Fast transit through gut following TG

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Following total gastrectomy on 10 July I returned home on 17 Jul only to return to hospital via A&E with blocked small and large intestines the next day, unable to even keep down water.. Following extensive diarrhoea this cleared, confirmed by gastrografin and X-ray.. Home 22 July to resume eating little and often. But am still experiencing fast gut transit having 20-30 visits to the toilet every day. Water with small amount of solids.

is it appropriate to take loperamide to relieve this as it is very wearing

I was in a surgical ward, not specialist who sent me home with antibiotics and Omeprazole! So advice was scant.
I expect a little trial and error settling down with new regime but surely this is excessive

ive been drinking as much as possible and have rehydration salts but am concerned about lasting damage if this continues

i feel well in myself but am rapidly losing weight only 8 stone to start with and getting weaker I have a jejenostomy but all seem reluctant to suppplement food through this

any advice gratefully received

Annerose-Macmillan 1 month ago

Dear LadyRacer

Thank you for getting in touch with us, and welcome to our online community. My name is Annerose I’m one of the Cancer Information Nurses here at the Macmillan Cancer Support line.

I am sorry to hear about your diagnosis and treatment that resulted in fast gut transit, or ‘dumping syndrome’.

I understand you have been in hospital recently and have been given a new regime with the advised to eat little and often, but it is still difficult.

The first few weeks to month after total gastrectomy can be the most challenging. It will take time to adjust to the eating problems this can cause, and to find the right diet and modification that are best for you.

It is understandable to think of mediations such as Loperamide, but we would not advise to take any without first discussing this with your hospital team.

We would advise you get in touch with your hospital team that has performed the surgery, or your clinical nurse specialist (CNS), if you have one, to discuss your symptoms, and to ask to be referred to a dietician for advice and support.

Many hospital trusts that perform this surgery have information leaflet available about the time following a total gastrectomy. All state that it is a slow process and will take time. I will add some of the links below for you to have a look with the information on how to cope with the ‘dumping syndrome’ and diet they offer.

University Hospital of Leicester NHS, dietary information after gastrectomy, they give information on how to eat for the first few weeks after the operation

Bristol NHS, number 6 and 8 the appendix might be most interesting to you.

National Cancer Institute, what you should know, and diet and nutrition after gastrectomy: your plan

University Hospital Coventry and Warwickshire NHS, dietary advice after gastrectomy.

These are all general information, and your hospital might have their own dietary plan and information post-surgery.

You mentioned you are losing weight and even though this is not unusual after gastrectomy, it is important to contact your Doctor, CNS/Keyworker or Dietitian for support. They can also discuss with you the potential benefit of medication such as loperamide or food supplements via your jejunostomy.

I hope this has been helpful, but please don’t hesitate to get back in touch if you need any further information or support.

Best wishes and take care

Annerose (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.

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Fast transit through gut following TG