Duodenal Switch Post Operative Diet2018-08-16T16:05:11+00:00

Duodenal Switch Post Operative Diet

Duodenal Switch Post-Op Diet and Sample Menu

A standard approach to a Duodenal Switch Post-Operative Diet, also known as DS post-op diet, involves a modern sample menu plan. This dietary plan typically progresses in the following manner:

Phase One: Clear Liquids

Phase Two: Full Liquids

Phase Three: Puree Foods

Phase Four: Semi-Soft

Phase One: Clear Liquids for 5- 7 Days After Surgery

Duodenal Switch Post-Operative Diet Guide

This is used the day of surgery and the days following surgery if the upper gastrointestinal tract (stomach and intestines) is clear. A clear liquid diet consists of clear liquids such as water, broth, and plain gelatin. These substances are easily digested. They do not leave any undigested residue in the intestinal tract.

A clear liquid diet allows for healing time and to make sure that your body can tolerate anything by mouth. This phase takes a minimum of 2 days after your operation. At first, take in liquids every ½ hour – about 2 ounces at a time. Then gradually increase your intake of liquids to 6 to 8 ounces every hour. Drink very slowly and refrain from gulping. It may be difficult at first, remember to sip fluids. Aim for 48 ounces, to begin with.

The Goal of Phase One: Clear Liquids

The goal for this phase one is to stay hydrated- you want to consume a minimum of 48 oz. of fluids, optimal goal 64 oz.

  • Clear diet begins post-operatively if there is no nausea or vomiting.
  • You MUST sip VERY SMALL amounts of fluid ALL DAY.
  • Rotating between room temperature and warm fluids will help. Also use peppermint or ginger to may assist. AVOID COLD AND HOT FLUIDS.
  • The goal for a day is a total of 64oz of clear liquid per day by sipping SMALL SIPS 4- 8oz per hour.
    • Recommended Sugar-Free Clear Liquids:
      • Clear Broth/Bouillon: Chicken, beef, vegetable
      • Herbal tea- preferably peppermint or ginger tea
      • Teccino (coffee replacement, herbal, non-acidic coffee) https://teccino.com/
      • Gatorade/vitamin water (diluted with water 50/50)
      • Light or diluted (50/50) juices (apple, white grape, cranberry)
      • Coconut water- no or low sugar
      • Unsweetened caffeine-free herbal tea.
      • Sugar-free Jell-O.
      • Sugar-free popsicles
      • Ice-chips
      • NO carbonated beverages

CLEAR LIQUID DIET SAMPLE MENU

Important: You do not weigh your fluids; you measure by volume. You can have as many fluids as your body wants. The minimum goal is 48 oz. to prevent dehydration.

WAKE-UP – Duodenal Switch Post-Operative Diet:

4 – 6 oz. warm herbal tea- recommended ginger or peppermint (no milk/cream) or broth (warm fluids help in relaxing the stomach muscles)

BREAKFAST – Duodenal Switch Post-Operative Diet

8:00 am: 4- 6 oz. JUICE – Apple or cranberry, white grape, Gatorade, vitamin water (50% water/50% juice)- room temperature Sugar-free Jell-O

MID-MORNING SNACK – Duodenal Switch Post-Operative Diet

10:00am: 4 – 6 oz. warm tea (no milk/cream) or broth

LUNCH – Duodenal Switch Post-Operative Diet

12:00: 6 oz. Vitamin water
Sugar-free Jell-O or popsicle

MID-AFTERNOON SNACK – Duodenal Switch Post-Operative Diet

3:00 pm: 4 – 6 oz. herbal tea or broth

DINNER – Duodenal Switch Post-Operative Diet

5:00 pm: 4 – 6 oz. white grape juice (50% water/50% juice)
Sugar-free Jell-O or Sugar-free Popsicle

EVENING SNACK – Duodenal Switch Post-Operative Diet

4- 6 oz. herbal tea or broth

Phase Two: Full Liquids for 5 – 7 Days After Surgery

If clear liquids are tolerated, patients will move forward to thick liquids though lactose products will likely not be added for several months. A full liquid diet consists of fluids and foods that are normally liquid and foods that turn to liquid when they are at room temperature.

Goal of Phase Two: Full Liquids

The goal of phase two is to stay hydrated and focus on protein; 60 – 90 grams daily.

Recommended

  • All foods from the previous stage.
  • Protein powders/Pre-made protein drinks
  • Greek Yogurt (remember it needs to have more protein than sugar-Fage/Chobani plain Greek yogurt or Triple Zero by Dannon-Oikos
  • Almond or Coconut Milk
  • Fair Life Milk- https://fairlife.com/
  • Natural Unsweetened Apple Sauce
  • Vegetable juice (V8)
  • Hot cereals like oatmeal/ cream of wheat- use plain instant to start (use Fair life milk instead of water)
  • Sugar-Free Pudding
  • Soups (choose egg drop or low-fat soups, stay away from creamed soups.)
  • Recommended canned soup (Amy’s, Pacific organic Creamy Tomato, Healthy Choice Hearty Chicken, Progresso, Tabatchnick Split Pea, Health Valley Organic- Chicken Noodle)- for tomato, soups add Fair Life Milk for extra protein.
  • Start taking your multi-vitamins, calcium, and iron daily as directed two to three days after starting phase two. If you need guidance in this area or require vitamins, please contact us to purchase our recommended vitamins designed for your specific bariatric needs.

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Phase Two: SAMPLE MENU

WAKE: 4 – 6 oz. warm ginger or peppermint tea

BREAKFAST

Protein shake (minimum of 20 grams of protein)- clear or thick shake

MID-MORNING

¼ – ½ packet of 1 oz. packet high protein plain oatmeal made with almond milk or Fair life milk
½ scoop unflavored protein isolate added in

LUNCH

4 oz. Greek-style yogurt blended with almond or Fair Life milk (chose a yogurt that has more protein than sugar)

MID-AFTERNOON

Clear or thick liquid protein shake

DINNER

4 oz. Pureed soup or warm tea

EVENING

4 oz. Fair Life Milk

Phase Three: Puree 7 -14 Days After Surgery

This dietary phase may be used for up to 2 weeks. Some patients can reach this phase before discharge from the hospital. Foods are blended into the consistency of small-curd cottage cheese, baby food or applesauce. A pureed diet assists with the healing process and also ensures that blockages from food don’t occur while healing occurs. Although you are looking for the consistency of baby food, baby food is not recommended, there is not appropriate nutrition.

As a part of your new life, you will want to STOP drinking 30 minutes before a meal and 30 minutes after a meal.

  • You begin to weigh your food at this stage. Protein First. Goal: work up to 3 oz. of food by weight.
  • You probably will start out with 1 ounce at a time (a few TBSP) and slowly progress. Do not force the food, you will increase consumption with time.
  • Add only ONE food at a time.
  • Add 2 TBSP of healthy fat per day.
  • Goal for the day is 48-64oz of fluid to prevent dehydration
  • Cottage cheese (4%-whole fat)
  • Ricotta cheese
  • Soft Tofu
  • Scrambled Eggs
  • Refried beans
  • Sweet Potatoes/White potatoes (make with Fair Life Milk or add plain Greek Yogurt for protein)
  • Mashed Winter Squash
  • Pureed green beans, carrots, beets
  • Healthy fats: Barleans Swirl (essential fatty acids)-https://www.barleans.com/swirls, coconut oil (start with a tsp. and work up to 1 – 2 TBSP per day), pureed avocado
  • All Foods from previous stages

Phase Three: PUREED FOODS SAMPLE MENU:

BREAKFAST

Dannon’s Triple Zero Yogurt w/ ½ scoop unflavored or vanilla protein powder
2 scrambled eggs
1-ounce oatmeal w/ Fair life milk & 1 TBSP Barleans Swirl or coconut oil

MID-MORNING

Protein shake (blend in 1TBSP of Barleans Swirl or coconut oil)

LUNCH

½ cup 4% cottage cheese w/ 1/8 cup unsweetened natural applesauce
½ cup blended beans w/ 1 ounce melted the cheese
¼ cup potatoes with ¼ cup plain Greek yogurt

DINNER

2 ounces blended soft tofu w/ 1-ounce ricotta cheese
Blended high protein soup
¼ cup blended avocado, ¼ cup refried beans

EVENING

Protein shake or pudding with protein blended in

Phase Four: Semi-Soft for 7 – 30 days Day After Surgery

This is the transitional dietary phase preceding a regular diet. The semi-soft food stage provides more nutrients and bulk than the previous stages. This dietary step readies the body to digest solid foods that are part of a regular diet. You may transition between pureed and semi-soft foods for up to 30 days. Know each person is different and it is important to listen to your body.

Chew all your food well to applesauce consistency. If you don’t follow these precautions, you may experience vomiting, stomach irritation and swelling. You could also have obstruction of the small gastric pouch. If semi-soft foods cause nausea and vomiting, go back to the pureed and liquid diet you had earlier. Then you can slowly add soft foods and eventually transition to solid foods. IF VOMITING AND NAUSEA PERSIST, CALL YOUR DOCTOR IMMEDIATELY. Think of your new pouch as shaped like a funnel. You can pour any liquid into this funnel and it will run through and out the bottom. The same thing happens with your pouch when you only consume liquids. So you do not want to drink your calories or overeat.

Goal for Phase Four: Semi-Soft

The goal of phase four is 3 ounces of protein, 1 ounce of healthy fat to start. Then slowly add 2 ounces of soft-cooked vegetables or fruits. No more than 6 ounces of food by weight.

Recommended Foods:

  • All foods from previous phases
  • All canned meats (chicken, tuna, salmon)
  • Soft fish (take a fork and mush)
  • Deli sliced lunch meat (get natural nitrate and nitrite free)
  • Shrimp, crab, lobster
  • Ground Turkey
  • Egg salad
  • Soft cheeses (mozzarella cheese sticks, laughing cow) Avoid American and Velveeta
  • Beans and lentils
  • Soft fruits may be added at this time AFTER you can eat 3 ounces of protein and 1 oz. of fat.

Phase Four: SEMI-SOFT FOODS SAMPLE MENU

BREAKFAST

Dannon’s Triple Zero Yogurt w/ ½ scoop unflavored or vanilla protein powder, ¼ mashed banana or ¼ cup mandarin oranges or other soft fruit
2 scrambled eggs, 1 oz. diced ham, 1/8 cup black bean salsa
1-ounce oatmeal w/ Fair life milk & 1 TBSP Barleans Swirl or coconut oil
Protein pancakes (2 eggs, 1 scoop vanilla protein powder, ½ cup mixed berries, 1 TBSP vanilla or almond extract, cinnamon.)

MID-MORNING

Protein shake (blend in 1TBSP of Barleans Swirl or coconut oil)

LUNCH

1/2 cup chicken, tuna or salmon salad made with mayo or avocado or plain Greek yogurt
2 cheese stick wrapped w/ 2 slices deli meat each

DINNER

3 oz. ground turkey cooked w/ olive oil, 1 oz. mashed green beans or veggie
3 oz. soft fish w/ squash w/ olive oil

EVENING

Protein shake or pudding with protein blended in

Regular Diet After Phase Four

There are numerous dietary considerations to take into account when reaching the phase of a healthy diet. A high-protein diet is critical to ensure the body gets the protein it needs. Many bariatric surgeons recommend consuming 80 to 100 grams of protein daily from sources such as lean meats, eggs, and dairy products. Foods high in trans fats, processed foods and simple sugars should be avoided following a duodenal switch procedure.

The body is no longer able to absorb fats as it once did and consumption of fatty foods may result in diarrhea, increased frequency of bowel movements, and gas. Sugary, calorie-rich foods such as soda, candy, and other sweets should also be avoided. These simple carbohydrates can quickly lead to weight gain. Complex carbohydrates, however, such as whole grains, fruits, and vegetables are an extremely helpful part of a diet following duodenal switch surgery.

Each patient undergoing this bariatric procedure will respond differently. This modern diet plan is just one example of a typical postoperative duodenal switch dietary regimen. Patients may experience problems at any phase of a continuous bariatric diet which could result in a longer time frame to reach the regular diet phase. Some of these issues may include nausea, vomiting, diarrhea or bowel obstruction. The good news is that patients that adhere to the dietary recommendations from their health care providers will likely experience life-changing results.

Goal: 6 oz. of food per meal by weight, 3 of protein (20 grams), 1 ounce of healthy fat, 2 oz. to play with.

At this phase, you start back on solid foods. Start with one to four ounces of solid food per meal and then slowly increase the amount of solid food per meal until you are eating at least four ounces per meal but no more than six ounces.

At each meal, you want to have at least three ounces of protein. In the beginning, mentally identify your protein source. You may want to get a pocket digital scale to weigh your food at the beginning so you know what three ounces of protein looks like as well as what four to six ounces of food is visual. You will find it is easier for non-protein foods to go down, so you may gravitate to choosing non-protein foods. You want to train yourself right at the beginning to eat protein. Eat three bites of protein to every one bite of something else (three to one rule).

It is easy to get certain foods stuck, so from this phase forward, it will be very important for you to slow down and chew your food thoroughly, pausing between bites.

Eat protein first. Make sure you have three ounces of protein at each meal. Add three ounces of healthy fats, fruits, vegetables or starches if you can tolerate them. Pay close attention to how you feel about the introduction of new foods.

Recommended Foods:

  • All other foods. Be sure to add one new food at a time.

Difficult to Tolerate:

  • Red meat

Items like bacon, sausage, salami, bologna, pastrami, pepperoni and hot dogs are considered fats, not protein.

Raw Vegetables/Salads – Duodenal Switch Post-Operative Diet:

Remember that raw vegetables are harder to digest. In the beginning, they can easily irritate your pouch. Remember to take small bites and chew thoroughly. With gastric bypass surgery, you may want to wait approximately 4 months before trying raw vegetables. It is recommended to try one new food at a time and to try them while at home.

Best Tolerated:

  • Fresh or frozen cooked vegetables, like green beans, carrots, sweet potatoes and squash

Difficult to Tolerate:

  • Raw vegetables
  • vegetables with tough skin or seeds, like celery or tomatoes
  • Vegetables like cabbage, cauliflower or broccoli may cause gas distress.

Citrus Fruits – Duodenal Switch Post-Operative Diet:

With all fruits, eat as part of your meal after you have had at least 3 bites of protein. Remember that the acid in citrus fruits can irritate your pouch. Remember to avoid the membrane portion (skin) of the fruit.

Best Tolerated:

  • Fresh fruit, peeled with no skin
  • Canned fruit in water or natural juice that has been drained and rinsed

Difficult to Tolerate:

  • Fruits with skin or seeds

Starches:

There are two types of starches: whole grains and simple sugars. Focus on eating whole grains, such as:

  • Ezekiel bread
  • Whole grain tortilla
  • Crackers
  • Oatmeal
  • Sweet potatoes
  • Quinoa

Minimize simply refined grains, like candy, white rice, pasta, cereals and processed sugars, including cookies, cakes, and pastries.

You want to limit the amount of starch you have at each meal to one or two ounces. Be sure that you only eat a starch with your protein. Starches can act like a sponge in your pouch, leaving you little to no room for healthy proteins and essential fats.

Oils and Essential Fats – Duodenal Switch Post-Operative Diet:

It is important to include essential fats in your daily meal plan to prevent deficiencies.

Examples of healthy fats are:

  • Avocado
  • Olives
  • A variety of nuts
  • Oils, like olive, grapeseed or coconut

Fats to Minimize:

  • Fried foods
  • Saturated fats, like bacon, sausage, pepperoni, salami and bologna
  • Mayonnaise/Miracle Whip
  • Salad dressings
  • Sour cream
  • Margarine/butter

Important Reminders: Remember to eat slowly. Cut your food into dime-sized bites. Chew each bite thoroughly, at least 25 times, before swallowing. Do not drink any liquids ½ hour before you eat and during your solid meal. Do not drink any liquids for a ½ hour after your meal. Liquids will pass through your new stomach pouch quickly and will not make you feel full. Consuming only solids at each meal will give you the proper feeling of fullness (satiety) while limiting the amount you eat. Take at least 20 minutes to eat your meal. Always read labels.

REGULAR FOODS SAMPLE MENU – Duodenal Switch Post-Operative Diet:

BREAKFAST

¼ cup Kashi crunch cereal, ½ cup Greek Yogurt, ½ scoop vanilla protein powder, ¼ cup berries

MID-MORNING

Protein shake (blend in 1TBSP of Barleans Swirl or coconut oil) or a protein bar

LUNCH

3 ounces’ chicken, tuna or salmon salad made with mayo or avocado or plain Greek yogurt, 4 – 6 crackers
3 ounces Deli meat, 1 oz. cheese, 1 tortilla, ¼ avocado or 2 TBSP sun-dried tomato

DINNER

3 ounces of chicken, 3 ounces of tomatoes and mozzarella w/ olive oil, basil and balsamic vinaigrette
4 ounces salmon, 2 ounces green beans w/ olive oil

Remember:

  • Only add ONE new food at a time!
  • Avoid starchy food like white rice, pasta, bread.
  • Chew completely and slowly.
  • Protein Supplements: 60-90g.
  • In between meals, drink at least 6-8 cups of water and any other non-calorie, non-carbonated beverages.
  • Stop drinking 30 minutes prior to eating and DO NOT drink until 30 minutes after a meal.
  • EAT 6 small liquid and blended meals each day, but add one solid food item at one meal the first day. Add one more solid food item each day.
  • ALL NEW FOODS NEED TO BE SOFT, COOKED OR CANNED.
  • AVOID all raw fruit with skin, vegetables, nuts, popcorn, sweet pickles/relish for first 2 – 3 months.
  • RECORD all new foods and any problems you have with them in a food diary and let your doctor know of any problems or questions you may have.
  • CHEW your food very well before swallowing. The consistency of the food should be liked mashed potatoes. Make sure that each bite is very small (as if you were feeding a baby) and continue to eat small amounts slowly. Eat about 2 Tablespoons over 10-15 minutes.
  • CONTINUE to take your multiple vitamins, calcium supplements, iron and B12 supplement as directed.
  • AVOID beverages that have alcohol or caffeine and those that are carbonated.
  • REMEMBER, do NOT use a straw or chew gum!

We hope that this information proves useful to you. If you have any questions you are welcome to contact us at any time.

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