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Digestion problems after gastrectomy for stomach cancer

StClares
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Hello,

I had a complete gastrectomy and Roux en Y 3 months ago following stomach cancer diagnosis, with a histology of 3/14 lymph nodes involved and cells at the oesophageal margin, and no chemo before or after because of the risk to existing lung and heart conditions.   I followed diet advice carefully and maintained my weight until a month ago when I began Forceval multivitamins, which coincided with feeling sick having reflux and some discomfort swallowing and losing weight.  I have bowel problems too.  I stopped the Forceval  - am regaining weight - and discussed with my nutritionist who diagnosed pancreatic enzyme deficiency and prescribed Creon 25000. On my 4th day of taking these I am still feeling sick around once a day and am then unable to eat.  My questions are, is this usual?  Second, is there an alternative to Creon? And third, what do I do when these run out, as after 10 days, I found the last two boxes locally and there are apparently no more where I live, near Exeter!

  • Hi StClares,

    I’m Kirsty one of the cancer information nurse specialists that work on the Macmillan support line. Thanks for getting in touch. I see that you have joined our stomach cancer forum and hope that you are finding it welcoming and supportive.

    Recovery from stomach surgery is often not straightforward and it can take awhile to get used to a different way of eating. The side effects post-surgery you mention are common, and I am glad to hear that you have worked your way through them with the support of your hospital team.

    Changes in weight are expected as you recover from surgery. You have done so well to maintain your weight initially and being able to regain weight now.

    Unfortunately, common side effects from Creon do include nausea. Four days into taking a new medication is early to predict if your nausea will settle. Some people find that changes in dose are needed to help with side effects. Please discuss this with your dietician who will be monitoring your body’s reaction to Creon.

    An alternative prescription to Creon would need to be discussed with your hospital team. I appreciate that you are desperate to feel better, eat better and continue to regain weight. Even though you are not seeing the benefits yet from this medication, doesn’t mean you won’t. Stick with it and raise any issues with your dietician, cancer nurse specialist or consultant. Their aim is to help you feel better not worse so please do update them.

    Information about the supply of Creon 25,000 was updated this month on the pancreatic cancer UK website. They suggest taking Creon 10,000 instead to make up a prescribed dose, which although involves more capsules, will allow people to continue with medication.

    Best wishes 

    Kirsty, Cancer Information Nurse Specialist 

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

    Ref/CF

     

     

  • in reply to Kirsty-Macmillan

    Dear Kirsty,

    thank you very much for your quick reply which cheered me up.  I hadn’t realised Creon could have a side effect of nausea as that has been one symptom I’d hoped it would help with.  I’m willing to keep on trying of course and my nutritionist is very helpful.  The main reason for asking so soon after starting is that it had taken me 10 days to track down a supply (Creon 10000 is also not available at least from Boots ) and I wondered about alternatives.   I’ll ask my nutritionist.

    many thanks

    Tina 

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