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Complaining of cramping feeling in stomach. Undergone total gastrectomy and a partial esophagectomy. Suggest diet?

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General Surgeon
Practicing since : 2008
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Dear Doctor,

I am asking this on behalf of my father, aged 67.
This is regarding the "Dumping Syndrome" that he experiences because of which he is unable to take in food ( of any quantity /proportion)
My dad underwent ( in January 2010) a total gastrectomy and a partial esophagectomy following a diagnosis (in December 2009) of Adenocarcinoma of GE junction. The histopathology reports post surgery analysed the cancer as Stage 2 (T2 N0 Mx).No chemotherapy administered post surgery. He underwent the Roux-en-Y procedure. Ever since this operation, he has been having and complaining (almost daily for the past 3 years) of crampy feeling in the stomach as soon as he eats even small amounts of food. Miraculously he managed to gain back 10Kgs of weight post his operation (despite all these cramp feelings). Over these 3 years, he managed to avoid foods that made his condition worse.
He is a diabetic for the past 27 years. He was a smoker and quit as soon as he was diagnosed with the adenocarcinoma.
In march 2013, he was diagnosed with stomach cancer).Because of the daily radiation and weekly chemo (and his loss of apetite), he is going down on weight. He is refusing to take in any food, complaining that there is a heavy burning sensation in the throat region.
He also mentions that he is unable to take in any food because of the crampy feeling he has in his stomach.

Doctor, need advice to a couple of questions/concerns from our side
1) my dad wants to understand if there is any medication that can be prescribed to alleviate this cramped feeling (dumping syndrome), he says that despite his will to eat food, this crampy sensation is not allowing him to take in any amount of food.

2) Also Please suggest something regarding his diet and an. As he has gone down drastically in weight.

thank you
Posted Tue, 9 Jul 2013 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 1 hour later

Thank you for the query.

First of all please note that stomach cancer (I assume this was the reason of gastrectomy) is a very serious disease. Lack of chemotherapy were not the best idea in my opinion. So please do not expect your father to get as healthy as he was before.

1. There is a medicine Metoclopramide which helps with bowels movements. It is also a good idea to check if the junction is wide enough. Some kind of stents are available to make narrow areas wider and that way help with eating. He can also try Mebeverine. However, all this medicines can be ineffective if the junction is narrow. That is why I suggest you to start with gastroscopy.

2.To improve his appetite and allow to gain some weigh he should definitely try Megace medicine (should be prescribed by your doctor). Proteins XXXXXXX foods (like meat) or protein supplements along with Omega-3 acids should be in his diet.

Hope this will help. Feel free to ask further questions.
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