Dietetics - What can I eat after a pyloric (stomach) or duodenal (small intestine) stent?

Who is this leaflet for?

This leaflet is intended for people who have or are having a stent placed in their stomach or small bowel.

The information in this leaflet aims to guide you on how to build up your eating and drinking once the stent has been placed.

Why do I need a Pyloric (Stomach) or Duodenal (Small Bowel) Stent?

When we eat and drink, food travels into our stomach and bowel to be broken down and absorbed to provide nutrition for your body. The food waste exits your bowel as faeces (poo).

If you experience a blockage in your digestive system, food will not be able to pass through normally. This may cause sickness and vomiting, feeling full too quickly, a reduced appetite and reduced energy levels. You may also notice that you have lost some weight or muscle strength.

What is a stent?

A stent is a small flexible tube made from expandable metal or plastic. If you have a blockage, a stent may be placed to hold open the narrowing and allow for food to travel through. This is usually placed in the Endoscopy (camera guided procedure) or Radiology (imaging guided procedure) department at the hospital under sedation.

After the stent is placed, it will gradually expand and fix into its opened position over the following 3 days. This may feel uncomfortable but should not cause significant pain or sickness. As the stent expands, you can gradually start increasing the foods you eat.

The stent will not be as wide as the exit to the stomach or the small bowel, so you will need to take care with certain foods and the way you eat to prevent a blockage of the stent.

What can I eat and drink after the stent is placed?

Once your sedation has worn off, your doctor will advise you when it is safe to eat. You can begin by introducing fluids, such as water, cordial, tea, coffee, Bovril®, smooth fruit juice or milk. If you can manage fluids without experiencing nausea or sickness, you can then introduce smooth foods with no lumps such as jelly, ice cream, smooth soups or yoghurts. You can then continue to increase the textures of your diet as tolerated over the next couple of days. You should aim for foods that are soft, moist, and easy to chew.

If you are experiencing sickness or significant pain after your stent, you should seek advice from your doctor.

Meal ideas

Once you have started introducing soft, moist foods, the following meal ideas are good to try.

Breakfast ideas:

• Scrambled eggs or omelette (you could add grated cheese and/or avocado)
• Skinless sausages
• Porridge made with milk (you could add jam, chocolate spread or smooth nut butter)
• Cereal softened with milk
• Fruit such as ripe banana or stewed apples or pear
• Smooth yoghurt

Main meal ideas:

• Cottage pie
• Spaghetti bolognese
• Fish pie
• Jacket potato (no skins) with cheese/baked beans/tuna mayonnaise/chilli con carne
• Casseroles or stews with soft meat and vegetables
• Curry or dahl with soft meat, fish (no bones) or paneer
• Macaroni cheese or cauliflower cheese (well cooked)
• Lasagna or pasta bakes
• Corned beef hash
• Tinned spaghetti or ravioli
• Soups
• Mashed potato with stewed tender meat, mince, fish (no bones) or keema with lots of sauce

Pudding ideas:

• Rice pudding/semolina
• Custard
• Trifle
• Egg custard/creme caramel
• Smooth yoghurt
• Jelly and/or ice-cream
• Sponge cake with custard, cream or ice cream (no dried fruit)
• Soft tinned or stewed fruit

Snack ideas:

• Plain crackers or breadsticks with lots of butter, cream cheese, peanut butter, sour cream, hummus or pâté
• Homemade milkshakes or smoothies
• Biscuits, such as digestives, ginger nuts
• Milky drinks, for example hot chocolate, milky coffees or Ovaltine
• Melting corn-based crisps such as Wotsits or Quavers
• Chocolate (without fruit or nuts)

Should I avoid any food?

There are certain foods that you should continue to avoid after you have had a stent placed to allow the stent to keep working properly and to prevent any blockages.

Foods to avoid:

• Try to avoid bread, as this expands in your stomach. If you do want to eat bread, try small bites of toast or day-old bread with no hard crusts and use plenty of butter or spread
• Doughy food like pizza, pasties or pastries
• Wholegrain foods (such as brown rice or pasta)
• Chips
• High fibre cereals (Bran Flakes, muesli)
• Fresh fruit and vegetables that are crunchy, have skins or have a stringy texture (e.g. lettuce, coleslaw, berries, pineapple, sweetcorn, citrus fruit)
• Food with seeds (e.g. oranges, tomatoes, strawberries)
• Nuts, dried fruit, seeds and popcorn
• Tough and gristly meats (e.g. steak), poultry skins and fish with bones

Helpful tips

• Eat slowly
• Chew your foods well
• Sit upright whilst you are eating, and for at least 30 minutes after a meal or snack
• Sip fluids with meals and snacks
• Add gravy or other runny sauces to moisten foods
• Eat small portions regularly throughout the day

What if I am not eating enough?

If your appetite is low, eating small amounts but frequently throughout the day may be helpful, aiming for 5-6 small meals each day. Try not to get out of the habit of eating, as eating regularly helps you maintain an appetite. You should also choose foods that provide lots of calories and protein, for example by choosing full fat options or adding creamy sauces to your meals.

Tips to make your foods nourishing:

• Choose the full fat versions, such as full fat milk, yoghurts, cheese
• Cook with extra oil, butter, cream
• Add cheese as a topping to meals, or stir into mashed potato
• Add cream/sour cream/crème fraiche/smooth nut butters to soups and stews
• You can add skimmed milk powder to your milk (add 2-4 tablespoons to 1 pint of milk)
• Instead of drinking a glass of water, why not try a glass of milk? This contains extra nourishment
• Don’t worry if it isn’t your normal eating and drinking pattern, eat what you feel like eating

If you are struggling, speaking to family or friends can help you find solutions, such as getting help with shopping and cooking.

You may need nutritional supplements that can be prescribed by your dietitian. If you are struggling to eat or maintain your weight, please get in touch with your doctor or dietitian for help and advice.

Can I take medications with my stent?

If you are taking medications, discuss with your doctor whether any changes to your medications are needed.

Your doctor may prescribe you medication to help stimulate your digestive system, such as Metoclopramide. If your doctor recommends this, it works best if taken 30 minutes before a meal.

Possible complications or problems after your stent

Your doctor will discuss the risks and benefits of having a stent. Sometimes, a stent may not work. If symptoms return, contact your doctor immediately.

If the stent becomes blocked or the stent moves, you might start to feel sick, and your previous symptoms might return.

• Stop eating
• You can try sipping on fluids to try and clear the blockage

If this doesn’t work, contact your doctor or specialist nurse for advice.

Contact Details

Dietitian:

Contact number:

Useful Resources

Macmillan Cancer Support
www.macmillan.org.uk
0808 800 1234

Cancer Research UK
www.cancerhelp.org.uk
0808 800 4040