6 wks post op, difficulity eating

Louise,

I am sorry your Dad is having difficulties after surgery. The symptoms you are describing are not uncommon after recent gastric surgery; and can be caused by a number of issues. Some of the potential issues can include:

• ·        Moving to solid fibrous food too quickly
• ·        Not chewing food thoroughly enough
• ·        Narrowing of the anastomosis after surgery
• ·        Lack of motility in the remaining gastric system
• ·        Or just attempting to eat too much at one sitting

I assume your Dad had an esophagectomy with gastric pull up, and removal and reconnection of a section of his colon. With surgery and reconstruction this complex and extensive, I would assume it would take a significant period of time before you Dad could eat “normal” foods. Six weeks is a very short time after surgery and it will take your Dad’s system a while to re-adjust to his new anatomy.

You did not mention in your posting if your Dad has some form of auxiliary “tube” feed to help him maintain his weight while his body adjusts; after my esophagectomy I had a “J” tube (a jejunum) feeding device connected directly to my small intestine where a high calorie formula was feed via a pump while I sleep. I had this for approximately six weeks after surgery, while I re-adjusted to eating small amounts of solid foods.

In the short term, speaking with your Dad’s surgeon and discussing his current issues is the right approach. His surgeon should be able to assess if there is a “mechanical” reason for his symptoms. Also I would recommend my “rules for eating after an esophagectomy”. They include:

• ·        Eat very small meals six to eight times a day
• ·        Chew all foods very thoroughly (almost to the point that it is liquefied)
• ·        Put your fork down between bites to slow your eating
• ·        Drink only small sips of water during eating
• ·        Avoid food high in sugar and high in fat
• ·        Avoid food with rich sauces or gravy
• ·        Avoid carbonated beverages shortly before eating or with meals
• ·        Sit down and rest with upper body elevated for at least 30 minutes after eating
• ·        Drink liquids an hour after eating
• ·        Make high calories smoothies with bananas, strawberries, and protein powder

I assume your Dad met with a nutritionist after his surgery to help define a post-surgery diet but just in case; please find a reference to an appropriate diet: http://www.upmc.com/patients-visitors/education/nutrition/pages/esophagectomy.aspx

Although you did not mention it another common symptom after an extensive gastric surgery is “Dumping Syndrome”; I certainly had my share of challenges with this for the first few months after surgery. Here is a reference for a diet to address those issues: http://www.upmc.com/patients-visitors/education/nutrition/pages/dumping-syndrome-diet.aspx

Recovery from a surgery like this takes time and patience. I know these things can be scary, but these issues can be addressed with medication and time.

I hope your Dad will be feeling better soon,

Best Regards,

Paul Adams

McCormick, South Carolina

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009 - Post Surgery Chemotherapy 2/2009 – 6/2009
Cisplatin, Epirubicin, 5 FU - Four Year Survivor