Esophageal Resection and Reconstruction

Dear Sir or Madam:

My father underwent surgery for esophageal cancer back in May.  The surgery went as expected not complication while on the table however his recovery has not been so kind.  He developed bi-lateral pneumonia and became septic after the infections passed; he was having difficulty with items passing from his stomach to his intestine from his J-Tube.  Come to find out his pylorus was not allowing liquids to drain so a stent was put in.  After about 2.5 weeks of the stent in, he started vomiting blood.  He was taken to ER and they found a blood clot had fully incased the stent and would not let things pass.  The stent was removed however there was no sign of ulcerations around or under the stent.  It is unknown where the blood actually came from.  At this point, my father is at home however his quality of life is diminished due to the fact that he is always nauseated and occasionally vomits, however the vomiting does not actually bring much up other than bile at times.    

My question is, has there been cases where patients who have had esophageal cancer and the resection and reconstruction of their esophagus live in constant states of nausea?  Is there any cure or relief?  He is currently on Marinol and was on the strongest anti-nausea medication available however it doesn't seem to stop.   Any information would be helpful. Thank you.

[Kevin Pho, MD]

Nausea can occur as a complication with esophageal surgery.  Blockages would be the most obvious cause, can be evaluated with an upper endoscopy - which can also look for causes of upper GI bleeding.

As for treatment, it would depend on the cause.   If the Marinol isn't effective, you can try Zofran, which is an anti-emetic normally given to chemotherapy patients.  

These options should be discussed with his personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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