Nutritional Advice following Laparoscopic Fundoplication

Introduction

After fundoplication surgery, you will need to have fluids only for the first day, followed by a soft and moist diet for four weeks. This is because the swelling and bruising to your oesophagus (also known as gullet/food pipe) can make it difficult to swallow. After four weeks, you will be able to return to a normal diet.

This leaflet outlines the recommended texture of diet according to your post-operative stage, and the types of nutrition you should be aiming for to promote healing and recovery.

Soft and moist dietary guidance

• Choose food that is soft enough that it could be mashed with a fork
• Have plenty of sauce or sip a drink with any food
• Chew all food well
• Sit upright
• Eat and drink slowly
• To minimize burping/belching, avoid fizzy drinks, chewing gum or drinking through a straw
• Avoid hard, tough or crispy foods, such as tough meat, meat and fish with a coating (eg sausages, battered or bread crumbed food), hard fruit, raw vegetables, crusty bread, crisps, crackers and dry biscuits
• Continue to include foods from each of the different food groups below to achieve a balanced diet
• Keep to a soft and moist diet for a minimum of four weeks post-operatively. After this, progression back to a normal diet is individual and dependant on any discomfort felt when eating.

Meat, fish, eggs and vegetarian alternatives

This food group is the main source of protein in the diet. Protein is necessary for the repair of body tissue and will aid the healing process. It is important to have protein at each of your meals.

Meat and poultry
Use mince or cut tender meat into small pieces and soften with plenty of sauce or gravy.

Fish
Fresh, frozen or tinned fish is suitable. Beware of any bones. Add sauces, eg parsley, cheese or white sauce.

Eggs
These can be boiled, poached, scrambled or as an omelette.

Vegetarian alternatives
Lentils, chickpeas, beans and tofu are naturally soft when cooked well.

Dairy products

Milk, cheese and yoghurts are all really good sources of calcium, protein and energy which are essential for bone health and recovery after surgery. Most of these foods are naturally soft and moist, however, be careful of large chunks of hard cheese. Instead choose soft cheese, grated or melted. You may choose dairy free alternatives, however, please ensure they are fortified with calcium.

Fruit and vegetables

These provide fibre, vitamins, minerals and antioxidants which are important for a speedy recovery. Fresh, frozen or tinned vegetables and fruit are all suitable. Many fruits are naturally soft when ripe, such as bananas, pears, apricots, plums and berries, or you can stew fruit until soft. Add cream, custard or ice cream for more moisture. Vegetables on the other hand are likely to need cooking until soft. If you can, try to eat a variety of fruit and vegetables and aim for five portions per day.

Starchy carbohydrates

Starchy carbohydrates provide energy and are therefore essential to incorporate into every meal time to aid recovery post-operatively. Starchy carbohydrates include food such as bread, breakfast cereal, pasta, rice, noodles and potatoes. Whilst sticking to a soft diet, avoid crusty bread, cook pasta and noodles well, avoid potato skins or crispy chips and soak cereal well before eating and dunk biscuits in a drink.

Sweet treats

These can be included as part of a balanced diet, especially if you are struggling to eat enough food to aid your recovery. Soft options include rice pudding, semolina, custard, sponge cake, ice cream, jelly, mousse, trifle and cheesecake.

Drinks

Avoid fizzy drinks for the initial four weeks post-operatively, unless you feel food is stuck in your oesophagus, in which case a fizzy drink can help to dislodge this.

Malnutrition

If you are underweight or struggling to eat enough food to aid your recovery, aim to eat small and frequent meals and fortify your diet with nutritious drinks. Monitor your weight and, if you are losing weight, please speak to your surgeon or GP.

Contacts

We hope you have found this information useful, but if you have any questions or concerns regarding the diet you have been recommended to follow, please contact your GP at your local surgery.

About this leaflet

Authors: Hilary Beck and Ashley Davis, Dietitians
Written: July 2015
Updated: April 2021, Catriona Brown, Dietitian
Approved: May 2021
Review date: May 2024
Edition: v3

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk