From the Research
After a Heller myotomy procedure for achalasia, patients should follow a progressive diet plan that begins with clear liquids for the first 24-48 hours, as this approach has been shown to minimize complications and promote healing 1. The diet plan should include:
- Clear liquids for the first 24-48 hours, such as water, broth, apple juice, and tea
- Full liquids like smoothies, yogurt, and protein shakes for 3-5 days once clear liquids are tolerated
- Soft foods (scrambled eggs, mashed potatoes, well-cooked pasta) for about 1-2 weeks
- Gradual reintroduction of regular foods, avoiding items that commonly cause reflux such as spicy foods, citrus, chocolate, caffeine, and alcohol Throughout recovery, patients should:
- Eat small, frequent meals
- Chew thoroughly
- Stay upright for 2-3 hours after eating
- Drink plenty of fluids between meals rather than with food This gradual progression allows the surgical site to heal properly while minimizing complications like dysphagia or reflux. Some patients may benefit from acid-reducing medications like proton pump inhibitors (such as omeprazole 20-40mg daily) to manage post-surgical reflux, which is a common side effect of the procedure since the lower esophageal sphincter has been partially cut 2. It's worth noting that the treatment of achalasia should be chosen in accordance with patient goals, and peroral endoscopic myotomy may be associated with the lowest rates of perforation/leak, dysphagia, and reintervention 1.