Nutritional problems of patients after gastrectomy and the risk of developing malnutrition

Abstract

The radical treatment for advanced gastric cancer is gastrectomy. This procedure disrupts the anatomy and physiology of the gastrointestinal tract. After surgery, nausea, heartburn, biliary regurgitation, feeling of early satiety, belching, lack of appetite, and swallowing problems are reported to affect food intake. Decreased absorption, loss of nutrients, and increased energy requirements of cancer patients lead to weight loss and the development of malnutrition. After gastrectomy, the composition of the intestinal microbiome changes, the exocrine activity of the pancreas decreases, and deficiency-metabolic disorders (including iron, vitamin B₁₂, zinc, and vitamin D) develop. Approximately 60–70% of gastrectomy patients experience clinically significant deterioration in quality of life. Nutritional management should include dietary modification, appropriate nutritional supplementation and close monitoring of the nutritional status of these patients.