Introduction

After oesophagectomy dairy products (rich in lactose) should be slowly introduced into your diet. Some people may become lactose intolerant after having an oesophago- gastrectomy. This causes problems digesting lactose, a type of sugar found in dairy products. The reasons for this are unclear as the gut enzyme (lactase) responsible for lactose digestion is present in the upper small intestine only however the activity of this enzyme may decrease after such major surgery. Symptoms of lactose intolerance include bloating, flatulence, and diarrhoea. They usually start soon after eating dairy products. 

If you have symptoms of lactose intolerance early after surgery it may be worthwhile re-introducing dairy products after a few months as this condition can improve with time. Former patients have found that they are able to tolerate milk again in this way.

Milk and milk-based foods are an important energy and protein source - if you find no improvement in your symptoms with choosing lactose-free alternatives, reintroduce these foods and seek advice from your Dietitian.

To test your tolerance to dairy foods, start by drinking a small cup of milk. If you do not have any of the symptoms of lactose intolerance, you can start eating more dairy foods. Foods with large amounts of lactose are milk, butter, cheese and ice cream. If you become lactose intolerant, you may still be able to eat certain hard cheeses, yogurt, and butter. These foods have smaller amounts of lactose than other dairy products.. As an alternative, lactosefree milk is also available at major supermarkets. So for quite a few of the recipes that follow, you may have to use soya milk, lactose-free milk, rice milk or oat milk. If you think you may be lactose intolerant discuss this with your doctor who will be able to advise dietary review.

Having part of your digestive system altered/changed by surgery can sometimes result in food giving us sensations of dizziness, nausea and sweatiness (‘dumping syndrome’). This is due to changes in your blood pressure in the case of “early dumping” (soon after eating); and low blood sugar caused by insulin: sugar imbalance in the case of “late dumping” (an hour or so after eating).

Your Dietitian can advise you on dietary changes to help with Dumping Syndrome. A small number of people may also experience difficulties digesting and absorbing fats from their diet after the surgery due to poor release of enzymes in the gut (‘fat malabsorption’ or ‘steathorrhoea’). If your stools are pale, floating, loose and/or frequent, or you are losing weight despite a good 5 appetite, seek advice from your Doctor or Dietitian. Do not reduce fats in your diet, as these are an important energy source - discuss with your medical team before making changes.

For those who need to stabilise their weight or even put weight back on many patients recommend using butter, olive oil, cream cheese, double cream or crème fraiche as additives to foods. These are very tasty and the usual advice is to limit your intake of them but during periods where you need to put weight on they work very well for that purpose. It may be hard to reduce intake once you have succeeded!

The more of your stomach that has been removed, the more likely it is that you may suffer from low iron and vitamin B12 levels. This is because part of your stomach that helps you absorb vitamin B12 may be missing, and the altered environment reduces the amount of iron that can be absorbed from your food. We have therefore included a section on iron-rich foods, but some of us will need vitamin B12 injections and/or iron supplements. Zinc, Iron and vitamin B12 are both important to prevent anaemia. 

Some of the recipes will be suitable for vegetarians. This information is not prescribing anything. If you fancy a suggestion, try it. If you have something else that suits you and you wish to share it with others, please let us know and we will include it in any future editions. “We are all different” is something we are used to hearing, so please feel free to reject things that do not suit you.

This is recipes and food ideas for people who may need to put on weight, have difficulty in swallowing, or who are living with the after-effects of surgery on our stomach and/or oesophagus (gullet).

This is based on the experience of members of the Oesophageal Patients Association who typically face problems with altered taste buds, loss of appetite, weight loss, difficulty in swallowing, and/or a disrupted digestive system. Putting on weight is sometimes a distant aspiration rather than a problem (except for the wardrobe), so a great deal of the orthodox dietary and nutrition advice seems to be the opposite of what we need. Some of the recipes are favourites for those whose surgery was a number of years ago, but they have been included notwithstanding that some people may not feel able to cope with them at the moment. Things to look forward to, perhaps!

If we have had our stomach and/or oesophagus partly or completely removed, we have to eat small amounts, more often. So what to eat is a question that occurs many times each day! Sometimes the very act of eating and its consequences can overshadow what should normally be an important part of our quality of life, so anything that helps us find food that a) does not cause a problem, and b) is appetising, is very welcome.

We have given details of the origin of the recipes at the end of this page, and some sources for other ideas.

USING ENERGY SUPPLEMENTS

Special nutritional drinks may be supplied by the hospital, or through your GP. “Your Dietitian can assess your dieatry intake and advise which of the supplements listed below are most appropriate for your needs”. Others (like Complan or Build Up) can also be bought over the counter at chemists or certain large supermarkets. You may find you do not like all (or any!) of the flavours of these drinks on their own.

  • Resource Energy, Ensure Plus, Fortisip, Fresubin Energy: different brands of high energy and protein milkshake style drinks.
  • Clinutren 2.0 Fibre, Ensure Plus Fibre, Fortisip Multifibre, Fresubin Energy Fibre: different brands of high energy and protein milkshake style drinks with fibre.
  • Clinutren fruit, Ensure Plus Juce, Fortijuce: different brands of high energy and protein juice style drinks.
  • Ensure Plus Yoghurt Style, Fortisip Yogurt Style: different brands of yoghurt tasting supplement drinks.
  • Ensure Two Cal, Fortisip Compact, Fresubin 2kcal: different brands of higher energy and protein milkshake style drinks.
  • Enshake, Calshake, Scandishake, Complan Shake (different to over the counter Complan): different brands of high energy and protein powder sachets to mix with fresh milk.
  • Prosource, Procal Shot, Calogen: very low volume supplements concentrated in calories and or protein.
  • Vitasavoury, Ensure Plus Savoury: soup style supplement.

The following suggestions are made using appropriately-flavoured drinks such as Complan, Fortisip, Fortijuce and so on. The principle is the same regardless of which product you have.

Fortified milk is a useful supplement easily made at home, used like ordinary milk but giving more protein and energy. Mix 4 tablespoons of milk powder into a pint of milk (easiest in a blender).

Some people find it helpful to pour it into ice cube trays and then use them as ice cubes.

Complan Soup

1 tin or packet of soup
3 heaped dessert spoons natural flavour Complan

Heat enough soup for one serving, following the instructions on the tin or packet. Mix Complan with a little cold water to make a smooth paste. Remove soup from heat and slowly stir in the Complan.

Complan Angel Delight

1 packet Angel Delight
3 heaped dessert spoons natural flavour Complan
½ pint cold water

Mix Complan with a little water to make a thin cream, then add the remaining water. Sprinkle in the dessert powder and whisk briskly.

Complan Jelly Cream

1 pint packet jelly
4 heaped dessert spoons Complan (a flavour that blends with the jelly)

Make the jelly in the usual way and leave until cold by not set. Mix Complan with a little cold jelly to make a smooth cream. Blend mixture into jelly, stirring slowly all the time. Pour into four individual moulds or dishes and leave to set.

Build-Up Milk Jelly

1 sachet strawberry Build-Up
1 packet strawberry jelly
½ pint milk or fortified milk or vanilla Ensure

Dissolve jelly in a little boiling water and make up to ¾ pint with cold water. Mix Build-Up with the milk. When jelly is cold but not set, stir slowly into the Build-Up. Pour into individual dishes or moulds and leave to set. Alternative flavours. Vanilla Build-Up with various jelly flavours, or chocolate. 

Build-Up Yogurt

½ sachet Build-Up
5oz carton natural full-fat yoghurt

You may find Build-Up too sweet: mixing it with plain yogurt gives it a much sharper flavour.

Ensure instant Soup

1 can Ensure
1 packet instant soup mix (e.g. Cup-A-Soup)

Heat Ensure but do not boil, add soup mix, stir well, blend and serve.

Ensure Banana Shake

1 banana
1 can chilled Ensure

Peel and slice the banana. Place in blender, add Ensure and blend until smooth.

Chocolate Diablo

1 tablespoon drinking chocolate
1 teaspoon instant coffee
1 can Ensure Pinch cinnamon

Mix chocolate, coffee and cinnamon, add 2oz Ensure and stir until smoothly mixed. Stir in the rest of the Ensure and heat to required temperature, stirring all the time. Do not boil. Alternatively, use chilled Ensure, mix as before and blend (with a scoop of ice cream if liked).

Milkshake

1 cup milk
1 packet Build Up or Complan – flavour of your choice
1 Scoop ice cream

Blend all ingredients together and serve.

Fruit Milkshake

1 cup milk
1 cup tinned fruit (drained) or fresh fruit
1 packet vanilla Build Up, Complan or full cream milk
1 teaspoon sugar (optional)

Liquidise the fruit. Add other ingredients. Blend and serve.

SOUPS

Stilton Cheese Soup

2oz butter
1 onion, finely chopped
2 sticks celery, finely chopped
1 ½oz flour
5 tablespoons white wine
1 pint chicken stock
½ pint milk
4oz blue Stilton cheese, crumbles
2oz Cheddar cheese, grated
Salt and freshly ground pepper
4 tablespoons double cream

Melt butter in a saucepan, add vegetables and fry gently for 5 minutes. Stir in flour and cook for 1 minute. Remove from heat and stir in the wine and stock; return to heat and bring to boil; simmer for 30 minutes. Add milk and cheese, stirring constantly. Season, stir in cream, liquidise, reheat but do not boil.

Smoked Fish Chowder

1lb smoked haddock fillet
8oz potatoes, finely chopped
6oz carrots, finely chopped
2oz butter
2 level table spoons flour
¼ pint single cream
Salt and freshly ground pepper

Simmer the fish in 2 pints water for 10 minutes until tender; drain and flake coarsely, discarding the skin and bones. Sauté onion in the butter until soft, then stir in the flour; gradually add the strained fish stock and bring to the boil, stirring. Add potatoes and carrots, simmer for about 10 minutes until tender, stir in flaked fish and cream, season well; liquidise and sieve if necessary; reheat but do not boil.

Chicken and Vegetable Soup

2 onions
½lb carrots
2 turnips
¼lb mushrooms
A few frozen peas and any other vegetables in season
2oz butter
11/2 pints chicken stock
Salt and freshly ground pepper
Mixed herbs

Finely chop vegetables; melt butter in saucepan and sauté onions until soft; add the other vegetables and chicken stock; bring to the boil and simmer until vegetables are soft; season, liquidise, sieve and reheat. 

Cream of Mushroom Soup

½lb mushrooms, sliced
¾ pint chicken stock
1 small onion, chopped
1oz butter
1oz flour
¾ pint milk
2 tablespoons cream
Salt and freshly ground pepper

Place the mushrooms in a pan with the onion and stock, bring to the boil and simmer for 20 minutes until tender; liquidise. Melt butter in a pan, add the flour and cook for 1 minute; gradually blend in the milk and then the prepared mushroom purée and season to taste; bring to the boil and simmer for 5-10 minutes. Just before serving stir in the cream.

Winter Vegetable Soup

(It makes lots – so freeze half. You will need a blender)

500g Potatoes
300g Carrots
2 large onions
4 cloves of garlic
1 large leek
300g parsnips
300g swede
Small bunch of chopped parsley
2 vegetable stock cubes or 2 tbsp. bouillon/broth
Olive Oil
Salt and Pepper

Peel and chop the potatoes, parsnips, swede and carrots roughly into 2cm cubes. Wash and slice leeks. Peel and chop the onions and garlic. Put enough oil in a big pan to cover the bottom and gently fry the vegetables in this order: potatoes, swede, parsnips, carrots, leeks, onions and garlic. With the lid on, cook gently, stirring occasionally until the vegetables are really soft. Meanwhile: make the stock. Add the stock cube or bouillon to 2 pints of boiling water. Add to the pan and bring to the boil. Simmer for 5-10 minutes. Blend in the pan with a hand-blender or in a food processor. Add salt & pepper to taste and serve with the finely chopped parsley.

Spicy Lentil Soup

(This makes a lot and freezes well. Keep some for another day!)

250g dried red lentils
250g onions
3 cloves of garlic
250g carrots
250g leeks
Small bunch of parsley
3 bay leaves
1 tbsp. cumin powder
4 tbsp. tamari
Olive Oil
Salt and Pepper

Peel and roughly chop the carrots, onions, leeks and garlic. Fry the vegetables slowly in enough olive oil to cover the bottom of a large pan, and stir occasionally. Add the cumin and cook until the vegetables are almost soft. Add 2 ½ pints of boiling water, the bay leaves and lentils. Bring to the boil, turn down the heat and simmer for about 10 minutes until the lentils are soft. Add tamari, and salt and pepper to taste. Remove the bay leaves and blend the soup. Chop the parsley and garnish the soup. Eat with a green leafy salad.

IDEAS FOR HARD DAYS

If you cannot face the thought of other food, you may be able to manage some of these drinks, jellies and frozen desserts. Keep some in the fridge and freezer for days when you don’t feel like eating. Serve them well chilled and take drinks through a straw. You can also buy chilled and frozen desserts to use in the some way or freeze fruit-flavoured supplements to make ice-cream or sorbets.

Citrus Cup

Equal quantities of orange Polycal and lemonade.

Mix and serve.

High Protein Milkshake

½ pint fortified milk
1 scoop vanilla ice-cream

Put the ingredients into the blender and blend at low speed for a few seconds. Flavour with Ribena, Crusha syrup or fruit purée; for energy use maple syrup or honey. For iced coffee use a dessertspoon of coffee essence or a teaspoon of instant coffee with sugar to taste, and blend with milk before adding ice cream (vanilla, coffee or chocolate).

Tomato Yoghurt

5oz carton plain yoghurt
¼ pint tomato juice
2oz high energy powder, e.g. Maxijul or Caloreen
2-3 fluid oz hot water

Dissolve the high energy powder in the hot water; mix all ingredients by hand or in a blender; flavour with Worcestershire sauce, celery salt or just salt and pepper; chill well and serve in a tall glass with a straw.

Yoghurt Cooler

5oz carton fruit yoghurt
¼ pint milk

Mix together by hand or in a blender. Serve in a glass with straw.

Jelly Whip

1 packet jelly
1 small tin evaporated milk

Chill the tin of milk in the fridge for a few hours. Dissolve jelly in ¾ pint hot water and allow to cool. Whisk evaporated milk until it forms peaks and stir into the cool but not set jelly. Pour into individual dishes and place in the fridge to set.

Lemon Water Ice

Grated rind and juice of one lemon
2 oz sugar
2 tablespoons of honey
1 teaspoon of gelatine
½ pint of water

Heat sugar and water together, allow to boil for five minutes. Dissolve gelatine in a little hot water. Mix lemon rind, juice and honey into the hot syrup, add gelatine, and stir well. Cool, stirring occasionally, then freeze. When beginning to set at the edges, whisk with a fork, pour into individual dishes and complete freezing. 

Frozen Fruit Mousse

Best fruits to use: Fresh, tinned or frozen raspberries, strawberries, apricots, peaches, plums, blackcurrants and rhubarb.

¾lb fruit
3 - 4 oz sugar
½ pint whipping cream or small tin of evaporated milk, chilled
1 teaspoon gelatine

If using firm fresh fruit, stew in a little water until soft; drain and make into a thick purée in the blender or by sieving; add sugar to taste. Dissolve gelatine in a little hot water; stir into the fruit and cool in the fridge. When just beginning to set, whisk well. Whip the cream or evaporated milk and fold in the fruit; pour into individual dishes and freeze.

SOFT NUTRITIOUS FOODS AND SOME WAYS TO TAKE THEM

(Feel free to adapt the suggestions according to your own tastes!)

  • Porridge with full fat milk/fortified milk, ground almonds and sugar
  • Pancakes with chocolate spread
  • Many soup recipes are suitable as long as a processor/blender is used.
  • There are many varieties of prepared sauces, in tins, jars or packets.
  • Soups, especially if condensed, also make good sauces.
  • Shepherd’s pie, moussaka, pasta dished with creamy sauces or lots of olive oil (liquidise, if necessary, after cooking), braised meat and stews.
  • Poached or flaked fish in sauce – try hollandaise, lemon sauce, parsley or mushroom sauce
  • Instant mashed potato, enriched with butter or cheese, for when the family is having chips or roast potatoes.
  • Lentils; Dahl with coconut milk
  • Grilled bacon or ham, in scrambled eggs or omelettes.
  • Grated cheese, Omelettes, Soufflés, Scrambles eggs
  • Avocado, Hummus, taramasalata, peanut butter, cottage cheese, cream cheese
  • Fish pates – salmon, tuna, smoked mackerel, made softer with milk, cream, mayonnaise or stock
  • Ice cream, milk puddings, egg custard, mousses, full fat yoghurt, milk jelly, crème caramel, fromage frais
  • Angel Delight made with fortified milk and served with fruit, e.g. butterscotch flavour with stewed apple, or chocolate with mashed banana.
  • Fruit: mashed, blended or ripe (tinned or fresh) – stewed apple, soft banana, fresh strawberries, ripe melon, tinned pears etc. Add cream, custard, Greek yoghurt or ice cream for extra calories.
  • Milk shakes; Smoothies with yoghurt or soya milk
  • Use milk, cream fruit juice, sauces, stock or gravy as appropriate to soften the consistency of foods.
  • Cartons of fresh stock can be bought in supermarkets – more nutritious than stock cubes.
  • Herbs to add flavour – e.g. thyme, basil, oregano, parsley, mint, chives.
  • Cranberry sauce, red currant jelly and chutney to add piquancy to meat dishes

Stock

Ask the butcher for 1lb of soup bones
One or two peeled onions
One peeled clove of garlic
One peeled carrot
One medium – large tomato
One teaspoonful of herbs (dried or fresh)
One leek (optional)

Place these in a pan with peeled onions, peeled clove of garlic, peeled carrot, tomato, teaspoonful of herbs (dried or fresh). If you have a leek use one of them too. Cover with water, bring to the boil, and simmer for 2-3 hours allowing the stock to reduce to around a pint. Drain it through a sieve or a colander.

DRINKS

Banana Smoothie

Serves 3

¼ cup of orange juice
4 bananas
3 scoops of plain ice-cream
2 tablespoons of golden syrup
3 tablespoons of plain yoghurt
Lemon juice (optional)
Sugar (optional)

Cut the bananas into small pieces and put in the blender. Add all the other ingredients. Blend on full for 20 seconds. Put lemon juice around the rim of the glasses then roll the rim in sugar so it sticks to the lemon juice. Serve immediately.

Chocolate Dream Smoothie 

Serves 2

1¾ pint chocolate ice cream
18fl oz milk
1 scoop vanilla ice cream
Chocolate shavings

Mix all of the ingredients in a blender, then sprinkle the chocolate shavings on top for decoration.

Lemon and Melon Burst Smoothie 

Serves 2

½ cup of diced honeydew melon
½ cup of low fat lemon yogurt
1 cup frozen green grapes
1 tablespoon of chopped fresh mint
Fresh lemon juice to taste (if preferred)

Put the honeydew melon and lemon yogurt in a blender. Next add the grapes and mint then blend until smooth. Taste and add lemon juice if you like.

Yogurt smoothie

1 pot full fat yoghurt, flavour of your choice
1 banana
1 packet Build Up or Complan
1 cup milk
1 teaspoon sugar (optional)

Blend all ingredients together.

Milkshake

1 cup milk
1 packet Build Up or Complan – flavour of your choice
1 scoop ice cream

Blend all ingredients together and serve.

Coffee Calypso

1 cup milk
1 packet Build Up, Complan or full cream milk
1 teaspoon instant coffee (vary amount according to your taste)
1 scoop ice cream

Dissolve coffee in a little hot water. Add to other ingredients. Blend and serve. 

Choc-mint surprise

1 cup milk
1 packet chocolate Build Up or Complan
2 table spoons single cream
Few drops peppermint essence (vary to taste)
1 scoop ice cream

Blend or whisk all ingredients together except the ice cream. Pour into glass, add ice cream and serve.

Sherbet fizz

1 packet vanilla Build Up, Complan or full cream milk
1 scoop ice cream
150mls lemonade

Blend all ingredients together and serve immediately.

SNACKS

Eggs Benedict

“Can there be anybody who doesn’t drool at the thought of Eggs Benedict? Soft, squidgy, lightly toasted muffins, really crisp bacon and perfectly poached eggs which, when the yolks burst, drift into a cloud of buttery hollandaise sauce. It’s certainly one of the world’s great recipes. Although originally it was meant to be served at breakfast or brunch (and still can be), I think it makes a great first course, particularly in winter. A light version of this can be made using Foaming Hollandaise, which also has the advantage that it can be prepared ahead.

Serves 3 for brunch or 6 as a starter.

1 quantity Hollandaise Sause
6 large, very fresh eggs
12 slices of pancetta, grilled until crisp
3 English muffins, split in half horizontally
A little butter

Pre-heat grill to its highest setting.

Make the hollandaise sauce, if you wish, by referring to Delia Smith’s recipe.

Poach the eggs. When the pancetta is cooked, keep it on a warm plate while you lightly toast the split muffins on both sides. Now butter the muffins and place them on the baking tray, then top each half with two slices of pancetta. Put a poached egg on top of each muffin half and then spoon over the hollandaise, covering the egg (there should be a little over 1 tablespoon of sauce for each egg).

Now flash the Eggs Benedict under the grill for just 25-30 seconds, as close to the heat as possible, but don’t take your eyes off them – they need to be tinged golden and no more. This should just glaze the surface of the hollandaise. Serve straight away on hot plates.”

Extracted from Delia’s Complete How to Cook, published by BBC Books Copyright © Delia Smith, 2009. For more recipes visit www.Deliaonline.com

Avocado Mousse with Prawns and Vinaigrette

“This is a delicious, creamy and most attractive starter to a dinner party. But don’t make it too far in advance as it tends to lose its beautiful colour.

Serves 8

2 ripe avocados
½ oz (10g) powdered gelatine
5 fl oz (150ml) hot chicken stock
5 fl oz (150ml) soured cream
5 fl oz (150ml) mayonnaise
Juice of half a lemon
1 clove garlic, finely chopped
3oz (75g) peeled prawns
Vinaigrette to serve (see recipe underneath)
Salt and freshly milled black pepper

You will also need 8 small ramekins, lightly oiled, a pestle and mortar, a 1 ½ pint (850ml) basin and an electric mixer (or balloon whisk, if you need the exercise).

To make the avocado mousse, put 3 tablespoons of stock and the gelatine in a bowl and stand it in a pan of simmering water. Stir until the gelatine is dissolved, then pour into the goblet of a liquidiser with the rest of the stock.

Next, skin and stone the avocados, chop the flesh roughly and add it to the liquidiser (include the darker green part that clings to the skin – this will help the colour). Now add the lemon juice and garlic, and blend until it’s completely smooth. Empty the mixture into a bowl and stir in the soured cream and mayonnaise very thoroughly, then season with salt and pepper.

Spoon the mixture into the lightly oiled ramekins, cover them with cling-film and pop them into the fridge to set. When you’re ready to serve, slide a palette knife around the edge of each ramekin and ease the mousse away from the sides. Turn the mousses out on to serving plates, top each one of them with some of the prawns and sprinkle some vinaigrette over each serving. Have plenty of crusty bread ready to go with this”

Extracted from Delia’s Complete Illustrated Cookery Course, published by Ebury Press. Copyright © Delia Smith, 2009. For more recipes visit www.Deliaonline.com

Vinaigrette Dressing

(To accompany Delia’s Avocado Mousse with Prawns recipe on previous page)

“It has to be said that this is always going to be a matter of personal taste according to how much acidity you like and what your preferences are as to flavourings and so on. I seem to suffer from some kind of mental handicap with dressings, which roughly means that other people’s salad dressings always seem to taste better than my own – my husband’s particularly. Here I have set out my favourite version of vinaigrette, but its adaptable: you can use red or white wine vinegar, a different mustard or no mustard; if you like it sharper, use a higher ratio of vinegar, and if you want it less sharp use a higher ratio of oil. The following combination is my own personal favourite. Vinaigrette dressing is best made and used as fresh as possible, because once the oil is exposed to the air it loses some of its fragrance. If you want to prepare things ahead, proceed up to the vinegar stage and leave adding the oil till last minute.

Serves 4-6; halve the ingredients for 2-3. You will also need a pestle and mortar.

1 rounded teaspoon Maldon sea salt
1 clove garlic, peeled
1 rounded teaspoon mustard powder
1 dessertspoon balsamic vinegar
1 dessertspoon sherry vinegar
5 tablespoons extra virgin olive oil
Freshly milled black pepper

Begin by placing the salt in the mortar and crush it quite coarsely, then add the garlic and, as you begin to crush it and it comes into contact with the salt, it will quickly break down into a purée. Next, add the mustard powder and really work it in, giving it about 20 seconds of circular movements to get it thoroughly blended. After that, add some freshly milled black pepper. Now add the vinegars and work these in in the same way, then add the oil, switch to a small whisk and give everything a really good, thorough whisking. Whisk again before dressing the salad.”

Extracted from Delia’s Complete Illustrated Cookery Course, published by Ebury Press. Copyright © Delia Smith, 2009. For more recipes visit www.Deliaonline.com

Chicken Liver Parfait with French Bread

(A good source of iron)

325g unsalted butter, melted and cooled slightly, plus a little extra for greasing
500g chickens’ liver, trimmed
1 garlic clove, crushed
2 tbsp. brandy
Tiny pinch each of ground nutmeg, cloves, cinnamon and allspice
1 baguette, sliced and toasted, to serve

Preheat the oven to 110°C/fan 90°C/gas ¼. Grease 8 x 100ml ramekins with melted butter, then set aside.

Put the liver, garlic, brandy and spices into a food processor. Season with white pepper and 1 teaspoon salt and blend for 1 minute. With the machine still running, add 225g melted butter and blend for a few seconds. Press through a fine sieve into a bowl.

Divide the mixture among the ramekins and cover with buttered foil. Put in a small roasting tin and pour in hot water to come halfway up the sides of the ramekins. Cook for 45 minutes or until just set. Remove from the tin and cool. Remove the foil and cover each ramekin with cling film. Chill overnight.

Slowly melt the remaining butter in a small pan. Remove from the heat set aside for 10 minutes, then pour away the clear butter, leaving just the sediment. Pour a thin film over each parfait and chill until set. Serve with the toast and some onion marmalade.

Wine Recommendation - A luscious pudding win, well-chilled. Try Sauternes or a good value option, Monbazillac.

Reproduced by courtesy of Delicious magazine. The recipe was by Debbie Major. “For more delicious recipes” they invite you to go to www.deliciousmagazine.co.uk and state that the recipe cannot be reproduced without further permission.

Macaroni Cheese (by Nigella Lawson)

Serves 4

250g macaroni
250g mature Cheddar or red Leicester or a mixture of both
250ml evaporated milk
2 eggs Grating of fresh nutmeg
Salt and pepper

Preheat the oven to 220°C/gas mark 7. Cook the macaroni according to the packet instructions, drain and then put back into the hot pan.

While the pasta is cooking, put the cheese, evaporated milk, eggs and nutmeg in a processor and blitz to mix. Or grate the cheese and mix everything by hand.

Pour the cheese sauce over the macaroni, stir well, and season with salt and pepper to taste.

Tip into a 25.5cm-diameter dish (wide and shallow is best) and bake in the very hot over for about 10-15 minutes, or until it is bubbling and blistering on top.

Home-made chips

1 medium potato per person
Olive Oil Kitchen paper
Tomato Sauce
Salt

If using organic potatoes, just wash and chop. Fry in enough olive oil to half cover the chips. Keep turning until they are golden brown. Drain on kitchen paper. Serve with tomato sauce – home-made or bottled.

Jacket Potatoes

1 large potato per person
Filling

Skewer potatoes on metal skewers or warp in silver foil, and cook in medium oven until soft.

Split open and fill with hummus, soya cheese, baked beans, shepherdess pie filling or ratatouille.

Other Snacks

Keep snacks to hand so you can nibble throughout the day:

  • Nuts, Bombay mix, cheese, pate, peanut butter, cheese biscuits, crackers, breadsticks, dips – such as hummus or tarasamalata, crisps, nachos, tortilla chips, pepperoni, cheese dippers.
  • Popcorn, yoghurt, muesli bars, chocolate, sweets, dried fruit, breakfast cereals e.g. crunchy nut cornflakes.
  • Teacakes, muffins, crumpets, croissants – add butter and jam
  • Sandwiches – made from sliced bread, toast, bagels, baguette, chapatti or pitta bread. Fill with cold meats, tinned fish, pate, dhal, hummus, egg, bacon, cheese or peanut butter. Add mayonnaise, pickles, chutneys, salad or avocado to make them more interesting.
  • On toast: baked beans, cheese, sardines, eggs – poached, scrambled or fried. Add plenty of butter or margarine and top with grated cheese.
  • French toast (eggy bread) or omelette – add cheese/mushrooms/ ham.
  • Jacket potatoes – with butter and fillings such as cheese, beans, tuna mayonnaise, chilli con carne, coleslaw, bolognaise sauce, hummus or sour cream.

MAIN COURSES

Pork Tenderloin with maple syrup and beet glaze

Serves 2 - 3

1 tbsp. butter
Salt & Pepper
1 tbsp. coriander – ground
1 medium red beet
¾ cup maple syrup
¾ cup chicken stock
¼ cup Worcester sauce

Pork – rub the coriander into the pork, rubbing it well into the meat. Brown the pork tenderloin in a frying pan with melted butter. Turn the port to brown all sides well.

Sauce – in a skillet pour the maple syrup, chicken stock and the Worcester sauce. Add the chopped beets and bring mixture to boil. Then reduce the heat and let simmer to reduce the liquid volume.

Transfer the pork to the reduction skillet and coat the pork well. Then place in a pre-heated oven at 350°F (180°C) and cook for 15 minutes. Slice the pork and spoon the glaze over the meat

Ham Custard

Serves 2

4oz cooked ham, minced or chopped
½ pint milk
2 eggs
Salt and Pepper

Grease a 1 pint baking dish and place the ham in it. Beat eggs, milks and seasoning and pour over the ham. Stand the dish in a shallow pan of hot water and bake at 325°F (170°C, Reg 3) until set (40 – 50 minutes).

Variations; you can replace the ham with cooked chicken, grated cheese, or flaked cooked fish. Cooked vegetables may also be added.

Cheesy Tuna Casserole

Serves 4

7oz tin tuna
1 tablespoon chopped onion
2 eggs
8oz cottage cheese
2oz fresh breadcrumbs
Salt and pepper

Drain and flake the tuna; mix with cottage cheese, onion, breadcrumbs and seasoning. Beat the eggs and mix well with the fish mixture. Turn into a greased 1 pint casserole dish and bake at 350°F (180°C, Reg 4) until set (30- 40 minutes).

Fish Mousse

Serves 2

4oz tinned salmon, tuna or kipper fillets
3 fluid oz whipping cream
2 tablespoons mayonnaise
A little lemon juice
Salt and pepper
2 teaspoons gelatine

Dissolve the gelatine in a little hot water. Flake the fish, removing any bones or skin; blend if necessary. Mix well with the mayonnaise and lemon juice and season to taste. Stir in the gelatine. Whip the cream until it forms peaks, and fold into the fish mixture. Pour into a serving dish and place in fridge until set.

Chicken Supreme

Serves 1

About 3oz cooked minced chicken
Tinned condensed mushroom soup

Mix together and heat gently in a saucepan. Serve with rice. Variations; chopped cooked vegetables can be added or other kinds of meat or fish can be combined with different varieties of condensed soup.

Seafood Linguine

Serves 2

200g pack of seafood cocktail (Sainsbury’s do one that can be frozen)
225g linguine pasta
4 gloves of garlic (or more if you wish)
225g tin of chopped tomatoes
4 – 5 shallots (more if you like)
Glass of white wine
Olive Oil
Salt and black pepper
Chopped parsley
1 medium chilli (optional). If you like it hot, leave seed in; de-seed it if you want milder. Can use a pinch of dried chilli flakes as an alternative. The size of the pinch depends on how spicy you want it. Chilli does give it a lift, depending on your taste.

Cook linguine as recommended – usually 10 – 15 minutes. Heat oil and sauté shallots with crushed garlic and chilli. Drain tomatoes and keep liquid. Add wine and tomatoes and then re-add tomatoes juice to make the sauce to your preferred consistency. Add seafood and gently stir until heated through. Season to taste. Drain linguine and put in large, warned serving dish. Add seafood mixture and garnish with good handful of chopped parsley. 

Clam Linguine

As for Seafood linguine, but omit tomatoes, and use about 1lb of clams and 4 rashers of pancetta or thin sliced dry-cured bacon instead of seafood cocktail.

Fry the bacon with the shallots, but everything else is roughly as for Seafood linguine. May want to add a drop more wine!

Kedgeree

Serves 2

This is a traditional breakfast dish from colonial India, with a nice balance of spicy and smoky flavours. It also makes a tasty lunch or supper. The ingredients can be modified without too much of a drastic result!

1 large free-range or organic egg
175g undyed smoked haddock fillets, pin boned
2 fresh bay leaves
4oz long grain or basmati rice
Sea salt
110g pure butter ghee
A thumb-sized piece of fresh ginger, peeled and grated
1 medium onion, or 1 bunch of spring onions, finely chopped
1 clove of garlic, peeled and finely chopped
Juice of 1 lemon
1 good handful of fresh coriander, leaved picked and chopped
1 fresh red chilli, finely chopped (de-seeded if you want it milder)
A small pot of natural yoghurt

Boil the eggs for 10 minutes, then hold under running water. Put the fish and bay leaves in a shallow pan with enough water to cover. Bring to the boil, cover, and simmer for about 5 minutes until cooked through. Remove from pan and leave to cool. Remove skin from fish, flake into chinks, and set aside.

Cook the rice in salted water for about 10 minutes and drain. Refresh in cold water, drain again and leave in the fridge until needed.

Melt the butter ghee in a pan over a low heat. Add the ginger, onion and garlic. Soften for about 15 minutes, then add the curry powder and mustard seeds. Cook for a further few minutes, then add the chopped tomatoes and lemon juice.

Quarter the eggs. Add the fish and rice to a pan and gently heat through. Add the eggs, most of the coriander and the chilli and stir gently. Place in a warm serving dish. Mix the rest of the coriander into the yoghurt and serve with the kedgeree. 

Fish Pie

A great comfort food, and the fish combination can be almost anything!

2lb fish (e.g. haddock, cod)
Smoked haddock or cod if wished
A few queen scallops
Prawns
Butter
Flour
Parsley or similar seasoning
Potatoes

Boil and mash the potatoes. Poach the fish in milk. Make about a pint of white sauce, with butter and flour for a roux, and add the fishy milk to make it up. Do not make it too thick if you have made it in advance as it might make the pie heavy. Add layer of mashed potato, or boiled, sliced potatoes with butter on top.

Cheese Pudding

Serves 4

½ pint milk
Knob butter or margarine
3oz fresh breadcrumbs
4oz grated cheese
3 eggs
Salt and pepper
Pinch dry mustard

Grease a 2 pint baking dish. Put breadcrumbs into a bowl. Heat the milk and butter until just boiling and pout over the breadcrumbs; leave to cool for a few minutes. Separate the eggs; mix the yolks with the cheese and seasoning, and stir into the breadcrumbs. Whisk the egg whites until stiff and fold into the cheese mixture. Pour into the baking dish and bake at 375°F (190°C, Reg 5) until risen and brown (30 – 40 minutes). Serve at once.

Chicken and Pea Risotto

Serves 4 

2 tbsp. mild olive oil or sunflower oil
1 onion, cut in half, coarsely grated
2 garlic cloves, grated
250g/9oz Arborio risotto rice
100ml/3½fl oz white wine, dry vermouth or water
1 litre/1¾ pints chicken stock cube, made with 1 stock cube
250g/9oz cooked leftover chicken, skin removed, cut into small pieces
200g/7oz frozen peas
75g/2¾oz Grana Padano or other hard Italian-style cheese, finely grated
25g/1oz butter
Freshly ground black pepper

Heat the oil in a large, non-stick saucepan over a medium heat. Add the onion and garlic and fry for 2-3 minutes, stirring occasionally, until softened and just beginning to colour.

Add the risotto rice to the pan and stir well for 30-40 seconds, until the oil has coated the grains of rice.

Pour in half of the wine and allow to bubble for 30-40 seconds, then add all of the stock and bring to the boil, stirring well. Reduce the heat and simmer, uncovered, for 8-10 minutes, stirring frequently, until the rice is almost tender and the risotto is creamy in appearance.

Stir in the remaining wine, the chicken and the frozen peas, then continue to cook, stirring constantly, for a further 4-5 minutes, or until the chicken and peas are heated through and the rice is tender with a slight bite.

Remove the pan from the heat, then stir in the butter and cheese. Season with black pepper. Cover the pan with a lid and set aside for 5 minutes before serving. Courtesy of BBC Food - www.bbcgoodfood.com

PUDDINGS

French Rice Pudding

Serves 3-4

2oz ground rice
2oz sugar
1 pint fortified milk or milk and vanilla Ensure
1 egg

Heat milk and sugar in a saucepan until almost boiling; sprinkle in the ground rice, stirring well until just boiling. Simmer until rice is tender (3-4 minutes) and allow to cool slightly. Separate the egg and beat the yolk into the rice. Whisk the egg white and fold into the rice. Pour into a greased pie dish and stand it in a shallow pan of hot water. Bake at 350°F (180°C, Reg 4) until well risen (about 20 minutes).

Apricot Fool

Serves 3-4

12-16 oz cooked or tinned apricots (or other fruit)
½ pint high protein custard (see Sauces)
Sugar to taste

Drain the fruit well and sieve or blend to make a thick purée; sweeten to taste. Make the custard and whisk with the fruit. Pour into individual serving dishes. Chill, and serve with cream.

Quick Milk Pudding

Serves 3-4

2oz semolina, ground rice or flaked rice
2oz sugar
1 pint fortified milk or milk and vanilla Ensure

Heat milk and sugar until almost boiling. Sprinkle in the cereal, stirring well until just boiling. Simmer until cooked (3-4 minutes). Serve with jam, honey or golden syrup.

Baked Egg Custard

Serves 4

1 pint of fortified milk
3 eggs
1oz sugar
Grated nutmeg (optional)

Heat the milk until almost boiling. Beat the eggs and sugar together and pour the hot milk slowly over them, stirring well. Pour into a greased 1 ½ pint baking dish and sprinkle nutmeg on the top. Stand the dish in a shallow pan of hot water and bake at 325°F (170°C, Reg 3) until set (30-40 minutes). The finely grated rind of an orange can be added to the custard mixture if liked.

Other Puddings 

  • Milk puddings such as rice or semolina. Add jam, fresh or tinned fruit or cinnamon and sultanas and brown sugar.
  • Thick and creamy or custard-style yoghurt, fromage frais, fruit mousse or fool, trifle.
  • Tinned sponge pudding, jelly with tinned fruit and ice cream or cream. Add raspberry or chocolate sauce.
  • Hot or cold pie or crumble with cream, ice cream or custard. Waffles or pancake with maple syrup and cream or ice cream.
  • Cheesecake or sweet pastries with cream.
  • Baked apple or banana with brown sugar and sultanas. Serve with custard, cream or ice cream.
  • Whisk a small tin of evaporated milk into a cooled jelly made with ½pt water to make a milk jelly.
  • Use custard and stewed or pureed fruit to make a fruit fool.
  • Banana and chocolate or other confectionery can be chopped into Angel Delight.
  • Full fat Greek yoghurt with honey and soft fruit. This can be topped with brown sugar and grilled to make cr?me brûlée.
  • Adding cream to any pudding will boost the energy content. For convenience try aerosol creams. These keep well in the fridge. Long life cream is also useful. 

SAUCES

These recipes use fortified milk 

High Protein White Sauce

1 pint fortified milk
1 ½ oz butter or margarine
1 ½ plain flour

Melt the fat in a saucepan; add the flour and stir well. Cook gently for 1-2 minutes and remove from heat. Add the milk a little at a time, stirring well to make a smooth sauce. Return to heat, stir until sauce boils. For a savoury sauce season with salt and pepper; for a sweet sauce add sugar to taste. Variations, Cheese sauce; add 2-3oz grated cheese. Parsley Sauce; add 1-2 tablespoons chopped parsley. Egg Sauce; add a chopped hard-boiled egg.

High Protein Custard

1 pint fortified milk
2 tablespoons custard powder
1-2 tablespoons sugar

Mix sugar and custard powder to a smooth paste with a little cold milk. Heat the rest of the milk until just boiling. Pour on to the custard powder mixture, stirring well. Return to pan, stir until boiling and simmer for 1-2 minutes, stirring all the time.

High Protein Chocolate Sauce

1 pint fortified milk
1-2 oz sugar
1oz cornflour
½ oz cocoa powder

Mix sugar, cornflour and cocoa powder to smooth paste with a little cold milk. Heat the rest of the milk until just boiling. Pour into the cocoa mixture, stirring well. Return to pan, stir until boiling and simmer for 1-2 minutes, stirring all the time.

CAKE & CHEESECAKE

Cherry Cheesecake (Nigella Lawson)

125g digestive biscuits
75g soft butter
300g cream cheese
½ teaspoon lemon juice
60g icing sugar
1 teaspoon vanilla extract
250ml double cream
1 x 284g jar St Dalfour Rhapsodie de Fruit Black Cherry Spread

Blitz the biscuits in a food processor until beginning to turn to crumbs, then add the butter and whiz again to make the mixture clump. Press this mixture into a 20cm spring-form tin; press a little up the sides to form a slight ridge.

Beat together the cream cheese, icing sugar, vanilla extract and lemon juice in a bowl until smooth. Lightly whip the double cream, and then fold it into the cream cheese mixture.

Spoon the cheesecake filling on top of the biscuit base and smooth with a spatula. Put it in the fridge for 3 hours or overnight. When you are ready to serve the cheesecake, un-mould it and spread the black cherry over the top.

www.nigella.com/recipes

Chocolate Fridge Cake

50g sliced almonds, roughly chopped
25g pecans, chopped
25g walnuts, chopped
80g sultanas
80g dried cherries
220g digestive biscuits
170g butter, unsalted
150g dark chocolate (70%)
4 tablespoons golden syrup

Prepare the nuts and place in a large bowl with the fruit. Break the biscuits into small-sized chunks by hand, or with rolling pin and a plastic bag. Add to the fruit and nut mix.

Place a saucepan with hot water on the hob and place a glass bowl on top, making sure the water doesn’t touch the bowl. Place the butter, chocolate (broken into pieces to melt quicker) and the golden syrup into the bowl and stir until melted.

Remove the chocolate mixture from the heat and pour on top of the fruit and nut mix, incorporating it fully with a spoon. Grease and line with parchment paper or cling film and 28cm cake tin, leaving plenty of extra paper / film to cover the top later. Pour the contents into it, refrigerating for a minimum of two hours to allow it to harden.

If you wish, use shortbread instead of digestive biscuits; or use different sorts of fruit mixes. Pieces of white chocolate may also be added into the fruit and nut mix, along with miniature marshmallows.

This recipe (by Another cuppa?) is courtesy of www.Food.com

INCREASING YOUR IRON ABSORPTION

Iron is found naturally in certain foods. Haem iron, from animal sources, is more easily absorbed than non-haem iron, from plant sources. We can improve non-haem absorption by including a source of haem iron in the same meal. Iron absorption will also be helped by being including a source rich in vitamin C at the same time as your meal like:

  • Fresh fruit.
  • Fruit and vegetable juices e.g. orange, grapefruit, strawberry, mango, guava, papaya, blackcurrant, kiwi, tomato.
  • Vitamin C enriched squash or diluted fruit juice.
  • Fresh or frozen vegetables, such as broccoli, Brussel sprouts, tomatoes, potatoes, green & red peppers.

Some foods inhibit iron absorption, like:

  • Coffee, tea
  • Bran
  • Calcium and zinc supplements taken at the same time as a meal or an iron supplement.

Animal Sources of iron (haem iron):

Excellent sources: Red meat (beef, lamb, corned beef, beef burgers, pork, venison, veal), liver & offal (lamb, chicken, pork or beef)

Good Sources:

  • Liver plate* liver sausage, kidneys, black pudding
  • Salmon, sardines, pilchards, mackerel, kippers.
  • Turkey, chicken (especially the dark meat)
  • Prawns, crab, shrimp, lobster

Vegetable Sources (non-haem):

Excellent Sources:

  • Enriched breakfast cereals (Weetabix, bran flakes, cornflakes)
  • Pulses, beans, lentils (Baked beans, lentils, kidney beans, mung beans, split peas, chickpeas)

Good Sources:

  • Dried Fruits (apricots, raisins, dates, figs, prunes, sultanas)
  • Nuts and Seeds (pumpkin seeds, sunflower seeds, sesame seeds, almonds, brazils, cashew)

Other Sources:

  • Miscellaneous (blackstrap molasses, plain chocolate, treacle, tahini. Baked potatoes with skin, enriched pasta, canned asparagus)
  • Vegetables (green beans, broccoli, cabbage, spring greens, leeks, kale, okra, fenugreek, karela, watercress)
  • Wholemeal products (breads, chapattis, pitta breads) (Fortified in iron)

Meal and Snack ideas to increase iron intake:

Breakfast

  • Fortified breakfast cereal with semi-skimmed milk
  • Poached egg, baked beans, grilled tomato, lean grilled bacon, wholemeal toast. 

Lunch

  • Chicken Salad (watercress, grilled chicken, tomatoes, raw grated carrot)
  • Sardines in tomato sauce on wholemeal toast with mixed salad
  • Bean salad (chickpeas, red kidney beans, butter beans, onion, olive oil, garlic, lemon juice, cucumber, tomato)
  • Pitta bread with hummus, red pepper and celery

Dinner

  • Beef or vegetable stir fry
  • Low-fat frilled beef or lamb burger in a bun with side salad
  • Spaghetti Bolognese with lamb or beef mince, peas and kidney beans (for a vegetarian option, use soya mince and lentils)

SOURCES AND ACKNOWLEDGMENTS

Unless otherwise stated, recipes and ideas are taken from the OPA booklets Swallowing – Nutrition when It’s Difficult and A Guide to Life After Oesophageal/ Gastric Surgery. Both booklets have a lot more additional useful information.

Eggs Benedict, and Avocado Mousse with Prawns and Vinaigrette – Extracted from Delia’s Complete How to Cook, published by BBC Books, and Complete Illustrated Cookery Course, published by Ebury Press. Copyright © Delia Smith. For more recipes visit www.Deliaonline.com

Chicken Liver Parfait with French bread – Debbie Major and Delicious magazine www.deliciousmagazine.co.uk

Chocolate fridge cake – www.food.com

Cherry Cheesecake, and Macaroni Cheese – Nigella Lawson

Winter Vegetable Soup, Spicy Lentil Soup, Homemade Chips, and Jacket Potatoes – So, What Do You Eat? – A practical guide to healthy animal-free nutrition and easy family meals Liz Cook.

Pork Tenderloin with maple syrup and beet glaze, Seafood Linguine, Clam Linguine, Kedgeree, and Fish Pie – Philip Marlow-Mann

© Oesophageal Patients Association

Email Newsletter

Sign up to the OPA e-newsletter for the latest news updates via email.

Subscribe To Oesophageal Patients Association