Eating problems and stomach cancer

Dumping syndrome

After surgery for stomach cancer, there is a risk that food moves too fast into the small bowel. This causes a group of symptoms called dumping syndrome. It can happen just after you’ve eaten or some time later.

Dumping syndrome just after a meal happens because the small intestine draws in a large amount of water from your body to help break down the food. This can cause a sudden drop in your blood pressure and make you feel faint and dizzy.

Dumping syndrome that happens some time after you have eaten is due to a sudden rise in your blood sugar. Food passes into your small bowel and the bowel absorbs sugar. The body produces a rush of the hormone, insulin. Insulin makes your blood sugar drop and you can feel very faint.

Other symptoms of dumping syndrome include:

• nausea

• diarrhoea

• tummy cramps

• bloating

• flushing

• a strange-feeling heartbeat (palpitations)

• cold sweats

Tips to reduce dumping syndrome

• Eat slowly, and rest after you eat.

• Reduce the amount of sugary foods you eat.

• Increase the fat content of your food to replace the calories from sugary foods.

• Add more fibre to your diet.

• Eat smaller meals more regularly (if possible).

• Avoid soup and very liquid foods.

Talk to your dietitian or specialist doctor if you have any symptoms of dumping syndrome. They can help diagnose dumping syndrome and give you advice.

Diarrhoea

You might have diarrhoea after surgery. There are several reasons for this.

After the surgeon removes all or part of your stomach, food moves through the digestive system faster. This can cause diarrhoea.

Surgery to remove part or all of the stomach affects the vagus nerve. During surgery, the surgeon divides the vagus nerve to remove the tumour and the lymph nodes. This nerve controls the:

• movement of your food through the bowel

• production of digestive juices

Diarrhoea happens occasionally and can last for about a day, sometimes longer. You might pass watery stools several times a day for several days out of each week. In a few people, this causes sudden and urgent attacks of diarrhoea. It can be difficult to treat. Sometimes taking anti diarrhoea medicine early in the morning can help.

You might also have diarrhoea with other treatments, such as chemotherapy or chemoradiotherapy.

Talk to your dietitian. They will look at your diet and give you advice about which foods to avoid.

Steatorrhoea

This is when your poo floats, looks pale or has a bad smell. It is caused by undigested fat. You may need to take some tablets (digestive enzymes) to help digest the fat. Talk to your doctor if you see these changes to your poo.

Feeling and being sick in the morning

You might be sick in the mornings if you have had removal of part or all of the stomach. Bile and digestive juices can build up overnight in the small bowel. They can spill back into the remains of your stomach making you feel full and sick. Vomiting up the excess fluid relieves the discomfort.

Medicines which help the stomach to empty, such as domperidone or metoclopramide (Maxalon) might help. But they might not get rid of your symptoms altogether. And they might make other problems worse, such as diarrhoea. 

It's important to discuss this with your surgeon if your symptoms are severe. Some people need surgery.

Who can help?

Dietitians can help you cope with diet problems and suggest the best foods to eat. 

You should have a dietitian working in your multi disciplinary team (MDT). Your doctor or clinical nurse specialist will refer you. They will support you from diagnosis, through treatment and afterwards.

Eating problems can be difficult to cope with. They can cause tension within relationships or families. Events and eating out with friends can be much harder when you have a problem eating. Talking to your dietitian or clinical nurse specialist can help.

It is important to get help as soon as you start to have problems.

This video tells you how to eat well after surgery for stomach cancer. It lasts for 3 minutes and 31 seconds.