HELP, Acid-Bile Reflux after Total Gastrectomy

Hi Mateo,

I had a total gastrectomy for stomach cancer (12/19) and went through the same issues. I am now aware of these points.

1. My Docs had me get another upper GI to see if the Roux-en-Y reconnection procedure which does have its own issues and cautions. I lost a lot of weight and looked like a 70 year old concentration camp survivor. Went from 220 at diagnosis (6'1 male) to 132 at my extreme low. Now 154 pounds.
2. I was trying to eat too much. I did better when I ate small meals or snacks five times a day.
3. I at too late in the evening.
4. The weight loss may have caused some gall stone and bile duct stone issue that went away with time. Put dried cherries in her tea.
5. I had to give up coffee, both caffeinated and decaf. I have found an Air roasted coffee that I now use in moderation.
6. Don't eat late in the evening.
7. Plain old Tums help me on a bad night.
8. Fruit and dried fruit in the morning to keep me from jamming up with constipation occasionally.

Some of this is still on-going with me but if it is only once a week I figure I am okay based on the bullet I dodged.

Prayers, Best Regards and I am happy to comment at any time,

Craig48

Ask your surgeon to explain what the reconnection method was after the removal of the stomach. Mine was a "Roux-en-Y reconnection" which has certain characteristics and issues both good and bad that can be monitored post surgery.

When I had digestive issues an upper GI was run with a camera to check for any inflammation or problems at that tie -in. The placement of the reconnection in relation to bile ducts is one issue for bile reflux coming back on you after eating. Also, a Roux-en-Y reconnection can have the patient with some iron deficiency issues.

I vary my diet quite a bit. Breakfast alternates as follows:

Egg omelet with cheese and vegetables. Oatmeal with cut up prunes and dried pineapple with applesauce. Bacon and eggs. Cream of Wheat with raisins. Fried bacon and egg sandwich on toast.

We have spent a lifetime with an expandable stomach. Now we must teach ourselves to stop immediately when the slightest feeling of fullness occurs -- that bite and not a bit more. Five minutes later we can try one more bite if we were hardly started with our meal but always error on the side of finished. Drink fluids apart from and after the meal. Additionally, walk around a bit after eating, avoid sitting or lying down.

Certain mild foods were difficult at first as they tended to "pack" into a wad. Chicken, breads, dried baked potato and the like as mild as they are were problems at first. After a year or so I handled them better.

I eat sandwiches now for lunch but in the initial year or two that was difficult. Progresso soup was my safe fall back in those cases. Modest sized pasta meals was a good fall back. Alfredo with shrimp and artichoke bottoms. Garlic and sausage fettuccini with tomato bits.

Dinners are varied now but grilled salmon is easy and always works but I do get bored with it. I was an army mess sergeant as a kid so I do a lot of my own cooking.

Vigorous activity seems to help comfort and digestion.

I take a Bariatric vitamin and a mineral supplement, both recommended by my MD Anderson surgeons dietician post surgery. You have to get your B-12 really up there and be above 400 on any blood test. I don't take anything else except tums or bicarbonate of soda if the bile reflux is out of bounds.

To Jayrock,

This old Jayhawk thanks you for the suggestion.

Craig