Eating Difficulty after Gastrectomy

Had partial esophogectomy and gastrectomy. Home from hosp.3 wks.It seems that I can eat less now than when I first came home. Lately food comes back up sometimes,not always. Am drinking Ensure 4x daily to supplement my diet. Can't get more than 1/2 cup food down at once.  Also how long does stomach take to empty? Any suggestions?

[JackieG]

I am assuming that they did a vagotomy (severed the Vagus nerve) when they did the esophagectomy. If so, the Vagus nerve sends signals to the stomach not only to generate acid but to control the motility of the stomach. Surgeons generally dilate the opening from the stomach to the small intestine in these types of surgeries to help food pass through the stomach with the help of gravity (since the stomach no longer contracts to force food into the small intestine). You would need to have a gastric emptying test performed to get an accurate sense of how your system is working.  I had the gastric emptying test. Two scrambled eggs with a radioactive material in them, and 12 oz of water. They then take a nuclear imaging picture every 15 minutes for two hours to trace the movement of food from the stomach to the small intestines. In my case, 80% of the eggs emptied into my small intestine in two hours, which my surgeon seemed to think was good news.

How much of your stomach was removed in the gastrectomy? The more they were able to preserve, the better your dietary recovery should be. Over time, the remaining portion of your stomach may expand to accomodate larger meals. The whole healing process takes up to one year, since this is major surgery. I would take it slow and easy initially, and keep a diary of your daily eating habits, any pain or discomfort you feel and under what circumstances, etc., so when you see your docs again you have an accurate account to refer to and discuss with them. It is easy to forget to mention /discuss everything you want to with a doctor without notes and reminders.

I have two post-esophagectomy diets (from two different cancer centers in the city in which I live). Did you talk to a dietician and did the surgeon or hospital give you a written diet to use for the first three or four months following the surgery? They should have. If not, ask for one. If they cannot provide one, post me back, and we will find a way to get a copy of mine to you. If we do so, you shpould review it with your surgeon to get her/his feedback on it.

Good luck. I hope you start to see improvement soon. Three weeks after discharge is not a long time for this type of surgery (I think I still had my J-tube three weeks after discharge), so don't get too discouraged.

Best regards,
Chicken Soup

[Bove]

A related discussion, Pain after eating was started.