Almost all stem cell transplant patients will experience side effects that make eating and drinking more difficult. It’s a perfectly normal part of recovery, but it’s important to be aware of the challenges you could face and how to cope with them.
This is a general guide and the care people need after their transplant varies. How you feel will change before, during and after your transplant. Speak to your transplant team about what to expect and look out for in your particular situation.
This webpage will cover:
- Eating well before and after transplant
- Tips for eating and drinking
- Following food safety advice
- Eating well for long-term recovery
- Five ways to make eating well a habit
Eating well before and after transplant
The advice about your diet is likely to change during the transplant process.
Before your transplant
Your team will give you advice about eating and drinking before your transplant.
Try and maintain your weight and eat well if you have an appetite. If you are struggling to eat enough calories and maintain a healthy weight, it can affect your general health. Simple things, like eating little and often or boosting meals with protein or calorie-rich ingredients, could make a big difference.
In the early days after your transplant you might not feel like doing much at all. Eating and drinking may be difficult, but it is an important part of the process. It will gradually get better.
During the transplant and recovery stage, your body needs more nutrients to rebuild and repair cells and tissue, and to develop new ones. Your weight will be monitored by your medical team regularly. Your dietitian will support you with getting enough nutrients.
What is a dietician?
A dietitian is a health professional who can assess, diagnose and treat dietary and nutritional problems. If you need any support with eating or drinking, your transplant team should refer you to a dietitian, or you could ask to be referred yourself.
You might need supplement drinks, or tube or vein feeding. This means you will either have liquid food fed directly into your stomach (naso-gastric tube feeding) or directly into your vein (parenteral nutrition).
Side effects during early recovery can make it difficult to eat and drink. For example:
- Feeling and being sick
- Having a sore mouth
- Diarrhoea (runny poo)
- Lack of appetite
We’ve suggested some basic tips that can help on the next few pages. Speak to a dietitian for more detailed advice.
You should also follow any guidelines your hospital has given you when choosing your food.
Tips for eating and drinking
We've given some advice here on what can help if you experience side effects that affect you eating and drinking, plus things to avoid.
Some of these tips might seem to go against standard ‘healthy eating’. That can come at a later stage when you’re further into your recovery, and your weight is stable and energy levels have improved.
- Eat little and often – try snacks and small meals 5-6 times a day.
- Find meals that are quick to prepare, especially for when you’re tired.
- Choose foods which are high in calories and protein.
- Go for what you really fancy and crave.
- Avoid low fat and ‘healthy’ versions of foods.
Boosting your energy and weight
- Eat high-protein, energy-rich foods such as meat, fish, eggs, pulses, tofu, dairy or vegan-friendly options.
- Boost calories. Add butter, cheese, cream, avocado, olive oil, coconut, nuts, honey or seeds to your dishes.
- Don’t fill up on low-calorie food like watery soup, or diet/low fat alternatives.
- Brush your teeth regularly, using a soft bristled brush.
- Choose food carefully:
- Try: Ice chips, lollies, ice cream, jellies, yoghurts, custards
- Try: Soft creamy food, purees, stews and casseroles
- Avoid: Foods that are hot, spicy, sharp or hard
- Avoid: Sticky food like peanut butter
Feeling and being sick
- Eat dry foods, like toast or crackers.
- Sit upright before and after eating.
- Ginger and peppermint might help.
- Eat cold foods as they smell less.
- Try and distract yourself while eating, e.g. talk to someone, watch TV, or listen to the radio or a podcast.
- Avoid greasy, fried, smelly, very sweet food.
- Keep away from the smell of cooking.
Constipation (difficulty having a poo)
- Eat high-fibre foods.
- Drink lots of fluids.
- Gentle walking or exercise can stimulate your bowels.
Diarrhoea (runny poo)
- Drink water to replace lost fluids.
- Eat plain, low-fibre food such as white bread, pasta, noodles, potatoes without skin, fish, eggs, tofu, cheese, fruits and vegetables without their skin or pith.
- Avoid: Alcohol and coffee
- Avoid: Rich, high sugar or high fat foods
- Avoid: Sorbitol, the sweetener, found in fizzy drinks for example
If food tastes like:
Cardboard or cotton wool:
- Try 'tart' foods like citrus fruits.
- Add a squeeze of lemon or lime to your food before serving.
- Use sauces, spices or marinades to adjust the flavour of iron-rich red meat. Or switch to different sources of protein, like chicken, turkey, fish or lentils.
- Use plastic or wooden cooking and eating utensils.
Bland or tasteless:
- Try stronger flavours like marinades and spices to make your meals more interesting.
- If water tastes horrible, use cordials or fruit juices to make it easier to drink.
Make a list of foods you like, or are able to eat. Make the most of those and experiment with new foods. Try 1-2 new foods per day and make a note of which foods you are able to eat.
Your taste will change over time. If you try something and don’t like it, give it week or two and try again.
Read more about eating well during cancer at World Cancer Research Fund's website.
Following food safety advice
As your immune system and gut are recovering after a transplant, you’ll be more vulnerable to infections. It’s important to follow general food safety and hygiene advice.
Here are some general top tips:
- Always wash your hands and kitchenware. Wipe down surfaces with disinfectant or sanitiser before and after preparing food and change your dishcloths regularly. This is extra important when handling raw meat or fish.
- Buy food in individual-sized portions or smaller containers. This means they will be open for less time before they are used up. It’s also better to avoid leftovers or re-heated food, too.
- Stick to ‘best before’ and ‘used by’ food labels. Never eat anything that is out of date.
- Only eat in restaurants or get takeaways from places you’re familiar with and that you know have good hygiene standards. You can check the latest food hygiene rating of any restaurant or takeaway outlet on the Food Standards Agency website.
- Wash all fruit and vegetables before eating them.
- Make sure food is cooked and heated properly. Avoid eating rare meat.
If your transplant team have told you to avoid foods which are considered to have a high risk of bacteria, find out more about a neutropenic diet on Blood Cancer UK’s webpage.
Eating well for long-term recovery
Some people find that during their recovery they:
- struggle to eat well
- have problems with diabetes
- have high blood pressure
- become overweight.
It’s natural to want to reduce the risk of your condition returning after transplant. But there is no scientific evidence that any diet or supplement can cure blood cancer or blood disorders.
It’s vital that your body can get the nourishment and energy it needs, so avoid cutting out individual foods or food groups. If you’re thinking of taking any supplements, ask your transplant team first if they are safe.
It’s important not to make any changes to your diet until you are well enough. If you are underweight, don’t have much appetite or have any other eating or drinking issues, get support from your GP, transplant team or a dietitian.
When your appetite has returned to how it was before treatment, making nutritious food choices and looking after your body can help you manage side effects, your general health, energy levels and can improve your mood.
This means you could:
- eat more fruit and vegetables - fesh, frozen and tinned all count
- choose foods high in fibre to support your gut health – oats, wholegrain cereal, wholewheat pasta and bread, nuts
- eat less fast food and processed food high in fat and sugar
- avoid processed meat and limit red meat
- limit sugary drinks
- limit alcohol to less than 14 units per week.
Read the NHS Eatwell Guide for a good guide on the type of foods and drinks to aim for.
Five ways to make eating well a habit
1. Be kind to yourself
Eating well doesn’t mean completely depriving yourself of your favourite foods. Healthy eating should be sustainable but can include treats. You can also try new foods or interesting recipes – eating should still be enjoyable. For inspiration, try the World Cancer Research Fund Recipe Finder.
2. Make small changes
It might be something simple like eating more fruit with your breakfast or adding some extra vegetables to your dinner.
3. Make smart swaps
Swap your usual foods with healthier alternatives rather than cutting them out altogether. Instead of eating a sweet snack, you could go for a healthier version. Try the NHS Healthier Food Swaps.
4. Make it easy for yourself
It helps to have nutritious food on hand, so stock up your cupboards and fridge. Take healthy snacks when you’re out and about. When you’re cooking, make a bit extra with each meal to have the next day, or batch cook meals at the weekend for the freezer.
5. Share your success
It can be easier to stick to changes if you let other people know what you’re doing. Tell friends and family about what delicious meals and snacks you have planned, or share on our Patients and Families Forum.
Information published: 14/11/23
Next review due: 14/11/26