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Understanding oesophageal (gullet) cancer

               When food passes down through the oesophagus and into the stomach, it is then
               mixed with gastric juices. This semi-solid food then passes into the small bowel
               where it is broken down further and nutrients are absorbed. The stomach starts
               the digestive process, but the rest of the digestive system can adapt well if the
               stomach is removed.

               The cause of stomach cancer is not clearly known. There is some evidence that a
               combination of risk factors come together to cause this disease, these are:

                   —  Gender – it is more common in men than in women.
                   —  Age – the risk increases with age. The majority of people with this disease
                       are over 55 years old.
                   —  H pylori infection (Helicobacter pylori) – if this infection has been in the
                       stomach over a long period of time, this may increase the risk of stomach
                   —  Diet – eating a lot of salty, pickled foods and processed meats such as
                       sausages and bacon can increase the risk.
                   —  General – smoking; general medical conditions such as acid-reflux and
                       Barrett's oesophagus; lower than normal levels of acid; family history and
                       genes, all can contribute to the onset of this disease.

                       there are other rare reasons why you might need a gastrectomy.

               Many of the symptoms are common-place, and many people with the following
               conditions will not have cancer, however, it is important that they are checked by
               their GP. Symptoms include heartburn or indigestion that is persistent; burping a
               lot; bloated feeling after having a meal; loss of appetite; difficulty in swallowing;
               unexplained weight loss; nausea and vomiting; dark blood in the stools; tiredness
               due to anaemia; feeling very full after eating.

               Breathing before your operation
               If you are a smoker, it is vital to stop smoking as soon as possible; help is
               available from your GP and most pharmacies.

               Prior to your surgery, a Physiotherapist will teach you how to use an inspiratory
               muscle training device; this device will help build up the strength in your breathing
               muscles so that they are fitter and more able to cope with your operation. Your
               fitness levels will also be assessed and advice around exercise before your
               surgery will be provided by the Physiotherapist. Current pre-op service is awaiting
               confirmation of ongoing funding - March 2020.

               A gastrectomy
               This operation involves the total removal (total gastrectomy) or the partial
               removal (partial gastrectomy) of the stomach. Which operation you will be
               offered depends on the size and position of the tumour. If you have a total
               gastrectomy, part of the small bowel (the jejunum) is joined on to the bottom of the
               oesophagus. If only part of the stomach has been removed the small bowel is

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