Stomach cancer - Gastrectomy: the facts

Gastrectomy: the facts

A total gastrectomy, or removal of the stomach, is usually performed on people with stomach cancer, but it can also be carried out where genetic tests show a significant risk of developing a hereditary cancer.

After removing the stomach, the surgeon will join the oesophagus directly to the small bowel. This procedure is called a Roux-en-Y reconstruction.

Surprisingly, the body soon adapts to the task of digesting food without a stomach, and the body's ability to absorb nutrients is affected very little. Instead of being mixed and stored in the stomach, foods will be broken down in the small intestine.

People who have had a total gastrectomy can eat most normal foods, but in smaller, more frequent portions. Some foods, such as sweetcorn, need softening by the acids in the stomach; these may cause problems with digestion and should be avoided.

In time, a pouch is formed in the small intestine, which allows food to be stored a little longer before continuing on its way. Eventually, many patients can return to eating normally.

Following a total gastrectomy, patients need to have regular injections of vitamin B12, as the stomach controls the absorption of the vitamin. A deficiency in this vitamin can lead to pernicious anaemia.