Oesophageal Patients Association

Digestion Problems after Surgery

We have just put up a new poll, but have included some symptoms that were not included when we did something similar a few months ago.

The reason is that we are trying to get a better picture of the problems that some people have well after the effects of the surgery should have settled down.

There is an increasing concern about the longer term consequences of cancer treatment. Sometimes the digestion problems are also relevant for other cancers, and seem to be related to the effect of chemotherapy, and of radiotherapy in the pelvic area. It may be related to the way in which the treatments affects the bacteria inside the digestive system. Other cancers probably do not have the effects of the loss of the vagus nerve controlling the way in which our digestive system sends signals to the brain, nor the surgically-shortened digestive system when the oeosphagus and/or stomach is removed.

We know that some people do suffer from, say, persistent diarrhoea, but we would like to try and find more information about how common this is, and the other digestion problems. I suspect that most people recognise that eating and digestion can never be the same in all respects, not least the size of meals that we can cope with, and some food that always seems to give us trouble. But this is really to do with problems that are quite serious, that might, for instance affect our lives and whether we can carry out our normal lives or not.

So thanks for your help.

9 Replies

Thats good news that somebody is investigating the after effects of the various types of treatment for UGI cancer. I brought the subject up a few months ago as I feel that although treatment is beneficial or successful, it is only a 50% answer to the problems people have. after. Not enough research has been done on the after effects.

My surgeon for instance, and myself, are pleased with the surgery which he performed to remove cancer but as he said there is nothing he can do about my digestion problems which I still suffer from - feeling ill after eating, constipation and now weight loss etc and this is nearly 2 years after my merendino interposition. Another factor is the psychological effects of treatment in handling the digestion problems. I for instance am now reluctant to eat as its usually followed by an hour or two of feeling ill.

I trust this is the beginning of a campaign for more research in this field.


I am 18 months post-Ivor Lewis and my problems are almost identical: weight down from 92 kilos to 59 kilos (fifteen stone to ten), feel ill with abdominal cramps about half an hour after eating, constant constipation (alternating with diarrhoea after taking laxatives), lassitude. Plus the same psychological feeling (which I think in fact is no more than a conditioned reflex: if eating is so predictably unpleasant, it is hardly a surprise if appetite disappears) and the added frustration of not knowing what to do about it. (The liquid concentrates that most recommend have a particularly unpleasant effect).

V reassuring to find someone else with the same problems: it's easy to feel it is somehow self-generated.

The OPA was marvellous when I had a hypoglycaemia incident quite out of the blue - the medics were nonplussed, but the OPA told me immediately what it was, and the simple way of dealing with it at the very outset, and it has ceased to be any problem.

Do others have the same symptoms as Medway (and I)? Any ideas how long it lasts, or how to proceed? Let's hope research gets under way.



Hi, I don't know if it will help but I find Movicol very good for sorting out the constant swing from constipation to diarrhoea. I used to take it only if constipation was really bad but my doctor advised me to try taking it every day, she said that it helped the liquids and solids to combine better, and it certainly works for me. It took my 'system' three or four days to get used to, but since then - no problems of that nature. I get it on prescription. I didn't have very bad stomach cramps, so I can't say if it will take care of that problem, but - here's hoping!


We have been in contact with CORE charity, closely linked to British Society of Gastroenterology, and hope that we can fix up a preliminary meeting with them, and other interested parties , in the next few weeks. I am not sure how much is known by specialists that could be be publicised and used soon; and how much would need to be research, but I am convinced that there does need to be research about exactly how many post-surgical patients have problems, and what can help. In this respect CORE have experience with research, and may have good ideas about the way forward.

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Hi Alan

What's the best thing to do if one continues to have digestive problems post op ?

And you mentioned the problems may be due to bacteria in the gut ? What are the best ways to treat this ?


Check with your specialist nurse and see if they have a gastroenterologist in the hospital they can recommend; otherwise ask your GP for a referral.

Try and keep a food diary of the things that cause you trouble so that you can present as good a picture as you can.

It may be that antibiotics might do the trick if, say, you have persistent diarrhoea. But also think in terms of whether leaving off dairy products and anything with processed sugar has any effect on you.

Some people stick to a low glycemic index diet or a low FODMAP diet (developed actually for people with irritable bowel syndrome) and find that this helps, but it is early days for us in this respect.



Its clear from the few responses so far that there are many suffering post op problems and my doctor for instance who knows his job well just does not know the answer as he does not know what exactly has been done inside and what has been disturbed. there doesn't seem to be link between the surgeons and post doctors. my surgeon told me he doesn't know anything about the solutions to the post op problems. His job is to keep us alive.

I've heard nothing about monitoring typical patients with the various problems but I'm sure if it was done by a medical team with all the facilities then they could learn a lot.

What is also missing is there is just nothing out there in the world warning people about how serious reflux can be long term. Its a silent killer and nobody knows until they have it. You hear about smoking and lung cancer, overweight and diabetes, too much fat intake and

blood flow problems and heart attacks and just about every other serious medical problem etc but who has heard anything about oesophical and stomach cancer in the media. What government advertising campaigns have been run?

If oesophical & stomach cancer is increasing in frequency at the rate I'm reading about, there is going to be a sudden rush of cancers and overwhelming demand for post op treatment with no answers.


The Department of Health are considering the next stages of their be Clear on Cancer campaign, and there is a possibility of oesophagogastric cancer being the subject of a regional awareness campaign involving TV advertising some time in 2014. There is a debate about what this means for endoscopy resources, but we do need to make an impact amongst the population suffering from chronic heartburn. Drugs like omeprazole are expensive; but an endoscopy, also quite expensive, can help to make a proper diagnosis. In Belgium, the GPs apparently cannot prescribe PPIs without an endoscopy being performed.

Meanwhile we plug away with Action Against Heartburn actionagainstheartburn.org.uk but have not got funds to pursue it as we would wish.

I do think that there is a need for gastroenterologists to follow up many surgery cases where there are lingering problems, along the lines pioneered at Royal Marsden


We are due to have a meeting with CORE, a charity closely linked with the BS of Gastroenterology, to see if we can take things forward with some proper research, but this will inevitably take time (and some money).


I have been told, quite rightly, that the poll does not allow for an answer for digestion problems that are not listed, so I have revised it, and created a new post to explain!


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