After surgery for stomach cancer it may take time to recover and eat well again.
You will still be recovering for some time after you go home from stomach cancer surgery and will need to take things easy for a few weeks.
Try building up the amount you do slowly. Gentle exercise, such as regular walks, builds up your energy. You can increase the amount you do as you feel better. Everyone is different, and some people take longer than others to recover.
Avoid lifting heavy loads like shopping, or doing vacuuming or gardening, for at least 8 weeks. This gives your wound time to heal.
Some insurance policies give specific time limits for not driving after surgery. Contact your insurance company to tell them you have had an operation. Most people are ready to drive about 4 to 6 weeks after their operation. Do not drive unless you feel in full control of the car.
We have more information about going home from hospital, which explains how to get support after you get home.
Before you leave hospital, you will be given an appointment for your check-up at an outpatient clinic. The appointment is a good time to talk about any problems you have after your operation. If you have any problems before this appointment, you can contact your cancer doctor, specialist nurse or ward nurse for advice.
After a partial gastrectomy
If you have had part of your stomach removed (partial gastrectomy), the remaining stomach will not be able to hold as much food as before. You may feel full after eating small amounts. Some foods might make you feel sick, or give you indigestion or diarrhoea. It is important to try to eat, even if you do not feel like it. Over time you will start to manage bigger portion sizes and different foods.
If you continue to have problems, it can help to write down what is happening so you can limit or avoid certain foods. Talk to your cancer doctor or dietitian if you continue to have problems with food.
After a total gastrectomy
If you had all of the stomach removed (total gastrectomy), the food you eat will go straight from the oesophagus into the small bowel. This does not affect being able to digest food, but the small bowel cannot hold as much food as the stomach could. Your body will slowly adjust, so you can eat more at one time.
You may have diarrhoea for a few days or weeks after surgery. Your cancer doctor or specialist nurse will give you medicines to help with this.
Some people have tummy pain and feel full when they wake up in the morning. This may get better after vomiting clear fluid, which has some dark brown fluid (bile) in it. This can be upsetting, but it may only last for a short time. Your cancer doctor or specialist nurse might give you medicines to help with this.
If some foods regularly make your diarrhoea and vomiting worse, it may help to avoid them. Tell your cancer doctor or specialist nurse if:
- the symptoms do not improve
- you are struggling to eat.
Indigestion or reflux (a backward flow of digestive juices into the oesophagus) can happen after stomach surgery. This can cause pain and inflammation of the lining of the oesophagus. Your GP or cancer doctor can prescribe antacid medicines to help with this.
The following tips can help:
- Avoid fizzy drinks, alcohol and spicy foods, as these may make your symptoms worse.
- Lying down may also make symptoms worse. After eating and drinking, try to stay sitting up for at least an hour. When you do lie down to sleep, try using pillows to raise your head slightly.
Indigestion can also be caused by wind trapped in the digestive system. You can reduce wind by:
- drinking peppermint water
- taking charcoal tablets.
You can buy these from a pharmacy.
To start with, you may find it hard to not to lose weight. Your body will use lots of calories to help it recover from surgery, but you may not be eating as much as you normally would. But in time, most people find they stop losing weight.
You will usually see a dietitian, who will talk with you about the effects of surgery on your diet. They will give you advice about eating a balanced diet and building up your weight.
After surgery, your body may not be able to absorb certain vitamins and minerals from your food as well as it could before. You need these to keep healthy, so you may need to have them as an injection or as tablets.
Vitamin B12 is important for making healthy red blood cells. If all of the stomach was removed (total gastrectomy), the practice nurse at your GP surgery will give you B12 injections every few months. If only part of the stomach was removed (partial gastrectomy), your GP will do a blood test to check your levels of B12 from time to time.
The stomach also helps absorb other nutrients. This includes folate (vitamin B9) and iron, which are important for making red blood cells. It also absorbs calcium, which we need for strong teeth and bones. Your GP will do regular blood tests to check you are getting enough of these nutrients from your diet.
Ask your dietitian for advice if you are worried about your diet or your weight. If you do not have a dietitian, your cancer doctor or specialist nurse can arrange for you to see one.
When the whole stomach is removed, the lower end of the oesophagus is joined to the upper end of the small bowel. The join is called an anastomosis. Sometimes the join becomes narrow, which can make it difficult to swallow food. This is called a stricture.
If you are having problems swallowing, tell your specialist nurse or cancer doctor straight away. Your cancer doctor can do an endoscopy to look into the gullet to check for a stricture. They may be able to stretch it to make swallowing easier. Sometimes they insert a small tube into the stricture to keep it open. This is called a stent.
If you are having problems swallowing, you may find you start losing weight quite quickly. It can help to try eating soft or puréed foods and have nourishing drinks. Rarely, you may need to have food through a tube (enteral feeding) for a short time. Your cancer doctor, specialist nurse or dietitian can give you more information about this.
We have more information about nutritional support and feeding tubes.