• When you have to avoid alcohol:
  When you are offered to have alcohol, you could disturb the atmosphere if you turn it down resolutely. In such a case, you can maintain the good atmosphere by turning the conversation to the person by saying, “Thank you, but I have had enough. Would you like some?”
• When you are offered something you do not like:
  Try to answer by being considerate to the person who offered by saying “I am sorry, I do not really care for XX. I will have this instead.”
• When you are invited to a banquet:
  Start by providing a favorable response such as “A party? That sounds good, I would like to go.” And then turn down by saying “But I’m sorry, I have just had surgery on my stomach and I am supposed to give my stomach and liver a rest. I am grateful for your invitation, though. I will let you know once I can participate, so I would love to join next time.” In this way, the person who invited will not feel bad.

A．As your stomach has become smaller after your surgery, the content you put in your stomach such as alcohol and food can flow into your small intestine in a short time.
Compared to your stomach, your small intestine absorbs alcohol quicker and it is said that you feel drunk quicker after your stomach surgery compared to before the surgery. Enjoy your alcohol at a slow pace.

The standard on a daily intake is around a glass (180 ml) of shochu (clear distilled liquor) or whiskey diluted with water, or a small glass (100 ml) of wine.
It is best to avoid carbonated beverages (such as beer and sour) as they make your stomach feel bloated.
Limit the intake of sake to around 100 ml as it is drunk undiluted and start drinking shochu and whiskey diluted with water rather than on the rocks.

A．If you are aware of the decline in your physical strength, it is a good idea to consider attending the party for a short time. How about considering going home early or arriving late? While it may depend on closeness between you and the organizer, etc., try to explain your illness and your current life briefly and ask the person to understand your short attendance.

For instance, how about telling the person “I have returned to work after the stomach surgery, but my condition is not back to normal yet and it is difficult for me to stay until the end of the party. I apologize for the inconvenience, but I would like to keep my attendance short. I would like to regain my strength and fully attend the next party.”

A．It is difficult to turn down invitations to banquets. It is acceptable to take it easy and make minimum effort at such events.
If you drink alcohol, how about having warm sake or shochu diluted with hot water instead of beer as it can quickly make your stomach feel bloated and cause diarrhea?
If you drink alcohol, you tend to become relaxed and eat too much.
Try to select food that you can eat slowly by chewing well and paying attention to the volume.

A．In the same way as your regular meals, select digestible food (Japanese-style food). If it is a buffet style meal, you can take suitable amount of what you can eat on plates. If you keep in mind to keep the volume relatively small and eat slowly, you will be able to enjoy your communication with your colleagues without reserve. Influenced by the surrounding atmosphere, you tend to eat more and quicker than usual. Enjoy your conversation with your colleagues while setting your goal to eat moderately.

A．If you are feeling well, there is nothing in particular that you cannot eat. In principle, it is best to enjoy delicious meals with a good nutritious balance. However, your digestive power has declined as a secretion of gastric juices and digestion enzyme has been reduced after the stomach surgery. Therefore, please be careful with dishes that use a lot of oil as it could cause a heavy feeling in your stomach. For ingredients and dishes that you have not eaten for a while since the surgery, take a portion onto your dish and start eating a small amount depending on your condition and appetite. We recommend Chinese congee, steamed flower rolls, soups, shaomais, steamed dumplings and stir fry eggs with crab meat. Ramen noodles contain a thickener called lye water (aqueous solution containing alkali salt) and are indigestible, so please be careful.

A．Izakayas have a wide variety of dishes. Enjoy your time with your colleagues by paying attention to the volume and how to choose your food.
For the first 1–3 months after returning to work, sashimi tends to be avoided. However, it is OK to eat if it is fresh. In particular, we recommend low-fat white fish sashimi. Avoid shellfish except for oysters as they are indigestible. However, it is best to avoid raw oysters to prevent food poisoning.

Intense sweetness and saltiness irritate the stomach walls and intestinal wall. Select dishes so you can avoid intense sweetness or saltiness as much as possible. Avoid overly cold or hot drinks as they also irritate them.

There are a number of oily dishes on izakaya menus. If you take a large amount of oil at a time, it may cause diarrhea as it is hard to digest and absorb. Be careful with deep-fried food as well as vegetables rich in fiber such as burdocks and seaweed salad as they are indigestible.

Grilled-liver on skewers tends to be avoided but it is rich in minerals such as iron and in vitamins. Depending on the atmosphere of the izakaya, you might be able to eat dishes like this.
As you tend to eat main dishes at the end, please pay attention to the volume.

A．You may feel that the French cuisine should be avoided as there is an impression that the French course menus contain a lot of oil and have a large volume. However, it is an excellent dietary style in a way that you take time to eat your meal. It should not be a problem if you pay attention to the below points.

• Pay attention to the ingredients and avoid dishes that contain ingredients rich in fiber and that are not digestible. It is OK to eat white fish and low-fat meat. Avoid indigestible ingredients such as squids, octopus, seaweed, celery and nuts.
• Pay attention to the cooking method and select dishes that use little oil, butter, or spices. We recommend heated vegetables, steamed white fish mousse, fish piccata and stew cooked until soft. While soups are digestible, it is best to have only a small amount as they are filling.
• For dessert, avoid menus that contain ingredients rich in fiber. We recommend cooked fruit compotes, Bavarian cream, pudding, bananas and peaches. Avoid fruits with seeds such as strawberries and kiwi fruit and fruits rich in fiber such as pineapples.
• The whole volume from the appetizer to the dessert might be too much. We recommend asking to reduce the whole volume to one third or ordering an à la carte meal. It is also a good idea to share with a child or an elderly person with a small appetite or start with lunch in a small volume.
• In most cases, French cuisine restaurants require reservations. How about explaining your illness at the time of the reservation and ask to change the menu or volume to a degree that will not be inconvenient to the restaurant? If the change is not possible, you could tell them in advance “I’m sorry that I cannot finish the food because I have just had surgery.”

A．Famous Italian dishes include spaghetti Bolognese, pizza and lasagna. Dishes are mainly seasoned with tomatoes, butter and fresh cream. Main ingredients used include garlic, olives, olive oil, seafood (mainly octopus and squids), processed meat such as salami and bacon, and cheese.

Seafood (mainly octopus and squids) and processed meat such as salami and bacon are indigestible. Select digestible dishes.

Example:
Select slowly stewed soup-style spaghetti.
Risotto is also digestible as it has been boiled well.
In terms of meat, low-fat meat and chicken are suitable.

A．We hope you will have a great time eating yakiniku with your close colleagues. Good-quality protein is an essential nutrient for healing wounds from the surgery and recovering your physical strength. It will be good to efficiently take in such protein in your diet.

For the first 1–3 months after leaving the hospital, the volume corresponding to one strip of tenderloin is suitable. While you will not be able to eat as much as you did before the surgery, it is OK to eat parts with less fat and skin such as parts with lean meat of beef and pork and chicken tenderloin. We also recommend liver as it prevents anemia and is digestible. Fat may cause diarrhea as it is hard to digest and absorb. Avoid fatty meat such as ribs and bacon for a while.

Moreover, as some yakiniku sauces are heavily seasoned and spicy, they may irritate the gastrointestinal tract. Instead of a sauce, you could put lemon juice on the meat. Acid encourages a secretion of digestive juice. Make sure to remove the inner skin and seeds if you are having citrus fruit.

A person whose stomach was completely removed in the surgery often suffers from anemic conditions. To supplement the lack of iron, it is best to proactively select parts rich in iron such as beef, pork and chicken liver. Meat contains a lot of good-quality animal protein that improves the efficiency of iron.

Various parts of your body including the gastrointestinal tract are strained after surgery. We hope you will feel relaxed by having a friendly meal with your colleagues.

A．Given that the amount you can eat at a time is small at this stage, it is important to devise ways to take necessary nutrition sufficiently. While the function of the gastrointestinal tract has recovered gradually, there are food and dishes that you need to be careful with after the surgery. Those include brown rice, mochi (rice cake), ramen, shellfish, fish paste (excluding hanpen), fatty meat, deep-fried tofu and bean curd, garlic chives, royal ferns, bamboo shoots, burdocks, lotus roots, and seaweed (laver boiled down in soy is acceptable).
Above all, you need to be careful with sushi, steamed rice with red beans, squids, octopus and shirataki (noodles made from konnyaku [devil's tongue starch]). However, it does not mean that you cannot eat them at all.
Be careful right after the surgery or when you are unwell. Be careful with food that makes you ill after eating. Instead of starting with the entire portion for one person, try to increase the volume gradually depending on your condition.

A．It is hard to cook every day while taking care of your health. We believe it is OK to have some days on which you use precooked food at supermarkets and department stores. While there are impressions that a lot of oil and salt are used in precooked food, you can take advantage of them effectively by being mindful of below:

• Pay attention to the ingredients and avoid dishes in which ingredients rich in fiber and are indigestible are used.
• Pay attention to the cooking method and select dishes with less oil, salt and spices. For instance, we recommend heated vegetable salad, assortment of separately cooked vegetables, stewed fish and steamed fish.
• If the dish is seasoned heavily, you could boil it with other ingredients or eat it with other ingredients on the side.
• Dishes to avoid include deep-fried dishes and tempura, in which a lot of oil is used, and raw vegetable salad, sautéed burdock root, stewed hijiki (edible brown algae) and stewed dried strips of daikon, which are indigestible. Try starting with a small amount of deep-fried and tempura white fish, pumpkins and potatoes, which are digestible, after approximately six months after the surgery.

If you are purchasing precooked food to shorten the cooking time and labor, how about considering using cut vegetables and seasoning mix and cooking using a microwave?

A．100 ml or a glass of wine is 80kcal.
30 ml of undiluted brandy is 80kcal. After gastrectomy, alcohol is absorbed more quickly and makes you feel drunk easily. Reduce the amount of undiluted liquor and choose to dilute it with water rather than on the rocks to drink slowly.
A cup (180 ml) of sake is 200kcal.
50 ml of undiluted shochu (clear distilled liquor) is 80kcal. As carbonated beverages make your stomach feel bloated, it is best to dilute it with hot water.

A．Three pieces of chocolate are 80kcal. As it contains a lot of fat, it may cause diarrhea.

A．Be careful with acidic food for the first three to six months after the surgery. It is OK to have it if you mix it with other ingredients such as honey.

A．It is OK if you dilute it. It is best to cool it down if it’s hot and avoid having it cold.

A．It is OK if there are no symptoms.

A．Please come in for a consultation as we would like to confirm whether you are eating food that will put on weight or not. Please consult with a certified nutritionist regarding your concerns even if they seem little.

A．It is not good to put pressure on your body when you are not taking in energy. Please check your pulse during the exercise for reference. It should be around 120 beats per minute. Muscles have a nature to get stronger as defense. Excessive loads require proteins. If you are lacking energy and put pressure on your body, it could take energy away from the muscles. You must make sure to exercise with low loads.