Guide to the Esophagus Urgently Needed

[Bazz]

Thank you Alan M for answering my questions and your most helpful suggestions concerning dumping and pointing me to the CORE web site. However, I have read this article before and although it does contain helpful tips the trouble is that it is focused upon the stomach; not the oesophagus. It starts off by stating: " The name Dumping has been given to a collection of symptoms that occur after a meal in patients who have undergone certain operations upon the stomach." Note: there is no mention of the oesophagus. The article then goes on to talk about the surgical removal of most or all of the of the stomach (gastrectomy) nearly always involving the removal of  the valve at the bottom of the stomach (the pylorus). Plus another operation called a gastroenterostomy where the surgeon needs to by-pass the valve by making a communication between the stomach and the part of the intestine beyond the valve.  And a third group of patients may have had an operation to cut the vagus nerves to their stomach (vagotomy). But, as I recall, the words oesophagus or the operation oesophagectomy and the post operational implications for such patients are never mentioned in the CORE website and that's what I think is really specifically required. I have no medical knowledge whatsoever, but surely the post operational condition, difficulties and challenges for patients who have had entirely different operations must also be very different?

The article that I need would be called "The Oesophagus for Dummies and how to live without one" but unfortunately there is no such publication. When I was an engineer I wrote handbooks about understanding process control systems, how they worked and trouble shooting of problems. It seems to me that the human digestive tract is also a process control system that although very complicated could be described in layman's terms, complete with diagrams, as an aid to better understanding by patients of their condition, resulting in a more rapid recovery post surgery.

Even nearly a year after my operation I still suffer frequent periods of tiredness and malaise that I know from experience will pass within an hour or so, but it slows my life down. If I had more detailed knowledge then I may be able to prevent these attacks from occurring in the first place and even if they did I would know what to do about them. At the moment I do not know much about these things and that's not because I haven't experimented or tried to find out. For example: do I take glucose at the onset of one of these attacks, that I know from experience are often connected with sugar? But isn't that going to add to the problem? A drunk taking a drink to steady his nerves? Or do I drink water? Or do I take an indigestion pill? I have tried all these things and still cannot tell which is the right thing to do. So I need more knowledge and information and I know for a fact that there are many just like me.

Does anyone know the answer? If so as someone who could produce a competent layman's handbook or leaflet, complete with diagrams, I volunteer to work with that person free of any charge to jointly produce such a badly needed handbook. We could simply call it “A layman’s guide to the Esophagus.”

[Hidden]

Here is something to be going on with whilst we discuss how best to respond to your suggestion:

I suspect that, like many parts of the body, not many people know that they have an oesophagus until they have a problem with it! It is a tube, normally about 21cm long, that takes food from the bottom of the throat, past the heart and lungs until it reaches the stomach by your diaphragm. Where it passes through the muscles of your diaphragm is a sphincter valve to stop stomach acid and other contents rising up into your oesophagus. The cells lining your oesophagus are different from those lining your stomach, which are designed to cope with the acid.

The digestion system should take food progressively through the system (motility) with a regular action, and this is controlled by the vagus nerve. When this has been cut, the control system can go haywire, but normally does eventually train itself to be reasonable.

Here is a link to some information about your oesophagus:

opa.org.uk/pages/about-oeso...

Here is the booklet about life after an oesophagectomy:

opa.org.uk/pages/factsheets...

[jay2908]

Hello Bazz,

You have a very valid question. What does the oesophagus do and how does it play a part in the symptoms you are suffering post operation.

The key issue with not having an oesophagus is that it is simply much harder to get the food down from your mouth to your stomach. There are muscles that would normally assist in this. Also, there is a chance of scarring/stricture where the oesophagus is rejoined to your stomach. This can cause food to occasionally get stuck.

In terms of your other symptoms, dizziness, tiredness etc. I have had these issues too (and still do). The key is to have small regular meals, and in my case, I also use body building protein drinks and bars on the go to ensure I have consumed sufficient calories. All of which are Low GI. I also have a bag of toffee pop corn at my desk to snack on. Finally, I avoid too much caffeine as this can upset your blood sugar balance.

I've seems a diabotologist, who agreed that my blood sugar does spike for a short period of time after eating/drinking. Hence the sweats, dizziness etc.

To give you an example of my daily routine in terms of eating.

7.00 am 2 cups of strong tea (yes, generally not good for sugar levels, but I have 2 kids and it helps with my bowels).

7.30 am protein shake (double diluted)... note that I have stuck to liquids to avoid some dumping symptoms.

9.00 am Low GI protein bar (Maximuscle, Promax Meal). Only eat half.

9.30 am eat the other half.

10.30 to 12.00 am .... small hand full of toffee popcorn/crisps. Note that I eat about 4 pieces and then wait, then eat another 4 etc. I love the sugar, but want to avoid the sugar highs.

12.30 pm Cheese, Salad and pickle sandwich. Eat Half.

2.30 pm eat other half.

3.30 pm Double espresso. It's been a long day at work and I need the caffeine to keep me going. Small amount of liquid, so less likely to get dumping.

4.00 pm More crisps/nuts

5.00 pm half a protein bar

7.00 pm half a jacket potato with lots of cheese. I burn the potato on the gas as the charcoal helps keep my stomach settled.

9.00 pm cottage cheese/choc ice Staves off the hunger till the morning.

10.30 sleep.

I hope that helps. It's only over time that you'll get an idea as to what diet will work for you. In a nutshell, small frequent and low sugar meals. Use easy to carry foods if you're on the move throughout the day. Most importantly, say no to food when you know you're reached, or close to your limit.

Glucose tablets are useful if you know you've eaten too much and your sugar levels are going to drop or have started dropping. They help counter balance the insulin. I got a blood sugar test meter and checked my sugar level over a few days. Realised the foods that were causing the problem and took them out of my diet. E.g. eating one choc ice was okay, eating 3 was pushing it.

Let me know how you get on,

Jay

[liz_crisp]

Hi I am 7 years on and I have learnt to manage my energy, I have talked to many specialists and a endocrinologist I had the luck to be under for a pituatuary Gland explained why it is ramdom, the body is a very clever machine and if all is as it is designed to be it works incredibily well. the brain warns the body of approaching food when you start to chew, the pancreas produces some insulin to deal with the sugar spike and normally it all stays level, We however are differently engineered and the timings are a bit out, so sometimes your sugar spike is high as the insulin arrives and it says wow we need more and then it takes all the sugar out and hence we have a dumping episode, it you eat chocolate it has quite a bit of fat in it which means ittakes longer to get the sugar into the blood, it can mean a cheese sandwich will cause a problem and the chocolate bar doesnt. All abit hit and miss, thats why you need to put more sugar in so that you are evening out the sugar and your body get things under control again, the cramps are from the body pulling water into the gut, often because food is in the wrong place (travelled through a bit fast). As Alan says you have a digestive system without a conductor the Vagus nerve is like a 2nd brain and controls alot. Your system will learn again, but it will always be a bit odd, you just have to learn to recognise the symptoms, and work out if sitting down for a while after eating helps or if you should become a grazer and eat small amounts all day, I always have Dextrose and boiled sweets in my Bag. PM me if you want Cheers Lizzy