The stomach, as one of the most important organs of the digestive tract, is called the “back of the day” in Chinese medicine, and is the first place where our diet arrives, and is susceptible to many diseases, whether benign gastroduodenal ulcers or malignant gastric cancer. For some benign diseases such as gastroduodenal ulcers and gastric polyps, and malignant diseases such as gastric cancer, one of the most common and effective treatments is gastrectomy, so after the removal of this “backbone”, it will certainly bring a series of effects on the body, and many adverse effects can be self-adjusted to reduce the pain and Many adverse effects can be self-adjusted to reduce pain and improve the quality of life. First of all, let’s understand the physiological functions of the stomach, which has two main functions: secretion and digestion. The stomach secretes an acidic liquid, about 1500-2000ml per day, which contains a variety of ingredients that chemically digest food, kill bacteria that enter the stomach with food, help the absorption of iron, calcium, vitamins and other elements, and regulate the secretion and movement of other digestive organs such as the liver, gallbladder, pancreas and small intestine. Another function of the stomach is to grind the food through the movement of the muscles of the stomach wall, mix the food with gastric juice thoroughly for mechanical and chemical digestion, and then send the mixed chyme gradually into the duodenum for digestion and absorption. Gastrectomy is roughly divided into partial gastrectomy, major gastrectomy, and total gastrectomy. There are many complications after gastrectomy, both immediate and long term. Immediate complications such as bleeding, infection and anastomotic fistula are common, but with the improvement of surgical techniques, such immediate complications can be avoided. However, long-term complications such as alkaline reflux gastritis and nutritional disorders are often related to anatomical, metabolic and digestive changes brought about by surgery. These complications can be alleviated and improved to some extent with some self-care. Reflux gastritis Because in normal people, there is a structure called pylorus at the connection of stomach and small intestine, which controls the initial digested food in the stomach to enter the small intestine and prevents the digestive juices in the small intestine from entering the stomach to prevent the gastric mucosa from being corroded, while if the pylorus is removed by surgery, then bile, pancreatic juice and intestinal juices flow into the stomach, which will break the gastric mucosal barrier and lead to changes such as gastric mucosal congestion, edema and erosion. The main clinical manifestations are burning pain in the upper abdomen, aggravated after eating, nausea, vomiting of bile (golden yellow) like fluid, abdominal pain that cannot be relieved after vomiting, and weight loss. Gastric mucosal protective agents such as aluminum thioglycollate, bismuth colloid, gastric motility drug morphine, and bile acid combined with drug therapy are available. If the symptoms cannot be relieved, surgical treatment is feasible to change the intestinal structure to reduce the reflux of biliopancreatic fluid into the stomach, thus relieving the symptoms. Dumping syndrome This complication has the same cause as reflux gastritis. After the pylorus, which controls the passage of food from the stomach into the small intestine, is removed, it causes a series of uncomfortable symptoms due to the rapid emptying of food from the stomach. There are two types, early and late, depending on when the symptoms appear after eating. Early dumping syndrome mostly occurs within 30 minutes after eating and is characterized by gastrointestinal symptoms such as upper abdominal fullness, nausea, vomiting, abdominal cramps, diarrhea and other symptoms such as panic, sweating, weakness and pallor. Self-adjustment can be done by eating less and more meals, avoiding overly sweet foods, and lying flat for 20 minutes immediately after meals. Late dumping syndrome mostly shows symptoms 2 to 4 hours after meal, mainly manifested as dizziness, pale face, cold sweat, hunger, weakness and even coma, which is mainly due to the hypoglycemic reaction caused by the excessively fast discharge of food in the stomach into the small intestine, stimulating a large amount of insulin secretion. This syndrome can also be treated by dietary adjustment, eating less and more meals, eating drier food, drinking liquid after half an hour, adding pectin to the diet to delay the absorption of carbohydrates and other measures can alleviate the symptoms. Severe cases can also be treated with medication, which often works. Malnutrition Malnutrition is very common in post-gastrectomy patients, because after gastrectomy, the volume of the stomach becomes smaller, easy to feel full, so that the intake is not enough, food and pancreatic juice bile and other digestive juices can not be well mixed, coupled with postoperative gastric emptying and small intestine peristalsis accelerated, affecting digestion and absorption, causing weight loss and malnutrition. After gastrectomy, gastric acid is reduced, iron absorption is impaired (iron can be effectively absorbed only under the action of gastric acid), internal factor is insufficient, and vitamin B12 is lacking (internal factor is secreted by gastric acid-secreting cells, and vitamin B12 is combined with it to be absorbed by the body), iron and vitamin B12 are the main raw materials for hematopoiesis, and lack of them leads to anemia. Post-gastrectomy also tends to lead to reduced calcium absorption, leading to osteoporosis and bone softening, resulting in easy fracture. In case of gastric cancer patients who undergo chemotherapy after surgery, the gastrointestinal reactions of chemotherapy drugs are generally heavier, which further aggravates the lack of intake. Therefore, postoperative diet adjustment is very important, multiple meals, intake of high protein, high nutrition, vitamin-rich and low-fat food, supplementation of iron and vitamin B12, increase of calcium intake and supplementation of vitamin D. Through food structure adjustment combined with drug treatment, the nutritional status can be improved, and one should go to hospital for laboratory examination regularly for targeted supplementation. Postoperative diarrhea and steatorrhea Diarrhea is mostly caused by rapid gastric emptying and enhanced peristalsis of the small intestine, resulting in poor digestion and absorption. Excessive fast excretion of food coupled with structural changes in the intestine make digestion also not well mixed with food, which is fat not fully decomposed and absorbed, causing steatorrhea. Dietary attention should be paid to the consumption of less residue easy to digest high protein food. Generally, it can be relieved after adjusting the diet and applying anti-cholestatic amines. Remnant gastric cancer The cancer that occurs in the remnant stomach after 5 years or more of resection of benign gastric disease is called remnant gastric cancer. It occurs in about 2% of people, mostly 20 to 25 years after surgery, which is related to the reconstruction of gastrointestinal tract after surgery. It manifests as pain and discomfort in the upper abdomen, fullness after eating and wasting, etc. Gastroscopy and biopsy can confirm the diagnosis. Of course, patients with gastric cancer may also have cancer recurrence after surgery, so they should be followed up regularly to detect it as early as possible. ”The stomach plays an important role as the initial receiving and processing place of food. Once the stomach is partially, largely or completely removed, it will definitely have some physiological effects on the patients, first of all, we should recognize some complications after gastrectomy and make self-adjustment on the basis of understanding. If there is no effect, we should seek medical attention in time to get the maximum treatment so as to improve the quality of life.