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Stomach cancer

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From MayoClinic.com



After gastrectomy, it's not uncommon to experience nausea, vomiting, diarrhea, weight loss, nutritional deficiencies and dumping syndrome, which occurs when food enters your small intestine too quickly. These side effects usually result from eating more at one time than your digestive system can tolerate and can often be controlled with changes in the amount, frequency and kinds of food you eat.

You may also develop nutritional deficiencies because you're no longer able to absorb certain vitamins. Vitamin B-12, for example, can only be absorbed when it's attached to a protein produced in your stomach (intrinsic factor). For that reason, you'll need to receive vitamin B-12 injections for life. Your doctor may also recommend supplementing your diet with other nutrients especially folic acid, iron and calcium.

Although coping with the effects of gastrectomy can be challenging, the following measures may help improve or relieve your symptoms:

  • Eat small, frequent meals. Normally, your stomach can expand to hold nearly a gallon of food and liquid, which it then releases slowly into your small intestine. After gastrectomy, you won't be able to eat as much at one sitting as you once did, although you likely can consume the same amount overall. To get the calories you need while minimizing intestinal symptoms, try eating six small meals a day, rather than two or three large ones.

  • Avoid drinking with meals. Although it's important to drink plenty of fluids, especially water, drinking with meals hastens the movement of food through the upper part of your digestive tract and may reduce the absorption of nutrients. Instead, try to drink 30 minutes before or 60 minutes after you eat.

  • Eat slowly and chew thoroughly. This can help reduce nausea and vomiting and increase your ability to absorb nutrients.

  • Avoid extremely hot or cold foods or liquids. These may aggravate your symptoms.

  • Rest after meals. It's best to relax after you eat because activity increases the likelihood of nausea and vomiting. Don't lie flat, however, for at least two to three hours after a meal.

  • Avoid sugar. All forms of sugars and sweets aggravate dumping syndrome.

  • Use dairy products cautiously. Some people find that dairy foods such as milk, cheese and even yogurt cause gas, bloating and abdominal pain. In that case, an enzyme product such as Lactaid or Dairy Ease may help break down lactose. Consuming small amounts of milk products or combining them with other foods to slow digestion also may help. In some cases, though, you may need to eliminate dairy foods completely. If so, be sure to get enough protein, calcium and B vitamins from other sources.

  • Avoid troublesome foods. If certain foods make your symptoms worse, don't eat them. Common culprits include alcohol, chocolate, caffeinated beverages such as coffee and sodas, spicy foods, fruit juices, raw fruits and vegetables, beans, broccoli, cabbage and other gassy foods, and sugar-free sweeteners such as sorbitol or mannitol. Butter, margarine, oils and high-fat foods such as mayonnaise, nuts, cream, ice cream and red meat may be particularly troublesome. Instead, try eating softly cooked or pureed fruits and vegetables, rice, plain baked potatoes, soups, broth, and chicken or fish cooked without fat.

  • Talk to a dietitian. It's difficult to get the calories and nutrition you need on a restricted diet. A dietitian can help you plan healthy meals that don't aggravate your symptoms.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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Last Modified : 03/14/08 11:56 PM