Post Gastrectomy Diet

  My grandfather was diagnosed with stomach cancer and underwent
  a total gastrectomy in mid March.  Since then he's had a number
  of problems, the most noticeable being difficulty eating.
  Because most, if not all, of what he eats is thrown back up,
  he's dropped a considerable amount of weight.  Doctors have found
  and corrected a stricture in the esophagus, but this hasn't
  resolved the problem.  Other theories have been that there is a
  kink in the intestine and that the esophagus has elongated,
  causing a curve in the esophagus sort of like the trap in a sink
  which food can't get past.  Now we've been told his difficulty
  eating could be the result of being started back onto a solid
  food diet too quickly after surgery.  I'm looking for any
  information about how he should be transitioned to a solid food
  diet.  Currently he's taking liquids only simply because that's
  the only way he can prevent the vomiting.  Any help you can
  provide would be appreciated.
Dear Christine,
It is very common for patients who have had a gastrectomy to have vomiting and weight loss. Overeating relative to the size of the gastric remnant results in vomiting. It is difficult for post-gastrectomy patients to learn that they often cannot eat at one time the amount of food they were able to eat before the operation. A number of factors contribute to the development of weight loss post-gastrectomy. Those include: decreased acid secretion, inadequate mixing of food with biliary and pancreatic secretions, altered intestinal transit, dumping syndrome, bacterial overgrowth, nitrogen malabsorption, underlying disease and  inadequate oral intake. Nevertheless, even patients with total gastrectomy are able to ingest a quantity of food greater than that required for maintenance of ideal body weight. The key is to eat frequent, small meals. It may be necessary to try nutritional supplements such as Ensure (up to 6 cans per day if needed). He may also tolerate pureed foods. It will also be necessary to make sure that the narrowed segment is monitored to make sure it does not cause problems in the future. If this segment continues to present a problem a feeding tube placed in the small intestine may help maintain his weight. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call  1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: total gastrectomy, dietary management