Duodenal switch patients are able to enjoy a wide variety of foods from all food groups, but will also be expected to make permanent changes to diet and eating habits after surgery. Choosing healthy foods and taking vitamin and mineral supplements will be important aspects of maintaining good health and promoting weight loss.
Specific diet plans will vary between patients and bariatric surgeons and your nutritional advisor will help you plan a healthy diet based on your personal situation. Although patients should always follow the advice provided by their health care provider, the following nutritional guidelines highlight the general aspects of a duodenal switch diet.
After duodenal switch surgery, you will need to learn a new way of eating. The changes made to the digestive system will affect how much food you can eat, what types of food you can eat, and how you eat for the rest of your life. It may take a period of adjustment for your body to adapt, but eventually it will become accustomed to the new eating habits and behaviors.
Your diet after surgery will slowly progress from clear liquids, to purees, then to soft foods as your body heals from surgery and adjusts to the digestive changes. It can take up to a month or two before your body will tolerate solid foods. Throughout the recovery process, it is important to follow the guidelines of your bariatric surgeon and only reintroduce foods to your diet when informed it is appropriate to do so.
Duodenal switch patients are able to eat a wide variety of foods from all food groups, but it is important to choose foods wisely based on high nutrient value and low calorie content.
A typical duodenal switch diet consists of three high-protein nutrient dense meals and one high-protein snack each day. Protein is the most important diet nutrient and should always be the first food item eaten. Protein supplements can also be used to meet daily protein requirements.
Common sources of protein are lean meats, veal, poultry, fish, soy products, eggs, cheeses, yogurt, legumes, and nuts. Unlike gastric bypass patients, duodenal switch patients are generally able to eat dense, high-protein foods without difficulty including beef, steak, pork, and stew meat.
Although protein foods are the focus of meals, the diet should also include a variety of fruits, vegetables, and whole grains. Patients are usually able to eat fibrous vegetables, bread, and pasta without difficulty or getting stuck in the stomach. Dietary fat is best derived from monounsaturated (canola, olive, and peanut oils, avocados) or polyunsaturated (corn, safflower, peanut, soybean and sunflower oils) sources and low-fat dairy products.
The changes to the digestive system may cause some individuals to develop a food intolerance to certain food products. When foods are added to the diet after surgery, they should be introduced one at a time to rule out an intolerance. If a food is not well tolerated, it can be tried again in one week.
One of the more common reactions is an inability to handle lactose (milk sugar), resulting in gas and diarrhea. Patient who become lactose intolerant may find it easier to digest non-fat dairy products or lactose-free milk. Lactase pills are also available to help with lactose digestion.
Food intolerance and unpleasant side effects from different foods varies from patient to patient, so your experience may be different from the response of others.
After recovery, almost all foods can be eaten without the incidence of stoma blockage or dumping syndrome that is common with gastric bypass surgery. However, some types of food should be avoided because they either are high in calories or cause unpleasant side effects.
To keep the body hydrated, duodenal switch patients should drink at least 6 to 8 cups (8 oz) of fluid each day. Signs of dehydration include headache, dizziness, nausea, lethargy, dark urine, whitish coating on the tongue, and lower back pain.
Acceptable beverages include water, skim milk, decaf coffee and tea, broths, and sugar-free beverages (Crystal Light, Diet Snapple, sugar free Kool-Aid, sugar-free Tang, sugar-free vitamin water, flat diet soda).
Liquids should be sipped throughout the day to avoid becoming dehydrated. Do not drink within half an hour before or after eating otherwise there will not be room for food and the fluid will interfere with digestion. Also, using a straw may cause gas and should not be used.
Duodenal switch patients will need to take daily vitamin and mineral supplements for the rest of their lives in order to maintain health. The body is not able to absorb the nutrients it needs to function due to bypassing a large portion of the small intestine. Typical supplements include a multivitamin, ADEK's, calcium, and iron. Protein supplements may also be recommended. Your bariatric surgeon will monitor you on a regular basis to make sure you are maintaining the proper level of vitamins and minerals.