfort and vomiting by obstructing the stomach outlet.
• Pay attention to the feeling of your body!
• Stop eating and drinking when you feel satiety and pressure in the middle of your stomach.
• Stop when you feel nausea. Removing this sensation after the lockup will return you to pain, discomfort, and vomiting.
• It must be ensured that sufficient amount of protein is taken.
• Your meals should primarily contain protein, vegetables and fruit groups.
• Foods containing carbohydrates such as rice, pasta, bread, cake, cake should be avoided.
• To prevent dehydration (loss of body fluid), you should consume 1.5-2 Liters of water
• (Minimum 6-8 water cups a day) Otherwise, headache, dizziness, nausea, weakness, white wounds in the tongue, colored urine, etc. are some of the situations that may encountered. Do not forget that your liquid consumption is very important for your kidney health.
• Avoid fizzy drinks for a lifetime.
• Do not use gum or a straw to prevent gas problems for at least 1 month post operation.
• Remember, your meals can take up to only 150-200 ml of liquid post operation. You can feel full even when you take 2-3 tablespoons from your meal. Do not consume too much food after this sensation, otherwise you may feel spasms. After 6-9 months of your operation, your new eating system and diet plan will guide you for the amount of your food in the long term.
• Exercise must be carried out! Starting from the first month, with a light-medium tempo, a walk should be done during the period when the patient feels well.
• The success of the period of the surgery after bariatric treatments is related to adherence to the recommended nutritional program.

Nutrients That Should not be Consumed Post Operation

• Legumes (dried beans, chickpeas, lentils, etc.) should not be consumed for an average of 6 months to prevent gas.
• You should not consume cauliflower, broccoli, cabbage or vegetables for a month. Consumption be started in a controlled manner after the first month.
• Raw vegetables should not be consumed for the first 3 months. (Including tomato, cucumber, lettuce, etc.)
• Coffee should not be consumed in the first month. It can be consumed as decaf after the first month. After the third month, coffee can be freely consumed.
• Orange, tangerine, grapefruit, sour cherry, pomegranate, lemon fruit should not be consumed within the first month.
• Spicy food should not be consumed for the first 1 month.
• No food should be too hot or too cold. It should be consumed warm.
• Sugar content should be kept away from foods, including fruit juices and sweets.
• Pasta, rice, noodles, bulgur, bread and cereals should not be consumed in the first 6 months.
• Grilled, oven, boiled or steamed meat should be preferred instead of cooking methods such as frying and roasting.
• Nuts can be consumed in 3 months post operation within the amount recommended by a dietician.
• Foods with high content of pickled peppers should not be consumed for 3 months
• Patients should avoid alcoholic beverages for a minimum of 3 months.

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