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Life after an oesophagectomy or gastrectomy

                  Vitamin B12 and stomach surgery

                  Your body may experience difficulty in absorbing certain vitamins and minerals.
                  Vitamin B12 plays an important role in making red blood cells. So, if you have had
                  your stomach removed, you will need an injection of B12 at your GP surgery,
                  usually every 3 months. If you have only had a part of your stomach removed, or if
                  you have had an oesophagectomy, ask your doctor to check your levels of B12.

                  Vitamin and Mineral Supplements
                  After all types of stomach and oesophageal surgery it can be difficult to take in the
                  right amount of vitamins and minerals. Therefore, we strongly recommend that
                  you take a daily A–Z complete multi-vitamin and mineral supplement. Look for one
                  with at least 12mg of iron.

                  Unexpected symptoms
                  Following your operation, it will take your body some time to settle down and find
                  how to work with your new body. This may cause you unexpected symptoms.
                  Most of these will subside with time.

                  Dumping Syndrome
                  Normally, the stomach controls the release of food into the bowel. After an
                  operation to remove part or all of your stomach, the loss of this slow and steady
                  release can result in a number symptoms known as Dumping Syndrome. The
                  symptoms occur when the food you have eaten passes rapidly through the
                  digestive system and into the bowel. It can be unpleasant and distressing, or the
                  symptoms may be mild, but it is not serious and generally the frequency of
                  episodes becomes less. The effects normally disappear in half an hour or so. In
                  most cases, Dumping Syndrome symptoms can be avoided or managed by
                  reducing your portion sizes, reducing the amount of refined carbohydrate or
                  sugary foods. Speak to your Dietitian if you suspect you may have it. It is
                  important to try to limit the frequency of Dumping Syndrome to ensure that you are
                  absorbing enough energy, protein and vitamins and minerals to support recovery.

                  There are two types of Dumping Syndrome: Early and Late: –

                      •  Early Dumping Syndrome
                         This can occur within 30 minutes of eating. It is due to a high concentration
                         of undigested food moving too quickly into the bowel from the stomach,
                         stomach tube or oesophagus.

                         The stomach usually acts as a reservoir to store food while it is mixed with
                         digestive juices, churned and broken into smaller particles.

                         When food is delivered too quickly into the bowel either due to the loss of
                         the stomach or loss of its reservoir function, water will follow causing a drop
                         in blood pressure. This can cause bloating, nausea and diarrhoea.

                      •  Late Dumping Syndrome
                         Late dumping occurs 1–3 hours after eating. This happens when the food
                         delivered into the bowel is absorbed more quickly than usual. In response,
                         the body releases insulin, a hormone which causes blood sugar levels to

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