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Ulcer Trouble
October 2003

Q. I am a 53-year-old female. Due to bleeding ulcers healing over, breaking open, and healing again, I had a blockage in the pylorus area. Since having a partial gastrectomy, nissen wrap, bilroth I, vagotomy and then five weeks later, gallbladder removal, I now have gastroparesis. I have tried all medications to no avail. I am on a 99% liquid diet, but still experience nausea. I lost a lot of weight suddenly, but it has since leveled off. My doctor also said that within the next 3-5 years I will probably need total gastrectomy. If I have a total gastrectomy, what the recovery and quality of life after are like? Are there any other alternatives?

A. You have had quite a serious condition! Many ulcers now respond to treatment with medication alone, but surgery is still needed when complications such as recurrent bleeding or obstruction arise.

Discuss with your doctor why further surgery (complete gastrectomy) may be needed. You have already experienced some of the complications following the procedures you have had including weight loss, nausea, and now gastroparesis (loss of motility of the intestine, failure to move nutrients through the intestine).

The gastroparesis may have resulted from nerve damage in which case medications are often not helpful. Most complications of complete gastrectomy result from the difficulty in absorbing nutrients, vitamins, and minerals after the procedure.

Deficiencies in iron, B12, calcium, and vitamin D are common and must be detected and treated. Quality of life will be
greatly influenced by management of such issues.

http://www.nlm.nih.gov/medlineplus/ency/article/000297.htm

http://www.chclibrary.org/micromed/00049030.html

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