Answer to Question 1
She should be encouraged to chew her food slowly and lie down for 20-30 minutes after a meal. This will ensure appropriate digestion and will slow transit into the small intestine. The addition of fiber may help prevent diarrhea through its contribution to delaying gastric emptying.
Answer to Question 2
Typically a patient is NPO for 3-5 days and is fed enterally. Ice chips and sips of water are then given. First foods are low-carbohydrate clear liquids such as broth, unsweetened gelatin, and diluted unsweetened fruit juices. If the patient tolerates this initial introduction, the post-gastrectomy diet is then started. This consists of small, frequent meals that are high in protein and complex carbohydrates. Fat should be included in moderate amounts and all simple sugars should be excluded. Liquids should be given between feedings (30-60 minutes after meals). Foods and liquids should be room temperature. Lactose and carbonated beverages should not be fed initially. The rationale for this diet is to prevent the onset of dumping syndrome.
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