Dietary Recommendations for Dysphagia in Gastric Cancer

Eat slowly and allow enough time between each forkful.

Avoid eating bread, toast, breakfast cereal, crackers, crisps, fruit with skin, nuts, fibrous and dried meats and raw vegetables.

Avoid eating sliced bread, pre-cooked baguettes and pizza dough.

Liquid preparations, such as purées or creamy soups, are the easiest to swallow. Soft-textured foods such as pudding, flan, omelets and meat or fish cakes are also good choices.

Include meat, fish, eggs, legumes, tofu or seitan in soft-textured dishes.

• Eat smaller and more frequent meals.
• Enrich dishes or purées using virgin olive oil, cream, individually-wrapped cheese, egg whites, ground nuts, nut butter, powdered milk or sauces, adapting the texture according to the degree of pain or difficulty swallowing.

• In some cases, it may be enough to cut the food into small pieces; in others, it may need to be uniformly crushed with a fork.
• Prioritise stew, soup, flan, pudding, purée, soft cheese, yoghurt, ripe fruit, vegetables, overcooked pasta and rice, very tender and juicy fish and meat, omelettes, etc.

• Always cook all foods until they are tender. Using the pressure cooker is a good way to tenderise foods such as legumes, meat and some vegetables.
• If necessary, add sauces, broth or juice to drier foods, such as some meats or fish. Sauces will assist with swallowing.

Try to keep the dishes and menus that are eaten regularly, but just change their texture.
Eating ground food does not mean not eating what you like, but only that the texture has been adapted.
Almost all standard meals and dishes can be ground.

• Know what type of dish it is:
  • Ensure that it has been properly preserved and is in perfect condition for consumption.
  • Make sure it does not contain any solid parts that may make it hard to grind (bones, etc.).
• Think about the best way to adapt it (if it contains elements that give consistency, if it has enough liquid to grind it or not, how you want to grind it, etc.).
• In general, it is better to heat the dish in order to grind it more easily.

Examples to learn how to adapt common dishes to a ground texture

Many recipes and dishes are already suitable and do not need to be modified, so you can eat the same as other family members. They include the usual soups, purées and flans found at any family meal.

Protein is essential throughout the treatment process, so purées should include meat, fish, eggs or plant-based proteins such as soy at breakfast, lunch and dinner. You can choose between preparing a one-course meal or a first and second course. This second course can be a simple dish, like a piece of ground meat or fish, or an elaborate dish.
Table showing the amount of meat, fish, egg and soy by-products needed when making simple second courses that help to cover daily protein requirements. The goal is to take the protein-rich food, cook it as indicated in the table and grind it with the other ingredients (thickeners, liquid and oil).

You should grind at most around 300 ml at once (medium bowl) or grind small amounts of two foods to distribute the amount and simulate a first and second course. It is important to mix different consistencies and colours, as eating mashed food can make it more difficult to finish the dish and a uniform texture and colour can be boring.

The vitamins and bioactive compounds they contribute are essential during treatment. It is necessary to consume smoothies, soups, purées and cold vegetable and fruit shakes.

Due to painful swallowing, which may be accompanied by abdominal discomfort, acid reflux or other discomforts, try to avoid acidic fruit and vegetables or use them in smaller proportions, depending on tolerance.

*Depending on cucumber tolerance.

* Avoid acidic fruit and vegetables if there is abdominal pain or acid reflux in addition to difficulty swallowing.

Adjust the above recommendations with more digestible foods and cooking methods.
The following recipes may serve as examples of mild, easily digestible foods:

The following recipes may serve as examples of easily digestible ground foods:

Link to tips to enrich dishes with calories and protein.