Eating problems with stomach cancer
Stomach cancer and its treatment can cause problems with eating. It’s important to eat and drink enough calories and protein to maintain your weight and strength.
There is support available to help you cope with eating problems caused by stomach cancer, both during and after treatment.
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 makes 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)
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 the tumour and lymph nodes also 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 stools float, look pale or have 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 stools.
Feeling and being sick in the morning
You might vomit in the mornings if you have had removal of part of the stomach (partial gastrectomy). 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.
Feeling bloated
Wind and pain can be a problem after stomach surgery. A few drops of peppermint oil in hot water can help. Sip it slowly. It can relieve trapped wind and pain.
Indigestion
Your cancer might cause indigestion and this may also be a problem after surgery. Foods that can cause indigestion include fizzy drinks, alcohol, spicy food, pickles and citrus fruits. You should also avoid caffeine, peppermint and chocolate. Speak to your doctor if you have indigestion, they may be able to give you medications to help.
Weight loss
For many people, the side effects of cancer and treatment make it difficult to eat enough to stay at a healthy weight. This can be very upsetting and worrying. Speak to your clinical nurse specialist or dietitian about any eating problems. They will get you any help that you need.
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 nurse 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 a counsellor 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.
Eating after surgery for cancer of the oesophagus or stomach - Transcript
Voiceover: Eating is a very social thing. But surgery to your oesophagus or stomach can mean that when and how you eat is different. So, to carry on enjoying food and stay well, what changes do you need to make?
Catherine: After your operation, while you’re still in hospital, you’ll have plenty of support from people like me. We’ll help you to gradually build up what you’re able to eat and drink. However when you go home things may be a bit more difficult.
Voiceover: You will find that after your surgery, the amount of food and drink you can manage at any one time will be less.
Catherine: In general we tend to find that people cope best if they have 6 to 7 small meals or snacks each day, avoiding long gaps between eating and drinking. So that you don’t tire yourself out, have a selection of foods that are ready prepared that are quick and easy to get ready for you to eat when you fancy them.
So thinking about how you should actually eat. Make sure you’re relaxed and calm, chew, take it nice and slowly, and also try to make sure that you’re sitting upright when you’re eating. And avoid lying down too soon after eating. Drinks can be very filling, so it’s important to avoid drinking for about 15 to 30 minutes before you eat.
Voiceover: Generally, you can carry on eating what you like, just in smaller portions. But making a few changes can help you to overcome problems like poor appetite and weight loss.
Catherine: So this is what we suggest. Graze on high energy foods throughout the day. Choose foods that are full fat and avoid anything that’s labelled as diet or low in fat. You can also try enriching your favourite foods with things like cream, cheese, butter, sugar and honey.
Voiceover: Sometimes people find eating difficult because of issues like feeling sick, having diarrhoea or reflux.
Catherine: So making a few changes can really help to control these symptoms. Don’t rush your meals, chew well and try taking smaller portions more frequently. If you’re having a problem with reflux make sure that you don’t eat too late at night and try sleeping propped up with some pillows. Continue eating and drinking even if you have diarrhoea, as this will help to control your bowels and will keep you hydrated. But remember if any of these issues continue for more than a couple of days contact your doctor or your specialist nurse, as there are medications that you can be given to help control these.
Voiceover: While it’s good to eat and drink, taking too much food or fluid in one go, particularly sugary foods, can sometimes cause diarrhoea, bloating, sweating and palpitations – this is known as dumping syndrome.
Catherine: So it may help to eat little and often. And to have sugary foods and drinks in small portions as part of mealtimes rather than outside of mealtimes. Again, if you have any problems, so contact your doctor or your dietitian. Most people do have some problems after their surgery. But with time you will find that you’ll get back to eating and drinking, and enjoy your food again.
