Definitions/Medical Terms
This page will help explain some of the more medical terms and procedures related to gastrectomy for stomach cancer.
Endoscope: Upper GI endoscopy, sometimes called EGD (esophagogastroduodenoscopy), is a visual examination of the upper intestinal tract using a lighted, flexible fiberoptic or video endoscope.
http://www.gicare.com/endoscopy-center/upper-gi-endoscopy.aspx
Esophageal Motility Test (Manometry) The manometry is performed at the hospital’s GI lab. There is no sedation involved unless you can’t tolerate the catheter. It is a small one that goes through the nose. The test takes about 15-20 minutes – if all goes as planned.
Here is a link to the procedure details:
http://gicare.com/Endoscopy-Center/Esophageal-Manometry.aspx
Gastrectomy: Surgery to remove part or all of the stomach. There are two types of Gastrectomy – partial(subtotal) and total. http://www.cancerhelp.org.uk/type/stomach-cancer/treatment/surgery/surgery-to-remove-stomach-cancer
- Subtotal (partial) gastrectomy: This approach is often used if the cancer is in the lower part of the stomach close to the intestines. It is sometimes used for cancers that are only in the upper part of the stomach, too. Only part of the stomach is removed, sometimes along with part of the esophagus or the first part of the small intestine. When only part of the stomach removed, eating is much easier than when the entire stomach is removed.
- Total gastrectomy: This method is used if the cancer has spread throughout the stomach. It is also often used if the cancer is in the upper part of the stomach. The surgeon removes all of the stomach. The nearby lymph nodes are removed, and sometimes also the spleen and parts of the esophagus, intestines, pancreas, and other nearby organs.
Small Bowel Follow-Thru: A small bowel follow through (SBFT) is an X-ray exam of the small and large intestines. A contrast material called barium is used to make the intestines show up clearly on film. This procedure takes up to 7 hours because multiple x-rays are taken from the moment the barium is swallowed until the barium reaches the colon. X-ray images are captured as stills and as moving images. This procedure is useful for detecting obstructions in the intestines, reflux, and motility issues with the intestines.
Stomach Cancer: the following link is a great resource for understanding stomach cancer. http://www.cancer.org/Cancer/StomachCancer/OverviewGuide/stomach-cancer-overview-what-is-stomach-cancer
Life After Total Gastrectomy for Stomach Cancer (My Journey to find a New Normal) 
rymada2010 said
Colestid (and other bile related medications)
Using Colestid as a drug to reduce the amount of bile reflux. Sounds almost too good to be true (a fix for my frequent bile vomiting) – especially since my doctors hadn’t mentioned it. Therefore, I researched the drug.
There are several drugs in this arena. These drugs are known as bile acid sequestrants.
Colestid (aka micronized colestipol hydrochloride)
Questran (aka cholestyramine or colestyramine)
(the following I am pasting because it explains as well as I could) “…one of the first-line of drugs used to lower cholesterol levels, but has fallen out of favour since the development of newer drugs. How it works… it binds to bile salts in the intestines which prevents them from being re-absorbed further along in the digestive tract Re-absorption of bile salts is the normal process, but if you’re diagnosed with a problem [such as removal of gall bladder] that causes too much bile salts in the blood, then you’d need to take measures to reduce that. The big problem with Questran is that, because the bile salts are inactivated, your body can’t properly digest fats. Meaning, you might not be able to break down and absorb essential fatty acids, nor absorb fat-soluble vitamins. Many of the listed side effects [for Questran] are a result of deficiencies of fat-soluble vitamins … A, D, E and K. Moreover, although it reduces levels of cholesterol and bile salts in the blood, there is a rebound effect of stimulating the liver to produce MORE cholesterol (since you are not absorbing any that you eat). Bile acid sequestrants can also increases triglyceride production. Bile acid sequestrants are usually prescribed for cholesterol-lowering purposes, but is sometimes used for other liver and bile problems, such as diarrhea due to excess bile production, (which can happen after having the gallbladder removed).
Before taking colestipol, tell your doctor if have trouble swallowing, constipation or hemorrhoids, a stomach or intestinal disorder, liver disease, a thyroid disorder, a bleeding disorder, a history of major stomach or bowel surgery, or if you have a vitamin A, D, E, or K deficiency.
Side effects:
• trouble swallowing;
• severe constipation or stomach pain;
• black, bloody, or tarry stools; or
• easy bruising or bleeding, muscle or joint pain, loss of appetite.
•
Less serious side effects may include:
• mild or occasional constipation;
• gas, indigestion, heartburn;
• diarrhea; or
• hemorrhoids or rectal irritation.
[Crap, it doesn’t seem to fit the problem of vomiting bile as bile acid sequestrants affects bile in the intestines.]
Ursodeoxycholic Acid (aka ursodiol)
Prescription medication for the treatment of bile reflux is most often made up of ursodeoxycholic acid, which helps promote the flow of bile in the digestive tract and can relieve some of the discomfort associated with the disorder. Sometimes combinations of drugs are prescribed to help patients who have difficulty emptying the stomach completely.
Common side effects include stomachache, exhaustion, coughing, swelling, indigestion, dizziness, backache, headache, diarrhea, constipation, loss of hair, metallic taste inside of the mouth, joint or muscle pain, skin rash, nausea, gas and dry skin.
Sucralfate (aka carafate)
This medication is used to treat and prevent ulcers in the intestines. Sucralfate forms a coating over ulcers, protecting the area from further injury. Sucralfate also protects the mucus lining of the esophagus.
Side effects: Constipation, dry mouth, upset stomach, gas, and nausea may occur.
[I have been on sucralfate for quite some time – it does not help reduce the bile reflux – I can only hope it is protecting my esophagus because I have read that there is a direct link between vomiting bile and esophageal cancer. Bile is highly caustic besides having the most revolting taste.]
Metoclopramide (aka Metozolv ODT, Reglan)
Metoclopramide increases muscle contractions in the upper digestive tract. This speeds up the rate at which the stomach empties into the intestines. Metoclopramide is used short-term to treat heartburn caused by gastro esophageal reflux in people who have used other medications without relief of symptoms. Metoclopramide is also used to treat slow gastric emptying in people with diabetes (also called diabetic gastroparesis), which can cause nausea, vomiting, heartburn, loss of appetite, and a feeling of fullness after meals.
Important information about metoclopramide – Do not take it in larger amounts than recommended, or for longer than 3 months. High doses or long-term use of metoclopramide may cause tremors or other uncontrollable muscle movements, especially in older women. These cannot be reversed.
Take metoclopramide on an empty stomach, at least 30 minutes before eating. Metoclopramide is usually taken before meals and at bedtime. Your doctor may want you to take the medication as needed only with meals that usually cause heartburn. Follow your doctor’s instructions.
Metoclopramide side effects (these can be permanent and can appear at any time with continued use) tremors, or restless muscle movements in your eyes, tongue, jaw, or neck (permanent); mask-like appearance of the face (permanent); very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out (permanent); depressed mood, thoughts of suicide or hurting yourself (can be permanent); hallucinations, anxiety, agitation, jittery feeling, trouble staying still (can be permanent); swelling, fluid retention; jaundice (yellowing of your skin or eyes); or seizure/convulsions (can be permanent)
Less serious metoclopramide side effects may include: feeling restless, drowsy, tired, or dizzy; headache, sleep problems (insomnia); nausea, vomiting, diarrhea; breast tenderness or swelling; changes in your menstrual periods; or urinating more than usual
[My GI doc says this is one bad drug to take because of the permanence of side effects. He does not like to prescribe this drug and when he does, it is only a temporary measure. I was on it for a little over a month but did not experience any positive response so it was discontinued. One doc I see initially said that I might need to be on this drug for the rest of my life (didn’t even mention the side effects).]
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Robt Seneca said
Together with avoiding the foods and beverages that will cause heartburn or acid reflux you will find quite a few other people modifications you are able to make which are good preventative measures. These are the ones I utilised to cure my heartburn and acid reflux.
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