Through a complete but also partial removal of the stomach, numerous changes occur in the digestive tract, which can trigger more or less severe complaints in the affected person. Most problems, however, can be resolved by small changes in dietary behavior.
Most common cause: stomach cancer
The most common cause for removal of the stomach (gastrectomy) is stomach cancer. Gastric cancer affects about 15,000 people in Germany each year. An important treatment measure is surgery with complete removal of the malignant portion. Depending on the extent of the stomach cancer, a greater or lesser part of the stomach is removed (partial or total gastrectomy).
Possible complaints after gastrectomy
Many affected patients develop more or less severe feeding problems after surgery. As a rule, the problems decrease with increasing distance from the operation, because the organism can at least partially adjust to the changed conditions.
Upper abdominal symptoms
After eating, upper abdominal discomfort such as bloating, nausea, belching, and heartburn may occur as a result of the lifted gastric reservoir. Since the closure to the esophagus is missing, many patients complain of heartburn triggered by the backflow of the food pulp into the esophagus (reflux). This is especially pronounced when lying down.
Early Dumping Syndrome
Because the gatekeeper at the former gastric outlet is absent, there is often a precipitous emptying (“dumping”) of food components into deeper sections of the small intestine. This is particularly triggered by sweet, salty or highly concentrated food. The large quantity of nutrients thereby becomes an influx of fluid from the bloodstream into the interior of the intestine, which can lead to filling pain, dizziness and circulatory symptoms.
In addition, diarrhea often occurs due to the accelerated food transport. This so-called “early dumping syndrome” usually occurs about 20-30 min after the meal.
Late dumping syndrome
If symptoms such as lightheadedness, ravenous hunger, sweating, and pulse acceleration occur about 1.5 – 3 h after the meal, this is probably a “late dumping syndrome.” This occurs when large quantities of highly sugary foods and beverages are consumed. The rapid absorption of sugar in the small intestine leads to an excessive release of insulin from the pancreas into the bloodstream, which can subsequently cause hypoglycemia.
Deficiency of essential nutrients
Some patients can no longer digest fats very well. They then suffer from so-called fatty stools (steatorrhea). If the fats are excreted in the stool, they are missing as an important source of energy.
In addition, there may be a deficiency of fat-soluble vitamins and essential fatty acids. A cofactor (intrinsic factor) is formed in the stomach wall, which is required for the absorption of vitamin B
12
is required. The lack of formation of intrinsic factor after gastric removal leads to a vitamin B
12
-deficiency, resulting in anemia (anemia). Vitamin B
12
must therefore be injected regularly. Furthermore, vitamin D, calcium, folic acid, and iron may be critical.
