By a complete but also partial removal of the stomach, numerous changes occur in the digestive tract, which can cause more or less severe discomfort in the affected person. Most problems can be solved by small changes in nutritional behavior.
Most common cause: stomach cancer
The most common cause of gastric removal (gastrectomy) is stomach cancer. Gastric carcinoma affects about 15, 000 people every year in Germany. An important treatment measure is the operation with complete removal of the malignant part. Depending on the extent of the gastric cancer, a more or less large part of the stomach (partial or total gastrectomy) is removed.
Possible discomfort after gastric removal
Many sufferers develop more or less severe nutritional problems after surgery. As a rule, the problems decrease with increasing distance to the operation, because the organism can at least partially adapt to the changed circumstances.
After ingestion, abdominal discomfort such as bloating, nausea, belching and heartburn may occur as a result of the abolished gastric reservoir. Because the occlusion to the esophagus is lacking, many patients complain of heartburn triggered by the reflux of the food pulp into the esophagus (reflux). This is especially pronounced when lying down.
Early dumping syndrome
Since the gatekeeper at the former gastric outlet is missing, it often comes to a fall dumping ("dumping") of the food components into deeper small intestine sections. This is especially triggered by sweet, salty or highly concentrated food. The large amount of nutrients becomes a fluid influx from the bloodstream into the intestine, which can lead to filling pains, dizziness and circulatory symptoms.
Diarrhea also often occurs due to the accelerated food transport. This so-called "early dumping syndrome" usually occurs about 20-30 minutes after the meal.
Late dumping syndrome
If symptoms such as drowsiness, cravings, sweating and pulse acceleration occur about 1.5 to 3 hours after the meal, this is probably a "late dulling syndrome." This happens when large amounts of high-sugar foods and drinks are consumed The rapid absorption of sugar in the small intestine leads to an excessive insulin secretion of the pancreas in the bloodstream, which can subsequently cause hypoglycaemia.
Lack of important nutrients
Some patients may not be able to digest fats as well. They then suffer from so-called fatty stools (steatorrhea). If the fats are excreted with the stool, they are missing as an important source of energy.
In addition, there may be a lack of fat-soluble vitamins and essential fatty acids. In the stomach wall, a cofactor (intrinsic factor) is formed, which is required for the absorption of vitamin B 12 . The lack of intrinsic factor formation after gastric removal leads to a vitamin B 12 deficiency, which results in anemia (anemia). Vitamin B 12 must therefore be sprayed regularly. Furthermore, vitamin D, calcium, folic acid and iron can be critical.