Stomach Cancer Nutrition

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      Diet after stomach cancer

I have had most of my stomach removed because of stomach cancer. I am still losing weight and when I eat I start to cough, retch and feel sick.

I wonder if it might be a nervous thing?

Would tube feeding help with my problems?

Having stomach cancer will affect your eating and drinking habits, whatever your stage or treatment. This can be one of the hardest things to cope with. If you have all or part of your stomach removed you will need to adjust the amount you can eat at one time. You will probably have to eat small, frequent meals (about two hourly) for quite a long time after the operation.

Sometimes after surgery for stomach cancer you have side effects such as retching, feeling and being sick. It usually happens first thing in the morning. Bile and digestive juices can build up overnight in the duodenum and spill back into the remains of the stomach, causing you to feel full and sick.

Vomiting up the excess fluids often relieves the discomfort.

Unfortunately, this is a common symptom after a partial gastrectomy (removal of part of the stomach). Anti sickness drugs such as metoclopramide (Maxalon), can sometimes offer some relief.

You may have other problems after stomach surgery such as

• A feeling of fullness, even after eating small amounts

• 'Dumping syndrome'

• Diarrhoea

• Indigestion and colic

The links above will take you to information about these in our Diet after Stomach Surgery section. All these problems can make it very difficult to gain weight. Most people will see a dietician after stomach surgery. Dieticians are experts in dealing with dietary problems and will be able to assess your diet needs and offer you advice and support about your eating and drinking. If you have not already seen one, ask your GP or cancer specialist to refer you to the dietician in your hospital.

Sometimes people with cancer need to be fed by tube. This could be

• Through a drip directly into the blood stream (intravenously) called total parenteral nutrition (TPN) or

• Through a tube into the stomach or bowel called enteral feeding

It is important to point out these methods of feeding are only suitable for very particular situations. Your doctor is the best person to talk to about whether they may help you.

Total parenteral nutrition

This means being fed directly into your bloodstream through a drip into a vein. The feeds don't go through your normal digestive system. You are most likely to benefit from TPN feeding if you

• Have severe sickness

• Have problems with your stomach or intestine, or if they have been removed

• Are going to have a bone marrow transplant

• Have nutritional problems before surgery

• Have severe ulcers in your mouth or gullet (oesophagus)

• Have a hole (fistula) in your stomach or oesophagus

• Are losing weight or not coping well with enteral feeding

There is more about TPN in CancerHelp UK’s section on diet problems and cancer.

Enteral feeding

This means being fed with specially prepared liquid feeds through a tube into your stomach or small intestine. Enteral feeding is only suitable for people whose digestive tract (stomach and intestines) is working normally. This is because the feeds still go through the usual path of digestion. It is not suitable if you have had surgery to remove your stomach or intestines. It is often used for people who have swallowing difficulties.

Sometimes people can develop habits, like a cough, retching and vomiting, because they are anxious or frightened. Or it may be an association with an unpleasant experience in the past. If you have bad memories of recovering from your operation, this may be affecting you still. This can become a reflex reaction, which can be very difficult to control. There is more likely to be a physical cause following your stomach surgery, but check with your doctor if you are worried.

There is more information about diet after stomach cancer in CancerHelp UK’s section on stomach cancer.

http://www.cancerhelp.org.uk/
help/default.asp?page=6827