• Reference Number: HEY-1376-2023
• Departments:
• Last Updated: 2 January 2023

Introduction

The aim of this dietary advice is to help you re-introduce food following Laparoscopic Nissen’s Fundoplication.

As a result of your surgery, the top of your stomach is wrapped very tightly so the opening into your stomach has become very narrow. It is therefore important to follow this dietary advice to prevent a blockage, discomfort and vomiting.

Your stomach may have reduced in size slightly; therefore you may feel full easily.  We recommend you eat ‘little and often’.

If you have a milk intolerance, cow’s milk protein allergy or are vegan then you may wish to speak to a Dietitian for more tailored advice.

Main Aim of Diet

• Week 1 Thin Pureed diet
• Week 2 Thick Pureed diet
• Week 3 Minced & Mashed diet
• Week 4 Gradually introduce more textures

General Information

• You may lose weight
• It is important to have regular nutritious drinks to maintain your nutrition
• Eat high calorie, high protein, little and often, aiming for 6-8 small meals/snacks daily
• Avoid fizzy drinks for 8 weeks
• Ensure you are sitting upright during meals and for 30 minutes after

High Energy or Protein Drinks

If you are struggling to eat, a drink can be taken between meals if necessary. The following options will count towards your fluid intake and will increase your energy and protein intake.

Try:

• Complan or Build Up – both the sweet and savoury flavours can be made with cold or hot water but using cold or hot milk will give a creamier texture and extra calories
• Milkshakes or yoghurt shakes, for example: supermarket own brands, Frijj, Yop, Kefir
• Add milkshake flavouring and skimmed milk powder to ordinary milk to make enriched milk

You may be recommended to take nutritional supplement drinks to help increase your calorie and protein intake.

Remember

• You may feel full quickly therefore take small bites, chew foods well and sip fluids slowly
• Avoid fizzy drinks for at least 8 weeks
• Ensure you are sitting upright during meals and for 30 minutes after
• Fortify food where able by adding additional cream/cheese/butter/milk

If you are struggling with your intake your GP or practice nurse can refer you to your local community dietitians.

Week 1 – Thin Pureed Diet Examples

BREAKFAST	Smooth orange juice Sloppy porridge or Weetabix made with milk/yoghurt drink/ nutritional supplement drinks
SNACKS	Milky drink, milkshakes, yoghurt drink, Build Up, Complan, nutritional supplement drink
MEAL IDEAS	Soup – blend to a smooth consistency Ice cream, jelly, runny custard, smooth yoghurt, mousse

Week 2 – Thick Pureed Diet

BREAKFAST	Smooth fruit juice or smoothie Porridge or Weetabix with milk/smooth yoghurt/nutritional supplement drink
SNACKS	Milky drink, milkshakes, yoghurt drinks Build Up, Complan, nutritional supplement drink
MEAL IDEAS	Pureed meat/fish/pasta with lots of gravy or sauce, smooth mashed potato, pureed vegetables, ice cream, mousse, smooth yoghurt, pureed fruit and custard/cream, semolina, mousse

TIPS

• Continue to have 3 milky drinks per day
• Continue to add skimmed milk powder to milk
• Cook meat slowly so it is tender and easier to blend
• Cook vegetables until very soft to aid blending
• Add additional milk or butter to mash

Week 3 – Minced and Mashed Diet

BREAKFAST	Fruit juice or smoothie Breakfast cereal softened with milk Smooth yoghurt/nutritional supplement drink
SNACKS	Milky drink, milkshakes, yoghurt drinks, banana and custard
MEAL IDEAS	Fine minced meat/fine flaked fish mashed with sauce Cooked beans/peas (sieved to remove skins) Cook all vegetables until soft Stewed fruit (no skins), custard, yoghurt, milky pudding, rice pudding, crème caramel

TIPS

• If unable to cook, try tinned mince in gravy, ready made shepherds/cottage pie/fish pies
• Avoid stalks and skins of fruit and vegetables
• Food should break up easily when pressed with the back of a fork

Week 4

Start to gradually reintroduce other foods and textures.

• Eggs – try egg mayonnaise or scrambled egg before progressing to poached/omelette
• Fish – flaked fish mashed in a sauce. No batter or breadcrumbs
• Vegetables – soft cooked or mashed. Start with well-cooked carrots, swede, florets of cauliflower/broccoli
• Fruit – start with tinned peaches/mandarin and progress as tolerated. Take care with oranges and grapefruit – remove pith and skin
• Savoury starchy foods – start with cous cous and progress onto very well cooked pasta and then rice. Do not try bread yet
• Meat – start with tender meats. Slice meat very thinly. Avoid sausages, burgers and tough cuts of meat, eg chops as these can cause discomfort and blockage
• Take small bites and chew food well
• Continue to soften foods by adding sauces or gravy

Week 5, 6 and 7

Continue to gradually introduce more textures.

Week 8

• By this stage you should be able to eat most foods and introduce bread
• You may find it easier to start with thinly sliced bread, toasted, eg Danish bread and bread that crumbles
• Salad and more raw fruits can be introduced now
• You can try fizzy drinks but you may find you are unable to tolerate these

This leaflet was produced by the Nutrition & Dietetics Department, Hull and East Yorkshire Hospitals NHS Trust and will be reviewed in 2026

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.