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Stomach Cancer: Symptoms, Causes, Treatment
Stomach cancer is a change in the type of epithelium cells, lining the surface of the stomach. Most often, the tumor is due to the damage to the walls by the microorganisms of Helocobacter Pylori. To other reasons for the occurrence of the disease:
Clinical signs of stomach cancer:
The most common diagnostic method is gastroendoscopy with the taking of biological material, it can be held any oncological center. A patient survey is also conducted, ultrasound diagnostics, histology and cytology tests, laparoscopy, oncomarkers. Treatment depends on the stage of the disease, mainly the surgical removal of the affected area (resection of an endoscopic or strip operation), complemented by chemotherapy. After resection of the stomach, the patient can lead a normal lifestyle, subject to regular preventive inspections and compliance with the recommendations of nutritionists. If the body is completely removed, the infinity of the stomach begins to perform the delicate intestine.
First stage. The first two days are active therapy, the patient is powered by intravenous administration of solutions. Parenteral nutrition is appointed by a specialist, taking into account individual characteristics. If the doctor does not find a stagnant phenomena after the examination, it is possible to start giving a sick blade of rosehip, sweetened compote and tea. In a day or two, they begin to give mucous soups, puree from meat and fish. From the 6th day, rubbed vegetable purees and porridges (up to 50g on portions). Gradually, the amount of food can be increased to 300g.
Second phase. Duration of diet after surgery on the stomach oncology - at least 4 months. If there are complications during this time or the inflammatory process has not decreased, the diet remains for a long time. This is a complete diet that contains enough proteins, fats and carbohydrates, but mechanical and chemical irritants are completely excluded.
Tips on dietary nutrition:
During the rehabilitation period, the following products are allowed:
The resection of the stomach or its part in a number of cases is the only possible method of treating and preserving the patient's life. The operation on the stomach is a radical method of treating extensive malignant neoplasms ( cancer stomach ), not amenable to conservative treatment, polyps, gastric bleeding. Despite the progress of medicine, the removal of the stomach remains one of the most severe surgical operations and even with its successful conduct and the absence of pronounced complications, rehabilitation takes a long period of time, and the power after the operation on the stomach is the most important component of this process.
Parenteral nutrition after resection of the stomach starts with appointed sequentially Diet No. 0A. , 0b , 0V. ( , 1V. Surgical). Their targeted appointment is to provide the body with a minimum amount of basic nutrients, unloading and spares of the stomach, the prevention of the bowl of the intestine and. The diet contains easily digestible products containing full-fledged proteins, fats, carbohydrates, vitamins and macro / trace elements and an increased amount of free fluid. The use of salt is dramatically limited.
In the first postoperative day, the patient is shown hunger; For 2 days - the diet includes 250 ml of warm sweet tea and infusion of rosehip (50 ml), which are given after 15-20 minutes along a teaspoon; for 4-5 days in the absence of bloating and normal peristalsis, prescribe Diet number 0a and 2 eggs sick; By 6-8 days Diet number 0B. ; for 9-11 days - Diet number 0V. .
The duration of each of the surgical diets is 2-4 days, but, if necessary, the timing of them can be lengthened or declined. That is, approximately, after 9-12 days, the surgical diet after the operation ends, and the patient is translated into a standard singer (rubbed version), in which the amount of food used in one reception is limited: no more than 250 g of the first fiber dish or a glass of liquid ( 250 g), and at lunch - only two dishes. Eating fractional food, 5-6 times a day.
The diet contains an increased amount of protein (100-110 g), which uses boiled crushed meat dishes, boiled fish, fresh rubbed / calcined cottage cheese, omelets from egg proteins. The amount of fats in the diet at the level of physiological norms or several times higher (80-90 g). If the patient poorly transfers fats (and in its pure form too), which is manifested by bitterness in the mouth, shinking, diarrhea, their number is limited to 60-70 g. The content of carbohydrates is reduced to 300-320 g due to easily digestible carbohydrates.
In some cases, in particular when dumping syndrome , manifest, weakness, heartbeat , chills, feeling of heat, stomach pain and his bloating, which appear after meals, it is necessary to completely eliminate products containing sugar, since the use of accessible carbohydrates is one of the reasons for its appearance.
To slow down the evacuation of food from the stomach cult, it is recommended to use viscous and jelly-like dishes. You can practice separate meals with dense and liquid consistency, starting with dense, as well as power in the lying position. Eating with uniform small portions 6-7 times a day. After a meal, you must lie / head off in bed 30-40 minutes. You can also practice before taking carbohydrate food use of butter, which inhibits the removal of food from the gastric. With poor tolerance of whole milk, it is excluded from the diet and replace with other products.
From the diet of meat, mushrooms and fish, fatty red meat and fish, some species of birds (duck, goose) and products based on them (sausages, canned food, ham, smoked, fried dishes, products from the dough , Fresh bread, sharp snacks, salted fish and vegetables, solid fats, not rubbed raw vegetables and fruits.
With good patient's health, after 3-4 months after surgery, it is gradually translated on the wrong version Diet number 1. . The diet is physiologically full, contains an increased amount of proteins and the almost normal amount of fats and complex carbohydrates. The limitation relates to simple carbohydrates, in order to prevent the development of dumping syndrome. Culinary methods of product processing are preserved: products boil or prepare for a pair, and after boiling - baked or extinguished. For a set of products, the diet of this diet is more extensive, but the rules and limitations are the former.
The use of low-fat meat soups, boil, soup (once a week), dried wheat bread, low-fat varieties of fish and beef, dishes from chicken, non-adhesive cookies. The use of vegetables in boiled and raw form, garden greenery, dairy products, buckwheat and rice-based dishes, potatoes, non-frosted non-fat cheese, dietetic varieties of sausages, fresh fruits and berries.
In the absence of complications and satisfactory function of the gastrointestinal tract, 6 months after the operation, the patient can go to normal nutrition, but taking into account the power mode and the characteristics of the chemical composition of the diet. Independent correction of food set in the diet, taking into account individually intolerable products. With the pronounced loss of body weight (10-15%) after resection of the stomach, especially about cancer, the caloric content of the daily diet should be increased compared with the physiological norm by increasing the content of the main nutrients recommended for the diet.
When such complications appear as inflammation of an anastomosis or a stomach cult, occurrence peptic ulcers Prescribe the variant of the wipe Diet number 1. , and with exacerbation - consistently No. 1A. and 1B With the changes in their changes taking into account the intolerance to certain products. In general, the nutrition of patients in diseases of the operated stomach must be individualized.
In the food after the operation on the stomach, it is advisable to include specially designed dietary nutritional mixtures - " Nutrison », « Nutridrink », « Berlamin modular ", To be administered in small portions, can be diluted with water, with a constant assessment of their tolerability.
Diet food must necessarily include receiving tablets of a vitamin and mineral complex, drugs that normalize the motor-evacuation function of various sections of the tract and preparations containing enzymes to improve digestive processes ( Creon , Mezim-Forte ). The full rehabilitation of patients long and usually occurs by the end of the first year after surgery.
Recreation of the stomach and complications of the operated stomach.
Diet after resection of the stomach when translating the patient on Diet number 1 (BUT , B. ) Includes mucous baking soups from rice, buckwheat, oatmeal with adding butter, low-fat cream or egg-milk mixture, cream. For second dishes, low-fat types of red meat (veal, beef), chicken or turkey meat are well boiled and passed through a meat grinder.
Dishes from white fish (cod, pollock, pike, heck) are allowed in the form of steamed or boiled. Cereal dishes are prepared on milk / water in the form of liquid porridge from buckwheat, oatmeal, rice croup, in which the butter is added.
With good tolerance in the diet, milk and dishes based on it, low-fat cream, cottage cheese calcined, dairy cheese, chicken eggs in the form of a steam omelet or welded scholars.
From fat, preference is given to the creamy and vegetable oils, added immediately before use in the finished dish. Useful cookies and jelly from sweet berries. From beverages - juices from fresh berries, fastening tea with cream, infusion of rosehip.
Proteins, G. | Fats, G. | Carbohydrates, G. | Calories, Kcal | |
buckwheat (keris) | 12,6 | 3,3 | 62,1 | 313 |
oat flakes | 11,9 | 7,2 | 69,3 | 366 |
rice white | 6,7 | 0,7 | 78,9 | 344 |
white bread crags | 11,2 | 1,4 | 72,2 | 331 |
sugar | 0,0 | 0,0 | 99,7 | 398 |
milk | 3,2 | 3,6 | 4,8 | 64 |
cream | 2,8 | 20,0 | 3,7 | 205 |
cottage cheese | 17,2 | 5,0 | 1,8 | 121 |
beef boiled | 25,8 | 16,8 | 0,0 | 254 |
veal boiled | 30,7 | 0,9 | 0,0 | 131 |
rabbit | 21,0 | 8,0 | 0,0 | 156 |
clawed chicken | 25,2 | 7,4 | 0,0 | 170 |
turkey | 19,2 | 0,7 | 0,0 | 84 |
chicken eggs | 12,7 | 10,9 | 0,7 | 157 |
butter | 0,5 | 82,5 | 0,8 | 748 |
mineral water | 0,0 | 0,0 | 0,0 | - |
black tea with milk and sugar | 0,7 | 0,8 | 8,2 | 43 |
the juice | 0,3 | 0,1 | 9,2 | 40 |
kissel | 0,2 | 0,0 | 16,7 | 68 |
shipovniki juice | 0,1 | 0,0 | 17,6 | 70 |
In the diet of the patient after surgery on the stomach, bakery and pastry products are excluded, fresh bread, pastries, products from any type of dough. Meat or Fish-based Bouilloms are not allowed, meat and fish dishes, as well as products based on them (canned food, sausages, smoked, solid animals and culinary fats, fried dishes, pickles, mushrooms, various snacks, vegetables and Fruits in raw form, bold cottage cheese, cheese, sour cream, fermented milk products.
It is impossible to include various sauces and seasonings, spices in the diet. It is prohibited to use drinks with gas, strong tea, coffee, concentrated vegetable and fruit juices, any alcohol beverages.
Proteins, G. | Fats, G. | Carbohydrates, G. | Calories, Kcal | |
Vegetables and greens |
||||
vegetables | 2,5 | 0,3 | 7,0 | 35 |
vegetables legumes | 9,1 | 1,6 | 27,0 | 168 |
swede | 1,2 | 0,1 | 7,7 | 37 |
cabbage | 1,8 | 0,1 | 4,7 | 27 |
green onion | 1,3 | 0,0 | 4,6 | 19 |
bulb onions | 1,4 | 0,0 | 10,4 | 41 |
radish white | 1,4 | 0,0 | 4,1 | 21 |
horseradish | 3,2 | 0,4 | 10,5 | 56 |
spinach | 2,9 | 0,3 | 2,0 | 22 |
sorrel | 1,5 | 0,3 | 2,9 | 19 |
Mushrooms |
||||
mushrooms | 3,5 | 2,0 | 2,5 | 30 |
Cruises and porridge |
||||
corn grits | 8,3 | 1,2 | 75,0 | 337 |
pearl barley | 9,3 | 1,1 | 73,7 | 320 |
millet camp | 11,5 | 3,3 | 69,3 | 348 |
barley grits | 10,4 | 1,3 | 66,3 | 324 |
Flour and pasta |
||||
pasta | 10,4 | 1,1 | 69,7 | 337 |
Bakery products |
||||
bagels | 16,0 | 1,0 | 70,0 | 336 |
wheat bread | 8,1 | 1,0 | 48,8 | 242 |
Confectionery |
||||
jam | 0,3 | 0,2 | 63,0 | 263 |
candy | 4,3 | 19,8 | 67,5 | 453 |
confectionarian cream | 0,2 | 26,0 | 16,5 | 300 |
Ice cream |
||||
ice cream | 3,7 | 6,9 | 22,1 | 189 |
Cakes |
||||
cake | 4,4 | 23,4 | 45,2 | 407 |
Chocolate |
||||
chocolate | 5,4 | 35,3 | 56,5 | 544 |
Raw materials and seasonings |
||||
mustard | 5,7 | 6,4 | 22,0 | 162 |
ginger | 1,8 | 0,8 | 15,8 | 80 |
ketchup | 1,8 | 1,0 | 22,2 | 93 |
mayonnaise | 2,4 | 67,0 | 3,9 | 627 |
pepper black hammer | 10,4 | 3,3 | 38,7 | 251 |
chilli | 2,0 | 0,2 | 9,5 | 40 |
Milk products |
||||
sour cream | 2,8 | 20,0 | 3,2 | 206 |
Meat products |
||||
pork | 16,0 | 21,6 | 0,0 | 259 |
fat | 2,4 | 89,0 | 0,0 | 797 |
Sausages |
||||
sausage with / dried | 24,1 | 38,3 | 1,0 | 455 |
sausages | 12,3 | 25,3 | 0,0 | 277 |
Bird |
||||
smoked chicken | 27,5 | 8,2 | 0,0 | 184 |
duck | 16,5 | 61,2 | 0,0 | 346 |
duck smoked | 19,0 | 28,4 | 0,0 | 337 |
goose | 16,1 | 33,3 | 0,0 | 364 |
Fish and seafood |
||||
fish dried | 17,5 | 4,6 | 0,0 | 139 |
fish smoked | 26,8 | 9,9 | 0,0 | 196 |
canned fish | 17,5 | 2,0 | 0,0 | 88 |
Oils and fats |
||||
margarine creamy | 0,5 | 82,0 | 0,0 | 745 |
fat animal | 0,0 | 99,7 | 0,0 | 897 |
fat culinary | 0,0 | 99,7 | 0,0 | 897 |
Alcoholic beverages |
||||
wine white dessert 16% | 0,5 | 0,0 | 16,0 | 153 |
vodka | 0,0 | 0,0 | 0,1 | 235 |
cognac | 0,0 | 0,0 | 0,1 | 239 |
beer | 0,3 | 0,0 | 4,6 | 42 |
Non-alcoholic beverages |
||||
cola | 0,0 | 0,0 | 10,4 | 42 |
sprite | 0,1 | 0,0 | 7,0 | 29 |
tonic | 0,0 | 0,0 | 8,3 | 34 |
black tea | 20,0 | 5,1 | 6,9 | 152 |
energy drink | 0,0 | 0,0 | 11,3 | 45 |
* Data indicated on 100 g of product
The menu week after the resection of the stomach should provide alternation of various protein and cereal dishes in order to prevent its monotony, with strict observance of the allowed methods of culinary processing of products and, most importantly, compliance with the volume of portions. It must be remembered that meat / fish dishes are allowed to be used in the form of a puree or souffle 1 time per day. With the intolerance of milk, it must be replaced by other products or use small portions, as well as in diluted form with fastening tea.
Dietary food after resection of the stomach plays an important role in the process of restoring the body. In the postoperative period, the patient will have to completely change its food habits. The diet must necessarily be balanced, because the resection of the stomach often provokes a sharp weight loss, which is undesirable, as it is an additional stress for the diseased organism.
After Gastrectomy in the rehabilitation period, it is important to eat correctly so that further recovery takes place without complications. The postoperative diet is aimed at rapid healing of the remaining part of the stomach, because during this period the usual food may worsen the state. The approximate menu, permitted products and recipes for cooking dishes are necessarily approved by a gastroenterologist. After gastrectomy, the patient is hard to recover, and it quickly loses weight in weight. Therefore, another goal that the diet pursues after removing the stomach is not to bring the patient to exhaustion and maintain its weight within the normal range.
After resection of the stomach during cancer or any other severe pathology, the anatomy of the digestion organ changes, respectively, the conditions in which the food will be normally digested. Recoveful meals After removing part of the organ allows the body to gradually adapt to new conditions, due to which the risk of dangerous complications is minimized.
In the first 2-3 days after surgical intervention, regardless of the testimony and forces of pathology, it is prohibited any food. Sometimes restrictions are superimposed on the water, but here everything solves the doctor. When the risk of early postoperative complications passes and in the absence of contraindications, it is possible to start taking fluid in the form of vegetable broth, jelly. Then, the diet is added to the puree state of food, kefir, curd soufflé.
A week later, new dishes are added. A person is recommended to feed potato mashed potatoes, boiled or steam meat dishes, half-overly overcooked vegetable soups. Also allowed fresh juices, some crackers or dryers, dried bread. With a remote stomach, food is prepared by a gentle method, without the use of salt, spices and seasonings.
After 3 months, the nutrition after the operation on the stomach expands. You can eat half the flow of food, but each piece is important to chew carefully, in addition, special attention is paid to the use of fluid, which favorably affects digestion. After 6 months, you can eat most of the usual products and dishes, but it is worth sticking to the rules of separate food and try not to mix different foods.
Despite some restrictions in nutrition, after surgery, patients will not starve, because the dietary table contains a lot of delicious and useful food, but the method of its preparation is different from the usual. It is useful to eat more fractionally, 4-6 times a day, while the break between the trapes should not exceed 3-3.5 hours. Dishes are prepared for a couple or boiled. Fry on the oil or add to the finished food is strictly prohibited.
To accelerate the restoration of the stomach after surgical treatment, in addition to the diet, the doctor may advise to consume natural dietary supplements. The reception scheme is necessarily determined by the gastroenterologist. It is dangerous to use such additives.
The diet after resection of the stomach during oncology or ulcerative lesion will be strict, but the list of allowed products is not scant, so the person will not starve. In the menu, such food must be present:
In potato mashed potatoes, it is allowed to add butter - about 10 g, and also useful in the morning to eat a sandwich with butter and cheese. As a dessert, you can cook cottage cheesecakes or bake sweet fruit - an apple, a pear. Porridge is boiled only on the water, if you wish, you can add some milk, butter in the finished dish. As beverages, it is recommended to use green tea with milk, compotes from dried fruits, herbal decoctions and chamomile infants, hunter, mint, rosehip fruits.
The basic principles of the diet after resection of the stomach and ending the course of intravenous food can be formulated by three words: "less", "smaller" and "more often". That is, the portion must be minimal, thoroughly rub, the number of such portions per day increases at least up to six. Only after two or three months can be moved to an unzoped nutrition, which must still be gentle.
Resection - surgical removal of part of the stomach They are produced under ulcerative disease, which has not succumbed to therapeutic treatment, with punching ulcers, with long-term gastrointestinal bleeding, pronounced stenosis of the gatekeeper and the other. Nutrition immediately after resection of the stomach is carried out in the hospital (first intravenous) and therefore is not given here.
After about 7-10 days, the patient is transferred to the gentle wipe nutrition:
1. At the same time, limit the amount of food eaten by one reception: no more than 250 grams of soup or 1 cup of liquid, only 2 dishes at lunch.
2. Communicable frequent, not less than 5-6 times a day, meals.
3. In the diet of therapeutic food after resection of the stomach, up to 90-100 grams of content increase and limit up to 300-350 grams. Number of easily-friendly (sugar, jam, sweet drinks, honey).
4. In some cases, it is necessary to completely eliminate sugar products and dishes (you can use sugar substitutes).
What can be eaten after resection of the stomach as a source of protein? For this purpose, dishes made of boiled crushed meat, boiled fish, omelets made of eggs, fresh rubbed or calcined cottage cheese. With poor tolerance of fats (tightening, bitterness in the mouth, diarrhea), especially in its pure form, they are limited to 60-70 grams per day. In case of intolerance of whole milk in a diet after surgery for resection of the stomach, it is replaced with fermented with fermented milk products or used in dishes.
It is necessary to include drugs containing polyvitamins, iron and other minerals in the diet.
From food after surgery on the stomach resection, exclude:meat, fish and mushroom broths, fatty varieties of meat, birds and fish; Products from a juice and puff pastry, very fresh bread, all fried dishes, smoked meals, canned food (except canned food and diet food), salt fish and vegetables, sharp snacks, raw non-trap vegetables and fruits.
After 2-4 months after surgery, with good health, it is possible to gradually move on non-gentle gentle nutrition, that is, without mechanical gentry.
5-6 months after the operation, sometimes earlier, with a satisfactory function of the gastrointestinal tract, a transition to normal nutrition is possible, taking into account the marked features of the composition of the diet and power mode. At the same time, self-control of nutrition is extremely important, that is, the definition of those products and dishes that are good or poorly transferred.
After resection of the stomach, a complication is possible, accompanied by a deterioration in digestion and absorption of food, metabolic disorders, disorders of cardiovascular and nervous systems, called dumping syndrome, or simply dumping (from English. Demping- "dropping", "emission").
Dumping is due to the rapid transition from the stomach cult in the small intestine, which causes: Weakness, sweating, dizziness, heartbeat, feeling of heat, chills, less fainting, abdominal pain and his bloating, rumbling, diarrhea, belching.
Most often, dumping occurs after eating foods containing sugar products, honey, sweet drinks, ice cream, as well as fresh flour products, potatoes, bananas, milk, cottage cheese, greasy hot soups. Cold and hot food and its large amount for 1 reception often provoke dumping.
Therefore, strict records of all intolerable dishes and individual selection of the menu are important.
At the same time, food for patients who suffered resection of the stomach should not significantly limit the amount of food consumed, as it leads to depletion, hypovitaminosis, anemia and other violations.
To prevent dumping postoperative meals after resection of the stomach must be gentle, with an increased protein content of up to 110-120 grams (men), 100-110 grams (women), limiting carbohydrates 350 and 300 grams, respectively, mainly due to sugar (no more than 30 Grams up to complete exception) and bakery products from wheat flour of the 1st and highest grade.
Along with the diet, it is advisable to use medicines that normalize the motor function of the upper digestive tract, as well as enzyme preparations (festal, Digestal, Creon, Mezim) to improve digestion processes.
Be sure to supplement the diet with polyvitaminnomineral drugs.
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Faced with such an operation as precision of the stomach (this is such an operation at which part of the stomach is removed)?! Now, in order to restore the operation of the gastrointestinal tract, it is necessary to comply with all the prescriptions of the doctors, customize your thoughts only on good, and most importantly, special attention to pay a balanced and full-fledged diet.
To products that stand limit after resection of the stomach, relate: sweets, Jam, Honey, Kisl, Whole milk, cocoa and coffee.
But the list of products you need eliminate. These products include: pork, lamb, fatty, bold duck, goose, all fats, except vegetable and butter, sharp dishes, carbonated drinks, pies, pancakes, pancakes, chebureks, donuts and other fried dishes, and other flour Products. It is also necessary to eliminate cold dishes, such as ice cream.
First breakfast . Hercules porridge with small pieces of apples cooked on the water. Apple juice.
Lunch . Berry jelly cooked from sweet fruit. Rho rosehip.
Dinner. Buckwheat soup cooked on vegetable broth (potatoes, carrots, onions). Boiled potatoes with vegetable oil and made from lean beef meat meat steamed. Dried fruits compote.
Afternooner. Cottage cheese with sour cream and pieces of fruit.
Dinner . Boiled chicken meat. Tomato juice.
Thus, using the above products, which are recommended to use to use after resection of the stomach, you can make an approximate menu.
Attention! Be sure to agree on the Menu with the attending physician. And on such questions, such as you can eat cookies after resection of the stomach or whether the caviar is admitted during resection of the stomach, it can be replied that it all depends on the patient's condition of the surveillance operation available in the presence of complications, as well as the physiology of the patient himself.
If, in addition to resection of the stomach, the patient has no other complaints about health, in this case, it can eat unsweetened cookies, like a "crocket", only operated in water or in warm tea. And, with regard to caviar, herring and other salted fish, the amount of salt, after resection of the stomach, it will be necessary to minimize. Icra and herring can be eaten, but, it is desirable, as seafood of cooked pair or as an independent boiled dish.
If you have after resection of the stomach, complications began to be observed, and the doctors diagnosed dumping syndrome, in which case, the regime and therapeutic food will help to cope with this disease. It is very important to remember that it is necessary to eat during dumping syndrome and small portions, and after meals you can lie or relax in the chair.
And the last! If the doctors have appointed you resection of the stomach, do not delay for later, you should also not resort to the "grandmother" methods and hope for perha. And those who decided to have a similar surgery, not necessarily go abroad. Many good qualified specialists are located with us. For example, resection of the stomach in Minsk, where highly qualified specialists work, practically, always passes well and without any complications. But, in any case, you can only solve you. Good luck!
With you was Lyudmila D.