Dietary problems for gastric cancer patients – How to manage?

Dietary problems for gastric cancer patients. How to manage food intake after stomach cancer surgery ? What to eat and what not to eat for stomach cancer patients. A small guideline.

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There are but obvious dietary problems for gastric cancer patients. All tumors interfere with the intake and / or utilization of nutrients to varying degrees, causing malnutrition. The incidence of malnutrition varies among different tumors. According to statistics, the proportion of malnourished patients in gastric cancer accounts for 87%, and the incidence of cachexia is as high as 65% to 85%, which is higher than that of all other tumors. All occupy the first place in all tumors.


Five major causes of gastric cancer malnutrition

Gastric cancer is the tumor that has the most severe effect on nutrition among all tumors. The main causes of malnutrition in gastric cancer patients are:

Anorexia and depression-related anorexia caused by the disease itself reduce food intake.

② Difficult intake due to mechanical factors.

③ Absorption and digestive disorders caused by toxicity of chemotherapy drugs.

④ Combined with factors that increase catabolism, such as infection or surgical treatment.

⑤ Gastric surgery-specific effects: Of all gastrointestinal surgery, gastric surgery has the most complications, the greatest impact on nutrition and metabolism, and the longest duration. Patients who rarely see obesity and diabetes after gastric surgery are the best. prove. Among them, the metabolic changes and absorption disorders caused by gastrointestinal resection and diversion did not cause people to pay due attention, such as iron, calcium, vitamin A, vitamin B12, vitamin D absorption disorders and deficiency, such as fat, protein and Carbohydrate digestive disorders. The above five factors make malnutrition severe, frequent, long-lasting and complicated after gastric cancer surgery, so for most patients with gastric cancer surgery, the time for nutritional support should be extended.


Negative effects of gastric cancer malnutrition

As with all malnutrition, the negative effects of gastric cancer-related malnutrition are also reflected in the body and function. It reduces the efficacy of radiotherapy and chemotherapy, increases the risk of adverse drug reactions, reduces skeletal muscle mass and function, increases the chance of postoperative complications and nosocomial infections, prolongs the length of hospital stay, and increases the incidence of complications and mortality , Worsening the quality of life of patients and increasing medical costs. Malnutrition also limits the choice of treatment options for gastric cancer patients, making them have to choose some non-optimal or inappropriate treatment options. In short, malnutrition is closely related to poor prognosis.


Comprehensive diet guide for gastric cancer

1) After gastric cancer surgery, most of the stomach is cut off, and the volume of the residual stomach becomes smaller, which causes the patient’s digestive and absorptive functions to change. Good postoperative care and health guidance for gastric cancer can reduce symptoms. At 2 to 3 weeks after surgery, some patients may experience symptoms such as palpitation, sweating, dizziness, nausea, and discomfort in the upper abdomen after eating sweets. It usually resolves itself for 15 to 30 minutes. Sign. ” To prevent this, you should eat sweets, moderately digestible salty foods, and control the speed of eating. The diet should be quantitative and appropriate. It should be light and avoid irritating foods such as raw, cold, hard, spicy, and alcohol. Eat more vegetables and fruits, do not eat flatulence and fatty foods, it is best to lie down and rest for 15-20 minutes after eating.

2) The amount of eating should gradually adapt from small to large, from thin to thick. When eating, you should chew slowly to reduce the burden on your stomach. Eat less and eat more, usually 5 to 6 times a day. Each meal is about 50 g, and it gradually increases. After 6 to 8 months, 3 meals per day are restored, and each meal is about 100 g. After 1 year, it is close to the normal diet. Avoid eating too sweet food, rest 30 minutes after a meal before moving.

3) Due to the toxic and side effects of drugs during chemotherapy, patients’ appetite will be affected.The significance of dietary treatment and the importance of nutrition should be often advertised to patients, and patients should be instructed to eat high-protein, high-vitamin, easy-to-digest, less greasy food, and small meals . Do a good job of explaining before chemotherapy, strengthen dietary care, and give high-calorie, high-vitamin, high-protein, easy-to-digest liquid or semi-liquid foods, and small meals.

4) Usually guide patients to eat more fruits, vegetables, and drink plenty of water to maintain smooth stool, and observe whether there are black stools and blood stools, and go to the clinic or emergency department in time to find abnormalities.

5) If you have abdominal pain, acid reflux, belching or even nausea and vomiting, check them in time and treat them as soon as possible.

Postoperative dietary guidance for gastric cancer!

The principle of eating for patients with gastrointestinal tumors: small meals, regular meals, and nutrient-rich diets. Ensure energy supply and gradually transition to a balanced diet.

Avoid too cold or hot food. Fasting all irritating and crude fiber and gas-producing, fried foods. Limit simple sugars such as sucrose, sweet juice, etc. to prevent complications such as hypoglycemia or dumping syndrome after eating.

Stage 1: Fasting. The surgical trauma period is within 1 to 3 days after the operation, the anastomosis has not yet healed, and the gastrointestinal function is gradually recovering. Continuous gastrointestinal decompression is given before the gastrointestinal ventilation, which reduces the stimulation of gastric contents to the anastomosis, reduces gastric tension and prevents Anastomotic edema and anastomotic fistula. At this stage, the physiological needs of the body are maintained by supplying nutrients and water to the vein.

Stage 2: liquid diet. The postoperative trauma period has basically passed 4-10 days after the operation, and gastrointestinal function has begun to recover, showing that the anus is vented and has appetite. Stop gastrointestinal decompression, drink 20 ~ 30 ml of warm boiling water each time, 2 times a day. On the 4th day after surgery, give a clear liquid diet, rice soup 40 ml each time, 2 times / day; on the 5th day, rice soup 60 ~ 80 ml, 3 ~ 4 times / day; on the 6th day, rice soup and vegetable juice each time 80 ~ 100ml, 4-5 times / day; on the seventh day, give ordinary liquid diet, rice soup, vegetable juice, chicken soup, duck soup and fish soup, etc., 100200ml each time, 4-6 times / day. The above needs to be based on individual differences Increase the amount and meals as appropriate.

Stage 3: Semi-liquid diet. If there is no obvious discomfort in the above two stages, rice soup, rice flour, steamed egg custard, etc. can be given. Starting around the 10th day after surgery, the various drainage tubes indwelling in this patient have been basically removed, the amount of intravenous infusion gradually decreased, and the food intake gradually increased. Should eat a small number of meals, 57 meals a day, 150-200 ml each time, mainly digestible and less residue foods, such as rice porridge, noodles, noodles, barley, a small amount of puree, tofu brain, fish balls and so on. Some patients with large appetite can’t rush to achieve success. Don’t eat a lot to avoid anastomotic fistula.

Stage 4: Soft Food. Generally from the third week after the operation, the digestive function of most patients returned to normal, and various discomfort symptoms disappeared. Soft food is a soft, easy-to-chew and digestible, balanced diet with a variety of nutrients, such as soft rice, hair cakes, steamed buns, various stews, steamed, baked meats, soy products, dumplings, buns, various tender vegetables Etc., avoid vegetables containing more cellulose and fried foods.



Diet during gastric cancer chemotherapy

(1) Before and after chemotherapy

Patient performance characteristics: Appetite is basically normal, digestion and absorption are normal, no fever. This period is the best time for patients to supplement their nutrition. There is no chemotherapy response and normal diet. Good nutrition can enhance immunity and improve the body’s ability to resist adverse reactions to chemotherapy. In terms of diet arrangements, general food is the mainstay.

Principles: high calories, high protein, high vitamins; high iron (iron deficiency anemia) moderate amount of fat; three meals based, appropriate meals. Requirements: Dietary calories must be sufficient to maintain or gain weight. Protein is higher than ordinary people and should be derived from high-quality protein (meat, poultry, eggs) .Should eat more foods containing iron, folic acid, and vitamin C, such as Animal liver, meat, kidney, eggs, yeast and green leafy vegetables, bananas, tangerines, tangerines, oranges, pomelo, kiwi, fresh dates, prickly pears, etc .; diet is mainly light, less oil and high fat foods, avoid fried food. Eat more vegetables and fruits (about 500 grams of vegetables, 200 ~ 400 grams of fruits).

(2) Initial stage of chemotherapy

Patient performance characteristics: loss of appetite, oral ulcers, stomach burning, mild abdominal pain and diarrhea may occur. Although adverse reactions to chemotherapy have begun to appear, patients can still eat, and nutrition should be supplemented as much as possible. Diet can use semi-liquid food.

(3) Extreme stage of chemotherapy response

Patient performance characteristics: severe adverse reactions, nausea and vomiting, severe oral and peptic ulcers, severe abdominal pain, diarrhea, and even fever. Can no longer eat normally, even eating resistance. This stage is the nutrition maintenance stage. It only provides a small amount of calories and nutrition to protect the function of the gastrointestinal tract. If the response time exceeds 3 days, it should receive parenteral nutrition support. Liquid food is used in the diet arrangement.


Professional nutrition therapy

Cancer patients, for any reason, have reduced their food intake and cannot maintain normal nutritional requirements and healthy weight. They must receive professional nutritional support, including oral nutritional supplements and parenteral nutritional support.

Oral nutritional supplements are high-energy-density foods or enteral nutritional preparations that partially replace daily foods, or as supplements to insufficient daily diets to supplement the gap between daily dietary intake and target requirements. Small meals are recommended to reduce fluids. High energy density foods include peanut butter, dried fruit, cheese, yogurt, eggs, oatmeal, beans and avocado.

When daily intake and oral nutritional supplementation still cannot meet the needs of the body, it is recommended to receive supplementary parenteral nutrition support treatment to supplement the inadequate part of the daily diet and enteral nutrition with parenteral nutrition. Part of parenteral nutrition is of great significance to patients with advanced tumors who have severe toxic and side effects during radiotherapy and cannot eat normally.

Finally, regarding the nutritional support treatment of cancer, we recommend that you consult an authoritative oncology nutrition expert.



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