1.Sense of fullness after eating, weight loss, loss of appetite
The feeling of fullness after eating, even if you eat very little food, you will feel very full. The stomach is a “pouch” for storing food, and the muscles of the stomach wall relax to hold food after eating, and the movement of the stomach wall is governed by the vagus nerve. Surgery removes and scars part of the stomach, which can affect the stretching of the stomach and result in a smaller volume;
In addition, the surgical operation can damage the vagus nerve. Food enters the stomach and presses directly on the stomach wall, making the person feel full and the appetite becomes poor. The patient’s appetite becomes poor, and he or she cannot eat enough variety and quantity of food, and it is difficult to maintain weight and the nutritional balance is not guaranteed.
This requires eating smaller and more frequent meals. First, eat a small amount of food at a short interval, then gradually increase the amount of food, and finally extend the interval between meals. Eating coarse fiber foods can increase the feeling of fullness, so it is recommended to eat no more than one coarse fiber food per meal.
Carbonated beverages produce a lot of gas in the digestive tract that can aggravate the feeling of fullness; therefore, it is best not to drink beverages with meals. If intake is inadequate, patients need to eat more frequently and supplement with liquid foods as appropriate. Eating less at a time may stimulate appetite, or you can take medication to improve appetite under the guidance of a doctor.
2.Dumping syndrome
This discomfort usually occurs within half an hour after eating, the symptoms last 10 to 15 minutes, some people will be accompanied by stomach cramps and diarrhea. When the chyme rapidly enters the small intestine, in order to dilute the concentration of food in the intestinal lumen to ensure the balance of osmotic pressure, the cells of the intestinal wall secrete a large amount of fluid into the intestine, resulting in a decrease in blood pressure. These symptoms will resolve on their own after a few months.
Patients need to slow down the pace of eating, eat fewer meals and solid foods, drink water between meals, and also eating less sugary foods will help. Since sugar is a good food to provide energy, both sugar and food can be consumed. Foods high in protein, such as fish, meat, eggs and carbohydrates (rice, noodles, bread) can be chosen, and lying down for 15 to 30 minutes after a meal can reduce the onset of symptoms.
3.Late onset dumping syndrome
This syndrome usually occurs a few hours after eating or when hunger is prolonged, and patients feel dizzy, weak and shaky. As carbohydrate-rich chyme enters the small intestine directly after gastrectomy, absorption leads to an increase in blood glucose, at which time a large amount of insulin is secreted into the blood. Insulin levels continue to rise as blood glucose levels move from elevated to lower, leading to the onset of the above-mentioned set of symptoms.
Patients may refer to the dietary recommendations for early dumping syndrome. If this persists, eating some sugar may improve the symptoms, and eating dry and liquid foods separately may help prevent them. If symptoms still persist or are very severe, medication such as octreotide or similar may be received.
4.Indigestion
Indigestion or acid reflux (reflux of gastric juices into the esophagus) is more common after gastric surgery. Indigestion is sometimes related to gas accumulated in the digestive tract and can be alleviated by taking mint water, etc. Avoid carbonated drinks, alcohol and coarse fiber foods.
5, diarrhea
Diarrhea may occur after various gastric cancer surgeries, and it is more likely to occur if the vagus nerve is cut during surgery. Diarrhea occurs in the days or weeks after surgery until the intestinal function is restored. It is difficult to predict the duration and extent of diarrhea because it varies widely among individuals. Regular early morning doses of medications for diarrhea such as loperamide hydrochloride may help reduce symptoms.
Since diarrhea is surgery-related and therefore cannot be improved by dietary modifications, patients should try to avoid something if they find that it makes diarrhea worse. If the diarrhea remains uncontrolled, a hospital visit is required.
6. Bilious vomiting
Usually in the early morning, the patient wakes up with a painful and full feeling in the stomach, which can be relieved by vomiting the accumulated digestive juices in the stomach, sometimes bright yellowish gastric juice, sometimes mixed with dark brown (bile) gastric juice. Early morning vomiting is a very painful event for some patients, but the symptoms do not last long.
The cause of bilious vomiting is very complex. The accumulation of bile and digestive juices in the duodenum during the night, refluxes into the stomach and irritates it, making the patient feel bloated and nauseous. The discomfort can be relieved by vomiting out the excess digestive juices, and medications such as domperidone (morpholine) and metoclopramide hydrochloride (Gastrofluan) can be applied to relieve the symptoms. If symptoms are very severe or persistent, surgical treatment may need to be considered and the surgeon will discuss the benefits and risks of surgery with the patient.
Many of the problems mentioned above will improve over time, and patients may also take a long time to form new eating habits. A small number of people may not be able to consume enough food, and this can be done with a tube feeding diet to ensure nutrition and energy intake. Patients can discuss the need for this type of eating with their surgeon.