Page 6 - DietaryPlan02
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•  Small portions of fruit trifle, crumble or pie with ice cream or custard
                         •  Milk pudding such as rice, tapioca or semolina either tinned or made with full cream
                             or organic oat/almond milk
                         •  Small scoop of full fat ice cream topped with fresh fruit, cream and a dash of rum!
                         •  Jelly with ice cream
                         •  Full fat or Greek yoghurt, or Fromage Frais
                         •  Mousse, instant whips or blancmange
                         •  Custard, egg custard or creme caramel
                         •  Soft fresh, tinned or stewed fruit with cream, yoghurt or custard

               Early evening meal:

                         •  Pasta (e.g., fresh wholemeal spaghetti – supermarkets are expanding their range)
                             with a sauce - bolognaise, cheese, tomato, macaroni cheese or lasagne with a side
                         •  Moussaka, fish pie, Shephard’s or cottage pie with vegetables
                         •  Grilled or steamed fish with a sauce (white, mild cheese, parsley, hollandaise) and
                             buttered vegetables or wholegrain / wild brown rice
                         •  Small portion of chopped roast chicken or shredded lamb with roast potatoes and
                             buttered vegetables
                         •  Mild or medium spiced shredded lamb, chicken or fish curry with pulses with fresh
                             fruit and salad condiments and spicy pickle
                         •  Chinese style stir fried fish, prawns or chopped chicken with wholegrain egg and red
                             onion pilau

               Aches, pains and acid reflux

               It is not unusual to experience aches and pains after eating for a variety of reasons, including eating
               too quickly and or too much, not chewing food thoroughly enough, or having too much sugary food,
               or stodgy things like white bread or red meats.

               By being careful, it is possible to eliminate most aches and pains after eating.  If pains persist or
               become acute, it is advisable to contact your Advanced Nurse Practitioner (ANP) for advice. It’s not
               uncommon for the ‘pylorus valve’, situated between the new stomach and small intestine to
               gradually tighten, making it harder for food to pass through causing discomfort soon after eating.  In
               these circumstances a ‘pylorus stretch’ can easily be arranged through your ANP, which involves a
               straightforward 20-minute endoscopy day-procedure.  This usually resolves the issue almost
               immediately, but in a few cases patients may need further stretches over one or two years before
               the pylorus settles to a steady state.
               Acid reflux can be re-occurring and horrible issue for some patients, but thankfully in most cases it is
               manageable using a combination of approaches.  Here are a few tips to help reduce or avoid acid
                   •  Don’t eat late in the evening. Ensure a minimum of 2 hours after an evening meal before
                       going to bed.  This will allow sufficient time for food to pass through the new stomach,
                       reducing acids in the gut. Also avoid snacking late, but drinking liquid is usually fine.
                   •  Sleep on a slight angle, propped up by pillows or a tilting bed.  Lying flat allows acids left in
                       the stomach to flow back into the mouth and windpipe.  Lying on one side, usually the right-
                       hand side, can also cause acid to trickle into the mouth.  By trial and error most patients
                       work out a routine and sleeping position best for them.
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