Digestive Disorders: Post-Gastrectomy and Malabsorption

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Table of Contents

Introduction
Post-Gastrectomy and Malabsorption Symptoms
Post-Gastrectomy and Malabsorption Risk Factors
Post-Gastrectomy and Malabsorption Treatment
Conclusion
References

Introduction

The rise in cases of gastric/stomach cancer and complicated ulcers has led to ailments that need to be carefully understood for proper care to be availed to patients. Post-Gastrectomy and Malabsorption syndromes are disorders that occur around the digestive system. Post-Gastrectomy is a condition that affects gastric cancer patients and most of the patients undergo various treatments for the condition.

About 40% of gastric cancer patients undergo gastrectomy while others take drugs or undergo radiation to reduce effects of gastric cancer (Greenberger, 2009). Post-Gastrectomy patients lose the normal function of their stomach’s food emptying time because of the removal of pyloric valve used as a passage for food into the duodenum. While on the other hand Malabsorption refers to the inability for some food nutrients to be absorbed into the bloodstream, it is usually referred to as GI tract failure. Malabsorption usually occurs when the small intestines fail to absorb food.

Post-Gastrectomy and Malabsorption Symptoms

Post-Gastrectomy syndrome usually exhibits a lot of symptoms which include: rapid emptying of food into the small intestine, abdominal cramping pain, weakness and nausea. In addition, the rapid absorption of a large amount of glucose in small intestines causes a rise in blood glucose and subsequently a rise in plasma insulin. The elevated insulin level then causes a rapid fall in blood glucose levels referred to as “rebound hypoglycemia.” Therefore most patients who have undergone gastrectomy usually exhibit symptoms such as increased heartbeat, perspiration and nausea during meal times (Greenberger, 2009).

Most patients cannot tolerate large meals and have difficulty in absorbing food nutrients leading to Malabsorption. Symptoms of Malabsorption include diarrhea, cramping, bloating, and abdominal distention. The sharp drop in blood sugar levels due to the increased absorption of glucose are some of the indicators of Post-Gastrectomy. Decreased mixing of food with acid, pepsin, and bile usually makes patients vomit after taking large meals.

Malabsorption on the other hand is caused by the inadequate absorption of food nutrients into the bloodstream. Inadequate absorption of fat could lead to foul-smelling diarrhea while the symptoms such as diarrhea, bloating and flatulence are caused by insufficient absorption of sugar. Insufficient absorption of proteins could lead to a protein deficiency known as edema, which causes swelling in any part of the body (Losowsky, 2007). The most common cause of Malabsorption is faults in the digestive system due to the failure of enzymes to break down food. However, Malabsorption could be a result of Post-Gastrectomy condition because removal of the small intestines leads to absorption problems.

Post-Gastrectomy and Malabsorption Risk Factors

The risk factors associated with Post-Gastrectomy and Malabsorption are usually due to conditions such as obesity, perforated peptic ulcer diseases, H. pylori infection, and Japanese ancestry. Conditions such as Helicobacter pylori infection is a disorder that usually leads to stomach cancer. H pylori bacteria converts nitrates and other substances found in foods (canned) into substances that cause stomach cancer. Obesity is a common cause of many cancers including gastric cancer; obese people tend to eat foods rich in proteins and fats which affect the digestive time (Buchman, 2006).

The slow gastric reflux over time leads to obstruction of the pyloric tube which acts as an exit for the stomach; this may lead to gastric cancer requiring gastrectomy. Another major risk factor of Post-Gastrectomy is severe peptic ulcers; bleeding or perforated ulcers could lead usually affect digestion and cause gastric complications. Perforated peptic ulcers are treated through removal of the antrum, a portion of the stomach while duodenal ulcers are treated through gastrectomy to reduce gastric acid secretion associated with ulcers.

Malabsorption usually arises due to some disorders which present risks on Post-Gastrectomy patients, Lactose intolerance is one of the risk factors presented by Malabsorption. This disorder causes diarrhea due to lack of enough enzymes to break down certain sugars in milk. Whipple disease is one of the major causes of Malabsorption; this disease is common in middle-aged men where patients suffer nutritional deficiency and weight loss (Losowsky, 2007). Celiac disease is another disorder that causes Malabsorption and is a risk factor for Post-Gastrectomy patients. Celiac disorder occurs due to intolerance to gluten (the protein found in wheat/rye) and usually leads to diarrhea.

Post-Gastrectomy and Malabsorption Treatment

Treatment of Post-Gastrectomy disorders and diseases involves a lot of remedies that manage the condition easily. The most common and frequent treatment is through nutritional remedies, eating small and frequent dry meals is important in controlling digestive conditions. Avoidance of milk and its products usually reduces effects such as lactose intolerance in the body. Post-Gastrectomy patients could make use of drugs such as codeine to reduce excessive of the gastrointestinal tract while on the other hand, they could boost their health by using food supplements (Buchman, 2006). Food supplements are used in preventing nutrient deficiencies whereas patients are required to maintain low blood pressure levels.

Malabsorption as a disorder can be managed by treating the conditions and diseases that cause it. Monitoring of nutrient levels in the body and fluid intake is an important activity in managing Malabsorption. Administration of food supplements may help in replacing lost nutrients due to Malabsorption while diet changes are necessary while patients are advised to eat foods rich in proteins, carbohydrates, fats and minerals (Greenberger, 2009). Constant monitoring of Malabsorption symptoms is very prudent in the treatment of this condition, pulse and blood pressure levels should be monitored constantly. Symptoms such as tropical spruce are treated using food supplements rich in folic acid or antibiotics (Losowsky, 2007).

Conclusion

Post-Gastrectomy and Malabsorption are digestive disorders that usually occur due to partial or full removal of the stomach after an attack by an ailment such as cancer. Consequently, Malabsorption can result as a symptom of Post-Gastrectomy condition and both conditions can be treated using the same medical treatments. Both conditions in most cases can only be managed by minimizing side effects suffered by a Post-Gastrectomy patient as no definitive cure is available.

References

Buchman, A. (2006). Clinical nutrition in gastrointestinal disease. Boston, MA: SLACK Incorporated.

Greenberger, N., Blumberg, R., & Burakoff R. (2009). Current Diagnosis and Treatment in Gastroenterology, Hepatology, and Endoscopy. Chicago, IL: McGraw Hill Professional.

Losowsky, M., Walker, B., & Kelleher J. (2007). Malabsorption in clinical practice. Detroit, MI: Churchill Livingstone.

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