Nutrient malassimilation following total gastrectomy.
BACKGROUND
The aim of the study was to elucidate the degree and the pathophysiology of abdominal symptoms, malnutrition and malassimilation after total gastrectomy.


METHODS
In 174 consecutive patients, with potentially curative total gastrectomy for gastric malignancy, subjective symptoms and objective parameters of malassimilation were evaluated.


RESULTS
Abdominal symptoms were present in 86% of the patients. In spite of a high daily calorie intake (median 37.8 kcal/kg body weight) mean body mass index had been decreasing since good health. Anaemia was found in 46%, sideropenia in 31% and oesophagitis in 26%. Mean faecal fat excretion was 17.4 (1.4) g/day and mean fat malassimilation 14.8% (1.1) of the intake. A shortened small-bowel transit was measured in 21.7% of the patients, and bacterial overgrowth was present in 37.7%.


CONCLUSIONS
Malassimilation post total gastrectomy seems to be multifactorial. Shortened small-bowel transit and subsequent dyssynchrony of pancreatic enzyme supply seem to be of major importance.
Brăgelmann
R
R
Dept. of Gastroenterology, Academisch Hospital Maastricht, The Netherlands.
Armbrecht
U
U
Rosemeyer
D
D
Schneider
B
B
Zilly
W
W
Stockbrügger
R W
RW
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008286:Malabsorption Syndromes / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011183:Postoperative Complications / Q000503:physiopathology*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*