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Diet After Nissen Fundoplication Surgery for GERD

This diet and sample menu is for people who have recently had Nissen fundoplication surgery to correct GERD — short for gastroesophageal (GAS-trow-ee-soff-uh-GEE-ol) reflux disease — or to repair various types of hernias, such as hiatal hernia and intrathoracic stomach.

This diet may also be useful after other gastrointestinal (GI) surgeries, such as Heller myotomy and achalasia repair.

After Nissen fundoplication surgery, your surgeon will slowly advance your diet through the following stages:

  1. A clear liquid diet, generally for the first few meals.
  2. A full liquid diet for a meal or two.
  3. And, eventually a Nissen soft diet.

Please note: Because each person’s tolerance to food is unique, your doctor will advance your diet depending on how well you progress after surgery.

The diet will help control issues that may occur after GI surgery, such as:

  • Diarrhea
  • Excess gas
  • Swallowing problems

Clear Liquid Diet After Nissen Fundoplication Surgery

The first diet after Nissen fundoplication surgery includes the following clear liquids:

  • Apple juice
  • Cranberry juice
  • Grape juice
  • Chicken and beef broth
  • Flavored gelatin (Jell-O®)
  • Decaf tea and coffee
  • Caffeinated beverages (based on tolerance)
  • Popsicles
  • Italian ice

Note: You’ll need to avoid carbonated drinks (sodas) for the first six to eight weeks after surgery. After this time, you can try them again in small amounts.

Full Liquid Diet After Nissen Fundoplication Surgery

The full liquid diet contains anything on the clear liquid diet, plus:

  • Milk, soy, rice, and almond (no chocolate)
  • Cream of wheat, cream of rice, grits
  • Strained creamed soups (no tomato or broccoli)
  • Blended, custard style, or whipped yogurt (plain or vanilla only)
  • Vanilla and strawberry-flavored ice cream
  • Sherbet
  • Vanilla and butterscotch pudding (no chocolate or coconut)
  • Nutritional drinks including Ensure®, Boost®, Carnation Instant Breakfast® (no chocolate-flavored)

Note: Dairy products — such as milk, ice cream, and pudding — may cause diarrhea in some people just after GI surgery. You may need to avoid milk products. If so, substitute them with lactose-free beverages such as soy, rice, Lactaid®, or almond milks.

Nissen Soft Diet Tips and Foods to Choose

Tips for keeping your stomach from stretching and avoiding gas after GI surgery

  • Eat small, frequent meals (six to eight per day). This will help you consume the majority of the nutrients you need without causing your stomach to feel full or distended.
  • Eat very slowly. Take small bites and chew your food well to help aid in swallowing and digestion.
  • Sit upright while eating and stay upright for 30 minutes after each meal. Gravity can help food move through your digestive tract. Do not lie down after eating. Sit upright for 2 hours after your last meal or snack of the day.
  • Avoid sticky, gummy foods such as bananas. These types of foods can be hard to swallow.
  • Eat desserts and sweets at the end of your meal to avoid “dumping syndrome.” This describes the rapid emptying of foods from the stomach to the small intestine. Sweets move more rapidly and dump quickly into the intestines. This can cause symptoms of nausea, weakness, cold sweats, cramps, diarrhea, and dizzy spells.
  • Drinking large amounts of fluids with meals can stretch your stomach. You may drink fluids between meals as often as you like, but limit fluids to 1/2 cup (4 fluid ounces) with meals and one cup (8 fluid ounces) with snacks.
  • Avoid drinking through a straw and chewing gum or tobacco. These actions cause you to swallow air, which produces excess gas in your stomach. Chew with your mouth closed.
  • Avoid any foods that cause stomach gas and distention. These include many raw vegetables, dried beans and peas, and any food from the cabbage family.

Nissen diet — drinks and foods to choose and avoid

Food Category Choose Avoid
Beverages
  • Milk, such as whole, 2%, 1%, non-fat, or skim, soy, rice, almond.
  • Caffeinated and decaf tea and coffee.
  • Powdered drink mixes (in moderation).
  • Non-citrus juices (apple, grape, cranberry, or blends of these).
  • Fruit nectars.
  • Nutritional drinks including Boost®, Ensure®, Carnation Instant Breakfast®.
  • Chocolate milk, cocoa, or other chocolate-flavored drinks.
  • Carbonated drinks.
  • Alcohol.
  • Citrus juices like orange, grapefruit, lemon, and lime.
Breads
  • Toasted bread.
  • Pancakes, French toast, and waffles.
  • Crackers (saltine, butter, soda, graham, Goldfish® and Cheese Nips®).
  • Untoasted bread, bagels, Kaiser and hard rolls, English muffins.
  • Crusty breads.
  • Fresh, doughy breads such as sweet rolls, coffee cake, and doughnuts.
  • Crackers with nuts, seeds, fresh or dried fruit, coconut, or highly seasoned (garlic or onion-flavored).
Cereals
  • Well-cooked cereals such as oatmeal (plain or flavored).
  • Cold cereal (Cornflakes®, Rice Krispies®, Cheerios®, Special K® plain, Rice Chex® and puffed rice).
  • Very coarse cereal such as bran or shredded wheat.
  • Any cereal with fresh or dried fruit, coconut, seeds, or nuts.
Potatoes and Starches
  • Peeled, mashed, or boiled white or sweet potatoes.
  • Oven-baked potatoes without skin.
  • Well-cooked white rice, enriched noodles, barley, spaghetti, macaroni, and other pastas.
  • Fried potatoes, potato skins, and potato chips.
  • Hard and soft taco shells.
  • Fried, brown, or wild rice.
Eggs
  • Poached, hard-boiled, or scrambled.
  • Fried and highly seasoned eggs (deviled eggs).
Vegetables
  • Well-cooked soft vegetables without seeds or skins (asparagus tips, beets, carrots, green and wax beans, chopped spinach, tender canned baby peas, squash, pumpkin).
  • Raw vegetables.
  • Gas producing vegetables (broccoli, Brussel sprouts, cabbage, cauliflower, onions, corn, cucumber, green peppers, rutabagas, turnips, radishes, sauerkraut).
  • Tomatoes, tomato juice, tomato sauce, andV-8® juice.
  • Dried beans, peas, and lentils.
Fruits
  • Fruit juice.
  • Any canned or cooked fruit except those to avoid.
  • All fresh fruits such as citrus, bananas, and pineapple.
  • Canned pineapple.
  • Dried fruits such as raisins and berries.
  • Fruits with seeds such as berries, kiwi, and figs.
Meat, Fish, Poultry, and Dairy Products: Eat ground, minced, or chopped meats to ease swallowing and digestion.
  • Tender, well-cooked, moist cuts of beef, chicken, turkey, and pork.
  • Veal and lamb.
  • Flaky, cooked fish.
  • Canned tuna.
  • Cottage and ricotta cheeses.
  • Mild cheeses such as American, brick, mozzarella and baby Swiss.
  • Creamy peanut butter.
  • Plain custard or blended fruit yogurt.
  • Moist casseroles such as macaroni and cheese, tuna noodle.
  • Grilled or toasted cheese sandwich.
  • Tough meats with a lot of gristle.
  • Fried, highly seasoned, smoked and fatty meat, fish, or poultry (frankfurters, luncheon meats, sausage, bacon, spare ribs, beef brisket, sardines, anchovies, duck, and goose).
  • Chili and other entrees made with pepper or chili pepper.
  • Shellfish.
  • Strongly flavored cheeses such as sharp and extra sharp cheddar and cheese containing peppers or other seasonings.
  • Crunchy peanut butter.
  • Yogurt with nuts, seeds, coconut, strawberries, or raspberries.
Soups
  • Mildly flavored meat stocks.
  • Cream soups made from allowed foods.
  • Highly seasoned and tomato-based soups.
  • Cream soups made with gas producing vegetables such as broccoli, cauliflower, onion, etc.
Fats: Eat in moderation.
  • Butter and margarine.
  • Mayonnaise and vegetable oils.
  • Mildly seasoned cream sauces and gravies.
  • Plain cream cheese.
  • Sour cream.
  • Highly seasoned salad dressings, cream sauces, and gravies.
  • Bacon, bacon fat.
  • Ham fat, lard, salt pork.
  • Fried foods.
  • Nuts.
Desserts: Eat in moderation. Do not eat desserts or sweets by themselves.
  • Plain cakes, cookies, and cream-filled pies.
  • Vanilla and butterscotch pudding or custard.
  • Ice cream, ice milk, frozen yogurt, and sherbet.
  • Gelatin made from allowed foods.
  • Fruit ices and popsicles.
  • Desserts containing chocolate, coconut, nuts, seeds, fresh or dried fruit, peppermint, or spearmint.
Sweets and Snacks: Use in moderation. Do not eat large amounts of sweets by themselves.
  • Syrup, honey, jelly, and seedless jam.
  • Molasses.
  • Plain hard candies and other candy made from allowed ingredients.
  • Marshmallows.
  • Thin pretzels.
  • Jam, marmalade, and preserves.
  • Chocolate in any form.
  • Any candy containing nuts, coconut, seeds, peppermint, spearmint, or dried or fresh fruit.
  • Popcorn, potato chips, tortilla chips.
  • Soft or hard thick pretzels such as sourdough.
Miscellaneous
  • Salt and spices in moderation.
  • Mustard and vinegar in moderation.
  • Fried or highly seasoned foods.
  • Coconut and seeds.
  • Pickles and olives.
  • Chili sauces, ketchup, barbecue sauce, horseradish, black pepper, chili powder, and onion and garlic seasonings.
  • Any other food or strongly flavored seasoning, condiment, spice, or herb that you can’t tolerate.

Sample Menu for the Nissen Diet

Please note: You will need extra fluids throughout the day to meet your fluid needs.

Breakfast
  • ½ cup canned fruit (non-citrus)
  • ½ to ¾ cup cereal
  • 1 small pancake
  • 1 teaspoon margarine
  • 1 teaspoon jelly
  • ½ cup 2% milk
  • 1 teaspoon sugar
Mid-Morning Snack
  • 2 graham crackers
  • 1 tablespoon creamy peanut butter
  • 1 teaspoon jelly
  • 1 cup tea
Lunch
  • ½ cup tuna salad (no raw vegetables)
  • 3 to 4 saltine crackers
  • ½ cup canned peaches
  • ½ cup fruit juice (non-citrus)
  • 1 teaspoon mayonnaise
Mid-Afternoon Snack
  • 4 saltine crackers
  • 1 tablespoon cream cheese
  • 1 cup 2% milk
Dinner
  • 3 oz. roasted chicken (finely ground) with sauce
  • ½ cup cooked white rice
  • ¼ cup cooked carrots
  • ½ cup canned pears
  • 1 teaspoon margarine
  • ½ cup tea
  • 1 teaspoon sugar
Evening Snack
  • ¼ cup cottage cheese
  • ½ cup applesauce
  • ½ cup 2% milk