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Nutrient malassimilation after total gastrectomy and possible intervention.

U Armbrecht, L Lundell, R W Stockbruegger

    Digestion
    |January 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    Malnutrition after total gastrectomy is common. Pancreatic enzyme supplements did not significantly improve steatorrhea in patients with malabsorption following this surgery.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Nutritional Science

    Background:

    • Malnutrition is a frequent complication post-total gastrectomy.
    • Roux-Y esophagojejunostomy is a common surgical reconstruction technique.
    • Understanding malabsorption mechanisms is crucial for patient management.

    Purpose of the Study:

    • To investigate the causes of malabsorption after total gastrectomy with Roux-Y reconstruction.
    • To evaluate the efficacy of pancreatic enzyme supplementation in managing steatorrhea.

    Main Methods:

    • Analysis of orocecal transit time, upper intestinal bacterial flora, and small intestinal carbohydrate fermentation.
    • Assessment of pancreatic dysfunction in patients with steatorrhea.
    • A double-blind, cross-over trial of pancreatic enzyme supplementation.

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    Main Results:

    • Shortened orocecal transit time observed in 5/11 patients.
    • Probable upper intestinal bacterial overgrowth identified in 4/11 patients.
    • Suspected pancreatic understimulation and dysfunction in 3/11 patients with steatorrhea.
    • Pancreatic enzyme supplementation did not significantly reduce steatorrhea.

    Conclusions:

    • Malabsorption after total gastrectomy has multifactorial causes including rapid transit and bacterial overgrowth.
    • Pancreatic enzyme supplementation is not effective in reducing steatorrhea in this patient population.