After your esophageal surgery, you can expect some difficulty swallowing around weeks three through eight. If food sticks when you eat, it is called “dysphagia.” This is due to scar tissue forming around your surgery site and will most likely resolve over time.
Advancing Your Diet: The Post LINX Diet Progression
Day of Surgery: Soft Foods
A soft diet is recommended only for the day of LINX placement; a regular diet can be started the day after. We want you to get back to eating a normal diet right away. However, this initial soft food diet allows you to ease into solid foods. In general, a soft diet is “anything you can squish through your fingers,” but you can also start trying slippery noodles, whitefish and soft, cooked vegetables that are chewed well. Take it slowly – take small bites and chew well! Don’t be fooled. Avoid rice, bread, chicken and lettuce, as these things tend to be harder to swallow.
Weeks 1-2: Regular Food
We call the first one to two weeks the “honeymoon” stage. Many patients report food going down relatively well, and acid at a minimum, if any. (This is true only if a hiatal hernia repair is not performed). During this time, we suggest you:
Take small bites of food.
Chew food very well.
Eat frequently: five to seven small meals per day or a small snack every one to two hours.
Minimize the amount of dry food intake (i.e., chips, hard bread, crackers).
Weeks 3 – 8: Dysphagia Timeframe
Scar tissue will be forming at this time. This is a good thing! This is your body’s way of healing. The scar tissue forms a capsule around the device, preventing it from sliding up or down.
You may experience some difficulty swallowing, increased belching or chest pain. Occasionally, spasms of the esophagus cause the chest pain. Your esophagus is a muscle, and like any other muscle in your body, it may spasm as a result of the surgery. This pain is sometimes described as “sharp” or “stabbing” but does not last long. These are all known and expected symptoms! You should continue eating frequently, as eating often alleviates these symptoms.
If you experience food “sticking” or difficulty swallowing, drinking warm tea or other warm liquids will help by relaxing the esophagus.
To prevent the LINX device from scarring into a fixed position, “physical therapy” will be required. What is physical therapy for the LINX? EATING! By eating small meals frequently, you are exercising the device. Similar to exercising a knee after surgery, constant movement will allow the device to stay mobile and prevent long-term problems with swallowing.
We encourage eating five to seven small meals throughout the day or a small snack every one to two hours. Every time you swallow a bite of food, the device opens and closes, which stretches out the scar tissue. This results in optimum healing of the LINX.
If you do not eat solid foods, you may require a procedure called a dilation — this is rare and preventable if you follow the diet guidelines.
In general, you should refrain from drinking carbonated beverages to avoid gassiness.
Drinking warm liquids, such as tea, before a meal relaxes the muscle around the device. Some patients state that this has helped with food going down.
Experiment with your food!
In general, some simple rules to follow are:
Maintain an upright position (as near 90 degrees as possible) whenever eating or drinking.
Take small bites, only ½ to 1 teaspoon at a time at first.
Eat slowly. It may also help to eat only one food at a time.
Avoid talking while eating.
Do not mix solid foods and liquids in the same mouthful, and do not “wash down” foods with liquids, unless you have been instructed to do so by your surgeon. If you do feel that your meal is a bit “sticky,” a small amount of warm liquid may help. However, avoid drinking too much, or you may feel uncomfortable.
Eat in a relaxed atmosphere, with no distractions.
Following each meal, sit in an upright position (90-degree angle) for 30 to 45 minutes.
Avoid carbonated (bubbly) drinks; they will make you feel bloated.
If food does stick, don’t panic. Try to relax and let the food pass on its own. Sipping strong, hot black tea or warm broth can also help.
This information has been approved by Emily Speer, MD (January 2017).