Version June 2024
| Diet stage* | Begin | Fluids/food | Guidelines |
| Stage 1 | |||
| Postoperative days 1 and 2 | Clear liquids: Non-carbonated; no calories No sugar; no caffeine | Patients undergo a Gastrografin swallow test to rule out a leak on postoperative day 1 after Roux-en-Y gastric bypass. Sips of clear liquids may be started after the test. | |
| Stage 2 | |||
| Postoperative day 3 (discharge diet) | Clear liquids: Variety of no-sugar liquids or artificially sweetened liquids. Encourage patients to have salty fluids at home. Solid liquids: Sugar-free ice pops. Plus full liquids: Less than 25 grams sugar per serving; protein-rich liquids (limit 25 to 30 grams protein per serving of added powders). | Patients should consume a minimum of 48 to 64 ounces of total fluids per day, 24 to 32 ounces or more ounces of clear liquids, plus 24 to 32 ounces of any combination of full liquids (meal replacement liquids):
| |
| Stage 3 | |||
| Postoperative days 10 to 14* | Increase clear liquids (total liquids 60 plus ounces per day) and replace full liquids with soft, moist, diced, ground, or pureed protein sources as tolerated. Soft solid foods including eggs; ground meats; poultry; soft, moist fish; added gravy; bouillon; light mayonnaise to moisten; cooked beans; hearty bean soups; cottage cheese; low-fat cheese; yogurt. | Protein food choices are encouraged for 3 to 6 small meals per day; patients may only be able to tolerate a couple of tablespoons of food at each meal/snack. Protein should be moist and ground, pureed, or diced. Encourage patients not to drink with meals and to wait ∼30 minutes after each meal before resuming fluids. May continue to replace one meal or snack with a nutritional shake. | |
| Patients continue to advance diet as tolerated; emphasis on slow, mindful eating; planning 5 to 6 small meals/snacks and adequate hydration | Advance diet (amount and texture) as tolerated; patients should be incorporating well-cooked, soft vegetables and soft and/or peeled fruit. Include salads as tolerated. | Adequate hydration is essential and a priority for all patients during the rapid weight loss phase. | |
| Stage 3 lasts for months; every patient is different, and all patients should be encouraged to advance diet (texture and portions) at their own pace Frequent nutrition follow-up during this phase is imperative | Continue to consume protein with some fruit or vegetable at each meal; some people tolerate salads one month postoperatively. | AVOID rice, bread, and pasta until patient is comfortably consuming 60 grams protein per day and 3 to 5 servings of fruits/vegetables per day. Since grains are a rapid source of energy, they are not "essential" during the rapid weight loss phase, as caloric needs are met through utilizing body fat stores. The diet should provide all "essential" nutrients through food choices and supplementation. May switch to pill form of supplement. | |
| Stage 4 | |||
| 6 to 8 weeks after surgery | Healthy solid food diet, as hunger increases and more food is tolerated. Vitamin and mineral supplement daily.¶ | Healthy, balanced diet consisting of adequate protein, fruits, vegetables, and whole grains. Calorie needs are determined based on height, weight, and age of the patient. | |
RYGB: Roux-en-Y gastric bypass.
* There is no standardization of diet stages; there is a wide variety of diet protocols varying from how long patients stay on each stage to what types of fluids/foods are recommended. Dietary advancement is based on nutritional needs and increasing tolerance for dietary texture, meaning that soft foods should be introduced successfully before any hard solids are allowed.
¶ Nutritional laboratory tests should be drawn at 2, 6, and 12 months and yearly indefinitely and bone density tests at baseline and every 2 years.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
