The goal of your diet when you first go home is to maximize caloric intake while minimizing discomfort as you begin to eat. Ideally, meals should be moist in consistency.
Eat Small Meals
Since the capacity of your stomach is reduced after the surgery, you should eat small but frequent meals (four to six times per day) — for example, three main meals and two snacks. Do not force yourself to eat to the point of discomfort. Stop eating immediately when you feel full.
Foods to Avoid
Food should be mild in taste. Avoid foods that irritate the digestive tract, such as caffeine-containing beverages, alcohol, ground pepper (white and black), chili powder, and hot, spicy foods. If you experience pain or a burning sensation upon swallowing, also avoid the following: acidic foods (citrus fruits/juices, tomatoes and tomato products), peppermint, and salty or very hot or very cold foods.
For ease in swallowing, select moist foods that stay together easily without falling apart, yet will not stick to the roof of your mouth or gums. Use small amounts of gravy, sauce, butter or margarine to help moisten foods. Take small bites of food and chew thoroughly before swallowing. Sip small amounts of liquids slowly with meals if necessary to soften food. It is recommended not to exceed 4 ounces (1/2 cup) at a meal.
Avoid large amounts of fluids during meals, as these will fill you up quickly and may prevent you from eating other nutritious foods. Liquids may be taken between meals (1/2 to 1 hour after eating). Try to drink thick, nutrient-dense liquids rather than thin, clear liquids. To minimize gas, avoid drinking carbonated beverages, sucking on candies, chewing gum and using straws.
To avoid discomfort, remain sitting for at least an hour after meals. Elevate the head of your bed; gravity helps to keep stomach contents down.
Generally avoid dry breads (such as bagels), dry meats and steaks (unless they are easy to chew) and carbonated beverages.
The Feeding Tube
Esophagectomy patients will generally (but not always) go home with a feeding tube (a red rubber catheter in the abdomen) still in place. This tube is also called a jejunostomy or "J-Tube." Many times, esophagectomy patients will require extra nutrients to promote optimal wound healing. Generally patients find that putting the J-Tube feeds on at night while sleeping and off during the day works well. In this way, you are hungry during the day when you would normally eat.
Your social worker will work closely with you and your family to start arranging for the feedings and for the necessary equipment to be sent to your home in the early postoperative period. Your floor nurse will teach you and your family all you need to know regarding tube feeding at home and the care of your J-Tube.
J- Tubes often show signs of local irritation (some redness and drainage) at the insertion site, which can often be confused with infection. Do not be concerned about this. Things to look for include increasing redness around tube site, frank pus from around tube site, new pain around the tube site and fever. You should call your surgeon's office immediately if you develop any of these symptoms.
If your J-Tube comes out at any time after you are discharged, it is very important that it be replaced within a few hours so that the "track" does not close up. If it is not convenient for you to come into your surgeon's office, you can go to your local emergency room or your local physician's office, and they can replace it for you there.