Many patients ask me, “How long will I live if I have my stomach removed? I usually answer that the absence of the stomach will not affect your life, and the patient may believe it or remain skeptical. How can I live without a stomach? First of all, we understand what the stomach is and what it does to the human body, so we can understand the impact of losing part or all of the stomach on people. First, the normal structure and function of the stomach The stomach is the digestive organ of the human body, located under the diaphragm, connected to the esophagus above and the small intestine below. The upper opening of the stomach is the cardia and the lower opening is the pylorus. The stomach is divided into three major parts: the fundus, the body, and the sinus. The stomach wall is divided into five layers (from inside to outside): mucosal layer, submucosal layer, muscular layer, subplasma layer, and plasma layer. Gastric cancer originates in the mucosal layer. The main functions of the stomach are to temporarily hold food, to grind large pieces of food into smaller pieces (also known as physical digestion), and to degrade large molecules in food into smaller molecules (also known as chemical digestion) so that they can be further absorbed. It absorbs mainly small amounts of water and the vast majority of alcohol and very few inorganic salts. There are gastric glands that secrete gastric juice, which contains hydrochloric acid and proteases for the initial digestion of proteins. The main absorption organ for the three major nutrients (glucose, amino acids and fatty acids) is the small intestine, so a person without a stomach would have very little effect on the absorption of nutrients in the body, and therefore would not have an effect on human life. However, after all, the stomach is an important digestive organ of the human body, and there is still a certain impact on the patient after gastrectomy. Second, the impact of gastrectomy on the human body Diet impact: short-term postoperative (within three months) to eat a small amount of soft, easily digestible food. The emphasis is on small amount (especially 1 month after surgery) and unlimited variety. Some patients’ families have been giving the patients porridge after surgery, without nutritious feeding, and the patients have lost significant weight. The emphasis is on chewing and swallowing slowly, with small bites and small amounts. Patients generally return to three meals per day after three months (partial gastrectomy) and six months (total gastrectomy). Iron deficiency anemia: After gastrectomy, the patient’s absorption of iron is affected because the dietary iron is trivalent iron, which is required by the body’s hematopoietic cells, so a small number of patients need to take oral iron supplements. Reflux esophagitis: A small percentage of patients with total gastrectomy will have, bile reflux into the esophagus and damage the esophageal mucosa. Patients will have a burning sensation behind the sternum. Patients are advised not to lie flat after eating and to move appropriately; oral esophageal mucosal protective agents, such as magnesium aluminum carbonate preparations, Jervil, etc.; or drink water to do the downward swallowing action, which will gradually improve with the recovery of the disease. Dumping syndrome: As the volume of the stomach becomes smaller after surgery, so that the food is kept in the stomach for a short time and sent to the intestine rapidly. The intestinal tube has to secrete a lot of digestive juices in order to digest and absorb this large amount of food as quickly as possible. In particular, carbohydrates, which are the main food, can be absorbed quickly in the intestine. When a large amount of carbohydrate is absorbed in a short period of time, the body will experience a rise in blood sugar, which is the mechanism of early dumping syndrome. Patients may show symptoms such as sweating, panic, nausea, numbness, red face, general feeling of tiredness and abdominal pain within 30 minutes after eating. Other patients show cold sweat, dizziness and impaired consciousness only 2-3 hours after the meal, which are the characteristics of late dumping syndrome. The mechanism is the result of elevated blood sugar, and then the body reacts to secrete a large amount of insulin, which then causes a sharp decrease in blood sugar value. Preventive measures: small amount and many times, small amount of food at each time, and reduce sugar intake if you have similar symptoms. Therefore, if you are unfortunately suffering from stomach cancer, you should actively treat it, but of course, the most important thing is prevention. Finally, I wish everyone has a healthy stomach!