My 84-year old Mother was diagnosed with stomach cancer and had a sub-total gastrectomy in August of 2011. The pathology report showed clean margins with one of 21 lymph nodes positive, so she went through a course of chemotherapy and radiation. She recently had her third pet scan that showed no evidence of recurrence which makes us all happy. However, the problem she continues to experience is pain and nausea almost every time she eats almost anything. The pain remains for about half an hour and slowly subsides. She did lose 55 pounds which is expected from this type of surgery, but her doctors do not want her to lose any more weight. Her gastroenterologist told us that on two occasions while he was performing an endoscopy he saw the entrance to her stomach spasm, and he thinks that's what's causing her pain. He's tried anti-spasmodic meds, pain meds, stretching the area, injecting botox; nothing has helped. She has terrible pain and nausea every single morning that eases up as the day progresses. Can you advise if there are any post sub-total gastrectomy complications that cause pain like this? She is on meds for pain, nausea, constipation, hypertension. Thank you for your assistance.
Well, without knowing the relevant clinical details it would be difficult to comment specifically on the situation. Such complications may arise post gastrectomy and with chemo-radiotherapy. Management would largely depend on the severity of the condition. While nausea is largely managed medically, if the GI spasm is believed to be the cause of the pain and has failed to respond to medications; surgical options to dilate the pathway may be suggested, if feasible. I would suggest discussing the situation and the suggested management plan in detail with her treating gastroenterologist.
Hope this is helpful.
Thank you, Dr. Kaul. Her gastroenterologist and my Mom agreed that she doesn't want anything invasive at this point. She has stated that she will live with it and, hopefully, the pain will abate with time.
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