Re: Gastrojejunostomy

Posted By HFHSM.D.-ym on January 05, 1999 at 13:22:19:

In Reply to: Gastrojejunostomy posted by Carolee on January 05, 1999 at 02:45:50:






I had a Billroth II gastrojejunostmy with 60+ percent of my stomach removed and a truncal vacotomy performed approximately two years ago.  I feel that currently I do not get the nutrients out of my food like I should.  My immune system seems to be non-existent, my memory does not seem to work right and I have no stamina.  I would like to know if there is anything that I can do to help me feel better.  I do currently take good vitamins (I need to take at least double the dose to feel any difference) and I am also on monthly B vitamin shots. I eat healthy, in fact I crave vegetable and fruit.  I assume that I must need something in them.  
Dear Carolee,
It is very common for patients who have had a gastrectomy to have poor absorption,  diarrhea, 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). Sometimes it may be necessary to stay on pureed foods for a while. Some patients (especially those with poor mixing) benefit from pancreatic enzyme supplements to improve absorption of nutrients.  Anti-diarrheal agents or antibiotics may be appropriate in certain clinical situations. 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: gastrectomy, dietary and medical management