HF 368

Modified Diet: Diet After Esophagectomy

After surgery you will need to follow a strict diet because all or part of the esophagus is removed. Your diet will slowly change as you heal. The diet is to help make you more comfortable as you to eat.

The stomach is made into a tube and is pulled up into the chest to replace the part of the esophagus that was removed. The new tube-shaped stomach is then reattached to allow food to move from the mouth to the rest of the digestive tract. After surgery your stomach acts as a passageway for food to travel through rather than storing the food you eat. Because of this, you will need to eat smaller, more frequent meals.

Note: Each person tolerates food in a different way. Based on how you are doing after surgery, your doctor may change your diet plan more slowly.

Feeding Tube

Nutrition is very important after surgery. Calories provide the building blocks you need to heal. Most patients who have this surgery will have a feeding tube put in. This will help you get extra nutrition until you can go back to your regular diet. This tube is called a jejunostomy tube or J-tube. The tube is put in through the belly and into a part of your small intestine. Your doctor can give you liquid nutrition (tube feedings) through the J-tube until you can eat enough food by mouth.

Continuous Feeding

You will start tube feedings in the hospital a few days after surgery. We often start tube feedings at a low, continuous rate. If you tolerate the feeds, with no severe cramping, nausea, or vomiting, we increase the rate to provide more calories.

Cycled Feedings

As the rate increases, we may change you to cycled tube feedings. This means for some of the day the feedings will be shut off. Cycled feedings most often run from 6 pm to 12 pm (18 hours), giving you 6 hours during the day that you don’t need to be attached to the feeding pump. We may change the tube feeding rate to a 12-hour cycled feeding later on.

You will follow this feeding plan until your doctor believes you can eat enough nutrition to maintain your weight and heal. You will likely still have tube feedings when you go home after discharge. Depending on your progress, the J-tube may be removed in the clinic at a future date.

What to Expect with Tube Feedings

Expect some cramping when the tube feedings start. The cramping is often brief and stops within a few days. There may also be some loose stools. This may be from the tube feedings or medicines. If you are having a lot of, or uncomfortable, loose stools, we may change the type or rate of your tube feeding to help.

Tips for Common Eating Problems After Surgery

Feeling Full After Eating

  • After surgery you will have a smaller stomach. Eat 6 to 8 small meals per day.

  • Take small bites and chew your food fully.

  • Limit fluids to ½ cup (4 ounces) with meals and 1 cup (8 ounces) with snacks. This will help with fullness and dumping/diarrhea.


  • Avoid caffeine, carbonated drinks, alcohol, citrus, and tomato products.

  • Avoid highly seasoned, spicy, or fried foods.

  • Do not drink through a straw, chew gum, or chew tobacco. This will decrease the amount of air that you swallow and help with gas.

  • Do not eat for at least 2 hours before going to bed.

Discomfort when Swallowing

  • Eat soft, moist foods because they are easier to swallow and digest.

  • Avoid gummy foods such as bananas and doughy breads. If you feel like food is “sticking” in your throat or you have pain behind the breast bone, try sipping a small amount of fluid when eating solid foods. If these symptoms get worse, tell your surgeon.

  • Sit straight up when you eat. Gravity can help move food down. Keep sitting up 30 to 60 minutes after you eat. This will help with acid reflux also.


Dumping syndrome is when the food in the stomach empties too quickly into the small intestine. Dumping can cause diarrhea, cramps, nausea, dizziness, bloating, and light headedness.

  • Limit fluids to ½ cup (4 ounces) with meals and 1 cup (8 ounces) with snacks. This will help with fullness and dumping.

  • Limit sweets to the end of the meal. Sweets are digested more quickly than other foods. Eating sweets first can also lead to low blood sugar.

  • Avoid very cold or very hot foods

Types of Diets

Each person tolerates food in different ways and heals at different rates. Your doctor will change your diet based on your progress.

The 3 diets that you will be on:

  1. Esophageal Clear Liquid Diet

  2. Esophageal Full Liquid Diet

  3. Esophageal Soft Diet

Esophageal Clear Liquid Diet

This will be your first diet after surgery. To be a clear liquid, you must be able to see through it (no pulp or cloudiness). You may have:

  • Water

  • Clear juice (apple, cranberry, grape)

  • Clear broth (chicken, beef, vegetable)

  • Gelatin (such as Jell-O®)

  • Popsicles

  • Tea (decaf to avoid reflux)

Carbonated drinks are not allowed because they may cause gas.

Esophageal Full Liquid Diet

A full liquid diet includes anything that is liquid at room temperature. It is a liquid if the food item would be able to go through a kitchen strainer. Along with the liquids in a clear liquid diet you may also have:

  • Yogurt (without pieces of fruit or seeds)

  • Cream of wheat or cream of rice hot cereal

  • Pureed soups

  • Ice cream, frozen yogurt, sherbet, sorbet

  • Milk and milkshakes

  • Pudding

  • Liquid nutritional supplements like Ensure®, Carnation Breakfast Essentials® or Boost®.

Note: With dairy products you may, at first, have intolerance to lactose (not able to digest milk sugar). Add small amounts of milk to your diet to see if you can tolerate dairy or try lactose free milk-Lactaid®.

Full Liquid Diet Sample Menu


Apple juice (4 ounces)

Cream of wheat cereal made with milk or Lactaid®


Carnation Instant Breakfast® Drink (4 ounces)


Pureed soup (strained), not tomato or broccoli

Cranberry juice


Boost® nutritional supplement (4 ounces)


Pureed soup (strained) not tomato or broccoli
Vanilla pudding



Esophageal Soft Diet

This diet should consist of bland, soft foods. Cut up tough meats into tiny pieces and add sauces or gravies to foods.



  • French toast

  • Crackers

  • Toasted bread


  • Soft breads, rolls, bagels, bread, bread products that contain nuts, seeds, fresh or dried fruit or are highly seasoned such as garlic

  • Sweet rolls, coffee cake, and doughnuts



  • Regular milk

  • De-caffeinated tea

  • Powdered drink mixes

  • Non-citrus juices such as apple, cranberry, grape, and blends


  • Coarse cereals such as Grape Nuts® and granola

  • Any cereals with fresh or dried fruit, seeds, or nuts



  • Regular milk

  • De-caffeinated tea

  • Powdered drink mixes

  • Non-citrus juices such as apple, cranberry, grape, and blends


  • Chocolate milk

  • Soda (carbonated drinks)

  • Alcoholic drinks

  • Citrus juices such as orange juice, grapefruit juice, lemon and lime

  • Drinks that contain herbal ingredients such as St John’s Wort or ginseng

  • Drinks with caffeine: coffee, tea, decaf coffee

Meat and Alternatives


  • Finely ground lean beef, lamb, pork, veal, fish, and poultry (not fried)

  • Eggs prepared any way except fried

  • Cottage and ricotta cheese

  • Mild cheeses such as American, Brick, baby Swiss, or Mozzarella

  • Plain or flavored yogurt

  • Tofu and soy products

  • Smooth peanut butter

  • Casseroles prepared with allowed ingredients


  • Tough meat with gristle

  • Highly seasoned, smoked, or fatty meats/fish/poultry such as hot dogs, lunch meats/cold cuts, sausage, bacon, spareribs, goose, duck, beef brisket

  • Chili and other spicy foods

  • Strong flavored cheeses such as sharp cheddar and cheese that contains peppers or other seasonings

  • Crunchy peanut butter

  • Yogurt that contains nuts or seeds

Potato and Starches


  • Peeled white or sweet potatoes

  • White Rice and barley

  • Pasta such as enriched noodles, spaghetti, and macaroni.


  • Fried potatoes, potato skins

  • Fried, brown, or wild rice

  • Popcorn



  • Canned fruit

  • Cooked fruit (no skins)

  • Fruit juice, except citrus


  • Fresh or dried fruit

  • Citrus fruits and juices (orange, grapefruit, lemon, lime)



  • Cooked vegetables without seeds or skins, such as asparagus tips, baby peas, carrots, green beans, and winter squash.


  • Raw vegetables

  • Tomatoes, tomato juice, tomato sauce or puree

  • Gas-producing vegetables such as broccoli, Brussels sprouts, cabbage, cauliflower, corn, cucumbers, green peppers, onion, radishes, sauerkraut, and turnips

  • Dried beans, peas, and lentils



  • Mildly flavored meat stock

  • Creamed soups made with allowed ingredients


  • Highly seasoned soups and tomato-based soups



  • Plain cakes, cookies, puddings, custard, ice cream, ice milk, frozen yogurt, and sherbet.

  • Gelatins, popsicles


  • Desserts that contain chocolate, coconut, nuts, seeds, fresh or dried fruit, peppermint, or spearmint


Eat small amounts and with a meal. Note: If you have dumping, avoid these.


  • Sugar, syrup, honey, jelly, and seedless jam.

  • Unfilled hard candies and plain candies made with allowed ingredients.

  • Molasses

  • Plain cake, cookies, pudding, custard, ice cream, ice milk, frozen yogurt, sherbet, fruit ice, and popsicles.


  • Jam and marmalade, preserves made with seeds or fruit

  • Chocolate sweets/candy

  • Desserts that contain chocolate, nuts, coconut, seeds, peppermint, or spearmint

  • Dried or fresh fruit

Esophageal Soft Diet Sample Menu


Canned fruit
Cold/hot cereal (½ cup)
1 slice toast
Margarine (1tsp)
Milk (1/2 cup)
Midmorning snack
Blended yogurt (1/2 cup)


Mashed potatoes (1/2 cup)
Low fat gravy
Canned peaches (1/2 cup)
Milk (1/2 cup)

Afternoon snack

Turkey (2 ounces)
4-6 saltine crackers
Fruit juice (1/2 cup)


Roast chicken (ground) 3 ounces
Baked potato (small)
Margarine (2-3 tsp)
Cooked carrots (1/2 cup)
Canned pears (½ cup)
Milk (1/2 cup)

Bedtime snack

Cottage cheese (1/2 cup)
Canned peaches (1/2 cup)
Fruit juice (1/2 cup)

Returning to “Normal Diet”

There are no set rules as to when you will be able to return to eating the foods you ate before your surgery. In most cases, once the doctor says that you may go back to a normal diet, you will want to add one new food item each day and see how you tolerate the food before adding another food.

Who to Call

If you are a UW Health patient and have more questions, please contact UW Health at the phone number listed below. You can also visit our website at www.uwhealth.org/nutrition

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can be reached at: (608) 890-5500.