Your Diet after Nissen Fundoplication

When and what can I eat after Nissen fundoplication surgery for heartburn is a very common question. At Houston Heartburn and Reflux Center we have adopted a dietary guideline for our patients to follow after Nissen fundoplication surgery. Following anti-reflux surgery, the distal part of the esophagus or food pipe is swollen. Swelling or edema develops because of tissue dissection during surgery and takes around two to three weeks to subside. When the esophageal wall swells up, its lumen narrows. Indeed, on day one after Nissen fundoplication, esophageal lumen diameter is as wide as a straw. Solid food can’t go through a straw. Accordingly, heartburn patients are counseled to adopt a liquid diet for the first two weeks after surgery. Liquid diet consists of broth, protein shake, yogurt…Following this initial phase, patients transition to a soft or puree diet that consists of blended food. This baby food diet helps post-surgical patients gradually transition to regular diet around one month after surgery. These guidelines are not written in stone and some patients progress to regular diet faster than others. It is important, however, to follow these recommendations to avoid problems. Starting regular diet too early after surgery may cause food impaction in the esophagus. Food impaction causes significant discomfort and may lead to severe retching and dry heaving. This creates unwanted pressure around the gastro-esophageal junction that may disrupt the hiatal hernia repair and fundoplication.

Of note, acid reflux and heartburn trigger food items like spices, coffee, tomato soup… can be resumed immediately after surgery. I offer coffee to my patient on day one after surgery.