Dietary Guidelines - Post Nissen Pareesophageal Hernia

Thank you for the Minimally Invasive and Digestive Diseases Surgery Section at the Medical College of Georgia for your healthcare needs. This information is to help answer come common questions you may have about your operation and provide instructions to follow during your recovery period.

Following Nissen Fundoplication or Hiatal (Paraesophageal) Hernia Repair Surgery, you will need to follow a special diet for at least 6 weeks. The foods included in this diet will pass more easily through your esophagus, promote faster healing from surgery, and prevent possible complications.

You will leave the hospital on a full liquid diet and stay on this diet for 2 weeks from your surgery date. From 2 weeks to 4 weeks post surgery, you may have pureed or blenderized foods in addition to full liquids. 4 weeks to 6 weeks post surgery, you may add soft foods to your diet. Most patients can progress to a regular diet after 6-8 weeks, but the exact timeframe will depend on your individual tolerance and your surgeon's recommendations.

General Dietary Guidelines:

• Eat and drink slowly
• Chew food well
• Avoid gulping
• Do not drink with a straw
• Do not consume carbonated beverages (soda, beer, sparkling water, etc.)
• Do not chew gum
• Eat foods that are easy to digest (soft, moist foods)
• Avoid gas producing foods (beans, cabbage, onions, etc) as you transition to a regular diet
• Remain upright while eating
• Avoid laying down for at least 30 minutes after eating
• Eat smaller, more frequent meals and snacks rather than large meals

Liquid Diet Guidelines (first 2 weeks following surgery):

• Full liquids are pourable and include the following:
  • Juice (fruit and vegetable)
  • Broth or consomm
  • Jello
  • Popsicles and Italian ice
  • Milk
  • Yogurt (without fruit pieces)
  • Pudding
  • Ice cream (without candy pieces, nuts, or fruit chunks)
  • Milkshakes
  • Strained cream soups
  • Nutritional supplement drinks (Boost, Ensure, Carnation Instant Breakfast)

Pureed/Blenderized Diet Guidelines (weeks 3-4 following surgery):

• Pureed foods have a smooth texture. In addition to all foods on the full liquid diet you may add the following:
  • Blenderized meat
  • Blenderized vegetables
  • Applesauce and other pureed fruits
  • Mashed potatoes
  • Egg custard
  • Cream of wheat and other cooked cereals

Soft Diet Guidelines (weeks 5-6 following surgery):

• Foods included on a soft diet have a mushy texture and are easy to digest. The foods recommended on a soft diet are:

Food Group Recommended Foods

• Grains Well cooked pasta, noodles, moist rice, cooked cereal
• Vegetables Well cooked, soft vegetables
• Fruits Canned fruit, bananas, melon
• Dairy Milk, yogurt, soft cheeses, cottage cheese, ice cream, pudding, custard
• Protein Foods Moist meats with gravy, moist fish, soft cooked eggs, tofu
• Fats Butter, margarine, mayonnaise, salad dressing, cream
• Other Jello, Italian ice, popsicles, sherbert, sorbet
• Beverages Fruit and vegetable juice, non-carbonated soft drinks

Foods not recommended on a soft diet include:

Food Group Foods to Avoid

• Grains Bread, dry cereal, crackers, chips, popcorn

• Vegetables Raw vegetables, corn

• Fruits Dried fruit, fresh fruit with skins

• Dairy Ice cream with nuts, candy pieces or fruit chunks

• Protein Foods Nuts and seeds, peanut butter, dry meats

• Fats Crispy fried foods

• Other Candy, cookies, crusts, dry cakes and pastries
• Beverages Carbonated drinks, caffeinated drinks, alcohol

Example Soft Diet Menu:*

Meal Foods and amount

• Breakfast
  2 eggs, scrambled
  .5 cup oatmeal with milk
  .5 cup fruit juice
• Snack
  8 oz vanilla yogurt
  1 banana, mashed
• Lunch
  1 cup macaroni and cheese
  .5 cup cooked peas
  .5 cup vegetable juice
• Dinner
  4 oz moist cooked salmon
  .5 cup mashed potatoes with gravy
  .5 cup cooked green beans
• Snack
  .5 cup cottage cheese
  .5 cup canned peaches

* include additional non-carbonated, caffeine free beverages of choice with meals