Esophageal stent diet

An  omnipaque   swallow   study  may  be   used  to evaluate your  ability  to  swallow  and to see if you are healing well and if your stent is in place.  If you have a fever or elevated white blood cell count, you may have  another  study to  re-evaluate for leakage from around the stent. Your  oral  diet will progress from  “Clear  Liquids”   to   “Soft”   texture.   Your portions will be one quarter (1/4) of what you were eating before so you will need to eat 4-6 times a day. This means every 2-3 hours you should be eating or drinking something. (see sample meal plan). As your oral intake increases, your J-tube feeding (if you have a feeding J tube) will be decreased, changed to night time feedings (cyclic feedings) or discontinued.

Eating after Stenting:

Portion Control: The most difficult eating change will be portion control. Do not eat more than ¼ of the portions you used to eat in any one sitting. You can eat again in one or two hours.

Stop eating as soon as you are full: You do not have the storage capacity that you once had. Over eating can lead to vomiting, discomfort and pain.

4-6 meals a day: This will help meet nutrition goals even though the volume you eat in one sitting will be much smaller.

Eat Slowly: This will give you the opportunity to know when you are full. At the first sign of fullness stop eating. This will prevent you from spitting up, getting cramps or diarrhea.

Chew your food well: The texture that goes down your new esophagus should be soft. Cutting food in small pieces before putting it in your mouth will help with this. Meats especially can be problematic.

Sit upright when you eat: The sphincters that closed off your stomach from your esophagus may no longer be in place or may not work. Staying upright for an hour after meals and at least 2 hours before bed can help keep stomach contents from splashing back up into your new esophagus.

Take brief walks after meals: Walking stimulates stomach emptying.

Eat your solid foods first: Save your liquids until the end of the meal and drink the majority of your liquids between meals.

Limit peels, skins, and rough foods initially.

Gassy foods to avoid if sensitive: Carbonated beverages, milk products and fresh vegetables can contribute to gas and discomfort. If you are sensitive to these foods avoid them.

Dumping Syndrome: occurs when food moves too quickly through the stent and into the small intestine. This can cause symptoms such as nausea, weakness, cramping, sweating, faintness, and possibly diarrhea soon after eating. Following the fore mentioned guidelines will help avoid symptoms. Avoidance of concentrated sweets such as cookies, candy, regular soda, syrups, jelly, fruit juices, and ice cream may be necessary.

Delayed Stomach Emptying: Surgery itself, pain medications and inactivity can contribute to poor stomach emptying. If stomach emptying is a problem eating small frequent meals, limiting fat, walking after meals and saving liquids for between meals can help. Prokinetics are a class of medications that your physician may prescribe for this condition.

Vitamin and Mineral Supplements:  While on tube feedings vitamin and mineral supplements are unnecessary since they are provided in the formula. A standard multiple vitamin plus minerals may be necessary once transition to regular food has taken place. Discuss this with your doctor or dietitian. If you are eating a soft diet, consider taking the following supplements: Coromega 3 packets,

Meal Patterns:

These meal patterns are intended to demonstrate portion sizes. Your actual food choices can and should vary to provide a balanced diet.  The 1000 calorie diet may be of assistance when beginning the transition from tube feedings to oral diet. The 2000 calorie diet may be of assistance as a goal once tube feedings have been discontinued. Individual nutritional goals will vary.

Reflux:

The presence of a stent in your esophagus may make you more prone to have reflux.  If you are having too much reflux and the material is passing into your airway, please call us immediately. You may find food passes easily and you have less reflux if you keep the head of your bed elevated at a 45 degree angle.

Sample Menu Day 1

6 Small Meals a Day Approximately 1000 calories, .75 grams protein

Breakfast                                                   Lunch                                                          Dinner

1 scrambled egg                                  2 oz roast beef (shredded)            2 ounces turkey (shredded)

1cup oatmeal                                        ½ c buttered noodles or rice       ½ c buttered mashed potatoes

1 tsp butter                                                 ½ c cooked carrots                         ½ c cooked green beans

MidMorning Snack                             MidAfternoon Snack                         Evening Snack

¾ c corn flakes/cereal                      ½ c cottage cheese                            2 ounces cheese (1-2 slices)

½ c milk 2%                                              ½ c peach halves in juice               5 saltines soaked in soup

or ¼ c peanut butter

Sample Menu Day 2

6 Small Meals a Day Approximately 2000 calories, 90 grams protein

Breakfast                                                   Lunch                                                          Dinner

1/2 c orange juice                               2 ounces ground roast beef         2 ounces turkey (shredded)

1 scrambled egg                                  ½ c mashed potatoes                       ½ buttered noodles

2 slices bacon, ground                    2 Tbs brown gravy                               ½ c green beans (cooked)

1 cup oatmeal                                       ½ c carrots (cooked)                          1 tsp butter

1 tsp butter                                             1 tsp butter                                             ¾ c fresh fruit salad

½ c pudding (sugar-free)                 1 c milk 2%

Iced tea (sugar-free)

MidMorning Snack                             Mid Afternoon Snack      Evening Snack

½ c cottage cheese                            ½ c ice cream                                         1 c fruited yougurt

½ c fresh fruit, soft                              6 sugar-free cookies                         or  2 ounces cheese

(softened in milk)                                5 saltines soaked in soup

 

  • Consider using a hand-held food grinder to grind your food if you wish to go to restaurants and eat what is on the menu. It can be purchased on Amazon or the internet, and you can simply take it to the restroom after use to be washed.
  • Consider protein supplementation with shakes and powders.
  • Daily weight with a log- bring this with you when you com into clinic
  • Remember to sit upright for hours after each meal- try not to eat anything just before going to bed so that you are less likely to have problems with stasis in your conduit or the stent.
  • Remember with an esophageal stent not to drink liquids that are extremes of temperature- nothing too hot or too cold- this may alter the stent and cause movement or problems…All foods should be lukewarm…
  • Drink a lot of fluid after each bite to “wash” the material out of the stent.