Feeling of fullness after eating, weight loss, loss of appetite After eating, the feeling of fullness occurs, and 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 after eating to hold the food, and the movement of the stomach wall is governed by the vagus nerve. Surgery removes part of the stomach and leaves a scar, which affects the stretching of the stomach, resulting in a smaller volume, and also damages the vagus nerve. Food enters the stomach and presses directly against the stomach lining, making the person feel full, and the patient’s appetite becomes poor. And unable to eat enough variety and quantity of food, weight is difficult to maintain and 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, so it is best not to drink beverages with meals. If intake is inadequate, patients need to eat more frequently and supplement with liquid foods. Eating less at a time may stimulate the appetite, and medication to improve appetite may also be appropriate under medical supervision. Dumping syndrome This discomfort usually occurs within half an hour after eating. Patients may feel dizzy, weak and have a rapid heartbeat for 10 to 15 minutes, some with stomach cramps and diarrhea. As the chyme rapidly enters the small intestine, the cells of the intestinal wall secrete large amounts of fluid into the intestine in order to dilute the concentration of food in the intestinal lumen to ensure the balance of osmolarity, 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 and more frequent meals and solid foods, drink water in 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. Food choices can be bureau proteins, such as fish, meat, eggs and carbohydrates (rice, noodles, bread), etc. Laying flat for 15 to 30 minutes after a meal can reduce the onset of symptoms. Late onset dumping syndrome This syndrome usually occurs several hours after eating or if hunger is prolonged and the patient feels dizzy, weak and shaky. As carbohydrate-rich chyme enters the small intestine directly after gastrectomy, absorption leads to an increase in blood glucose, when 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 can refer to the dietary recommendations for early dumping syndrome. If the symptoms persist, eating some sugar may improve the symptoms. Eating dry and liquid foods separately can be a preventive measure. If symptoms persist or are very severe, medication, such as octreotide or similar, may be received. Indigestion Indigestion or acid reflux (reflux of gastric juices into the esophagus) is more common after gastric surgery. Indigestion is sometimes associated with the accumulation of gas in the digestive tract. The symptoms of flatulence can be reduced by taking mint water, etc. Avoid carbonated drinks, alcohol and coarse fiber foods. Diarrhea Diarrhea may occur after various gastric cancer surgeries and is more likely to occur if the vagus nerve is severed during surgery. Diarrhea occurs in the days or weeks following surgery until bowel function is restored. It is difficult to predict the duration and extent of diarrhea because of the wide variation in individuals. Regular early morning doses of medications for diarrhea such as loperamide hydrochloride may help reduce symptoms. Since diarrhea is procedure-related and therefore cannot be improved by dietary modification, patients are advised to avoid a particular food if they find that it makes diarrhea worse. If the diarrhea remains uncontrolled, a hospital visit is required. Bilious vomiting Usually early in the morning, patients wake up with a painful and full feeling in the stomach that is relieved by vomiting the digestive juices that have accumulated in the stomach, sometimes as clear, yellowish gastric juice, sometimes as a mixture of 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 relieve the symptoms. If symptoms are very severe or persistent, surgery 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 it may also take a long time for patients 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.