Adjustable Silicon Gastric Banding Surgery forms the first step of the change has been realized at the patient’s life style. The time of recovery will be advised you to maintenance yourlife more comfortable, to complete the healing due to operation you have underwent and to comply with the new stage of your life.
The patients have to learn the importance of chewing at the foods they have taken. They should also understand the importance of physical exercises and that they should bring those exercises as a part of their life. It is important to eat with the a baby spoon and to swallow as very small pieces at the beginning as you are new to the gastric band. Food intake with large pieces, may cause to pain and vomitting by making obstruction at the passage where the band is. You have to make a long time for yourself for eating. This duration must include a time period of 45-60 minutes. If you eat fast and much, this will lead to problems. The pouch above the band is very small and if you eat much the foods immediately come back. As you learn with time to eat slowly, you will better fill the band and understand when you have eaten enough and you will learn when will you end the eating without vomitting.
The patient’s diet should include only liquid foods at the first month after the surgery. Because the body needs time to heal and to provide adhesions those will fix the band at accurate position. At the patients those have hurried for solid foods intake, prolapsing of the band and expanding of the upper stomach pouch by this way are inevitable.
Liquid intake begins at the first night after the operation. A spoonful water is given at each 5-10 minutes until 250 ml (a glass of water) has been completed. Rest of the fluid need will be given by serum. Oral liquid intake is rapidly increased at following days. All fluid need at the diyet is begins to be met at 3rd day without the need to serum.
Liquid and solid food need after the patient has been discharged should be met as follows :
First 4 weeks
Liquid diet during first 4 weeks. On average 100 ml liquid is taken in small amounts with tablespoon each hour. Type of the liquid must differ and low-fat milk, yoghurt, gruel, tea, fruit or vegetable juice, warm soup or broth should be preferred. Diet supporting drinks must be added to provide balanced nutrition. It is important to spread the liquid intake to all of the day with small amounts. This period of time is very important for your stomach to heal. Fast beginning to the solid foods may damage your stomach and the band.
4 – 6 weeks
Pureed diet during 4 – 6 weeks. The puree should be taken in small amounts. Soup and nutritional supports are still added to the diet. A lot of markets sell baby food suitable to 5-6 months babies. These formulas are very useful at this period because they have included proper food ingredients.
The patients should drink water between the meals, not with the meals. The meal times can be adjusted according to the patient’s condition but recommended amounts should be checked as possible. Total liquid intake must be at least 1500 ml daily. The liquid should be taken at regular intervals and 100-200 ml at each time. Type of the liquid should be alternated and tea, milk or yoghurt, fruit – vegetable juice should be tried. Pureed food intake must be kept at 500 gr daily.The purees should include meat or fish meat and should not exceed 100-150 gr at once. The food should be eaten in small amounts and slowly everytime.
6 – 8 weeks
Normal foods in small amounts during 6 – 8 weeks. Foods with normal ingredients can be include to the diet. But they should paid attention to be in small amounts and to be taken between the meals. It is very important to eat slowly and to chew completely.The patient can take low fat milk or yoghurt.
Total liquid intake must be at least 1500 ml and the solid food intake must be kept around 500 gr. Solid foods now can be taken at normal mealtimes. However it is very important to eat slowly.
8th week and later
The patients now define their own food menu. Frequently, but slowly eating and completely chewing are still important. The liquids can be drunk only between the meals and as sugar free. The diet must mainly include boiled or crushed vegetables. Fish or low fat meat should be boiled rather than fried. Other foods also must be with low fat (milk and light cheese that have 17% fat in maximum).
FOOD LIMITATIONS
Some foods can not be easily tolerated and they should excluded from the diet unless they have converted to the alternative products those have been digested better. These are the foods which have generally got stuck on the cardia and caused to vomitting and lacking of liquid as a result of blokage.
Altough most of the patients can tolerate when they have chewed well the meats like steak they have difficulty to digest thick piece of the meat. Therefore it is recommended to avoid from eating meat and to gradually involve the meat into diet. Each patient has got his/her own eating capacity. Don’t compare yourself with the other patients eating.
LIMITED FOODS
Solid Foods
White, crusted thick bread
Dry meat, steak (boiled meat should be preferred instead of steak but it must chewed very well and digested in small pieces – after 8 weeks)
Fried potatoes
Cucumber, corn
Orange (It’s fibres may create problems when it has been digested – ATTENTION)
Fibrous Foods
Asparagus, it can be mixed in soup
Pineapple, it can be crushed for juice
Broccoli, it can be used only for it’s branches
Citrus fruits and dried fruits should be definitely avoided since they have obstructed the cardia by swelling.
Fatty Foods
Coconut
Potato chips
Popcorn
Soft white bread
Difficult to Digest Foods
Hazelnut
Almond
Peanut
Soda (carbonated drinks may make feel discomfort)
This list contains the foods which patients have experienced problems. Problem, doesn’t mean ‘imposible’. But it really required you to chew very well and eat slowly. Even so, it will be appropriate for you to make your choice in favor of the other foods.
You may harm your weight loss by taking high calorie foods (like chocolate, desert, ice cream and alcohol). Don’t wait from the band to do everything, know that the power is in you.
If you encounter a problem post operation, don’t hesitate to call your doctor and make your checks done regularly.
GOLDEN RULES
1 – You definitely must eat very very slowly. Comply with this rule even your eating a small portion takes your 45 minutes.
2 – You must chew very well.
3 – Carbonated drinks (soda, fizzy drink, cola) and effervescent drugs (Tylol Hot, Calcium Sandoz etc) are definitely forbidden. Gas bubbles in the liquids may expand the small pouch of your stomach.
4 – You must drink water between the meals. Otherwise quantity of the water that you have drunk with the meals is added to the food’s volume and it may be too much for your small pouch.
5 – You must divide the foods into small pieces before you take them to your mouth.
6 – You must chew the bite very well and swallow slowly after you have taken it to your mouth. Don’t forget to make your teeth checked to define whether your chewing is enouh or not.
7 – You must stop the eating when you have received the first signals of fullness. Even a more spoon may be too much and you may vomit (or you may feel pain at the area where the band is, your stomach pouch may expand and this can cause to form a second pouch and worthless of the band.
8 – You should joint to different exercises (swimming, gym, walking, dancing etc.) according your ability and preferences twice a week.
Assoc. Prof. Halil COSKUN M.D.
