The Billroth II, also known as a gastrojejunostomy, is the joining of the stomach and the jejunum -- the middle section of the small intestine. The Billroth II operation is used for reconstruction after removing two-thirds to three-fourths of the stomach due to gastric cancer or as a weight-loss aid. When this procedure is done to promote weight loss, it is called a Roux-en-Y gastric resection. Whether you’ve had a Billroth II or a Roux-en-Y, you will need to change the way you eat. To prevent nutritional deficiencies and unwanted side effects such as dumping syndrome -- rapid bowel emptying -- The University of Virginia’s Digestive Health Center of Excellence recommends patients follow an “Anti-Dumping Diet.”
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Dumping syndrome is accelerated gastric emptying that results in explosive diarrhea, fullness, abdominal cramps and vomiting. Early dumping syndrome occurs 15 to 30 minutes after eating. You may also experience dizziness, weakness and sweating. Late dumping syndrome occurs two to three hours after eating and symptoms include sweating, nausea, hunger, weakness and anxiety. Foods and beverages high in sugar and a high fluid intake at mealtime can cause dumping syndrome. Symptoms of dumping syndrome are more prevalent immediately after surgery and tend to subside over time.
Protein and Fiber
Protein is important because it aids in healing after surgery and maintaining muscle mass. It may also help you to avoid hair loss. DukeHealth.org recommends getting between 40 grams and 60 grams of protein per day. If you are following the Anti-Dumping Diet, you will eat a high-protein food at each meal. High-protein food choices include: eggs, poultry, fish, yogurt, cheese, peanut butter, tofu, beans and lentils. It is also important to choose fiber-rich foods whenever possible. Foods high in fiber include: whole-wheat bread, fresh fruits and vegetables, beans and lentils.
After a Billroth II, your mealtimes will look very different than they did prior to surgery. To avoid dumping syndrome, recommendations from the Anti-Dumping Diet include eating six or more small meals a day and the importance of chewing and eating very slowly to ease digestion. Be sure to sit upright while eating and avoid drinking fluids with meals. Drink liquids 30 to 60 minutes either before or after meals. It’s important to avoid high-sugar foods if you are experiencing nausea, vomiting or diarrhea. This includes fruit juice, soda, cakes, pies, candy, fruits cooked in or canned with sugar, jams and jellies.
Vitamin and Mineral Supplementation
Due to the stomach reconstruction surgery, your body does not digest foods as well as it did before. Because of this, most Billroth II patients take additional vitamins and minerals to prevent deficiencies. The University of Virginia’s Digestive Health Center of Excellence recommends patients take a daily multivitamin, calcium, vitamin D, vitamin B-12 and iron supplements. Often, the liquid or chewable forms of vitamins and minerals are more easily digested. Speak with your doctor or dietitian to determine your need for vitamin and mineral supplementation.