A Guide to Persistent Digestive Problems after Cancer Treatment

Some of you will know the excellent gastroenterologist at the Royal Marsden, Jervoise Andreyev. For some years, he and his team have been interested in the digestion after-effects suffered by patients who have had oesophagectomies and similar surgery, and they have now published a very useful guide that should be extremely helpful. It is, of course, aimed at the medical world, and you need to be careful about interpreting it, but it may well be useful for those who suffer from persistent problems that are puzzling their doctors.


There is a long list of symptoms. More than one of these can be present at the same time of course:

Belching / Burping


Poor Appetite

Rumbling / Noises in the abdomen

Problems with sense of smell

Loss of sense of taste

Chronic cough


Dry mouth

Dumping - post prandial dizziness

Dysphagia - difficulty in swallowing

Early Satiety - feeling full too soon

Upper Abdominal Pain

Gastrointestinal bleeding

Halitosis - bad breath


Hoarse Voice

Excess Saliva


Pain in swallowing



Steattorrhea - light brown oily floating stools


Unintended weight loss

Bile Acid Malabsorption

Carbohydrate malabsorption


Exocrine pancreatic insufficiency

Gastric dysmotility

SIBO - Small Intestine Bacterial Overgrowth

11 Replies

  • Alan

    In the "long list of symptoms" I note, they miss out the biggest and for some the worst one? The "it's back" feeling!!

    That is usually triggered by any of the symptoms in the list but can be worse than them all combined.

    A very good article. Thank you.

  • Bruce I have had many times experienced pain for weeks it is back, one time feel my body shutting down every scar insides should call ambulance wont no way hospital find me dead! Got used to it never a good day one thing and another no cure!

  • Thank You Alan,

    A brilliant piece of information. I don't completely understand all of it but it does go a long way to helping post op patients to understand how the combinations of symptoms can be addressed.

    I now understand why I wake up regularly at night with a wet chin and upper chest! I have become a drooler! And as odd as it may seem it puts my mind at rest.

    You always post good information and links, once again Thanks

  • I was lucky after my op (stomach taken away too T4) no end of tests he and his team sort my bowel problem diet etc! The outcome was I have an over reactive bowel. Got used to living with it accident's several things the list! Looking forward to next March 10 years determined to get there live with pathetic body! Not doom and gloom have good family support grand children one of them 18 months seeing me poorly on the settee rubbed baby cream talc on my stomach another potty training gave him hard time pood himself. Followed me in bathroom cleaning up "naughty nanny pood yourself" Gave up trying to explain smacked my leg naughty ha

  • The bowel control problem is dispiriting. There are a fair number of people who have this as a consequence of cancer treatment, and there is in fact a Pelvic Radiation Disease Association that was formed because of patients having 'accidents'. There is a chance that you might have SIBO - small intestine bacterial overgrowth, and that a serious course of antibiotics might make things a bit better. It is to do with the lack of stomach acid killing off the undesirable bugs in your system.

  • Thank you Alan I have experienced it the pain insides scars feeling my body shutting down. Got antibiotic, strong pain killer. I have got used to living with my pathetic body reaching to be sick daily, the toilet, muscles legs. Never a good day. But like us all a fighter! I am really looking forward to one of my daughters tell me I should go to a meeting inspire new members support as I had still here. 10 years next March beat the odds!

  • Hi

    My husband has the same problem he had no stomach at all we could not find any way to sort bowel problem out

  • I get the burping, I must admit that it is not the worst, though people have laughed at me over it. I am a type 1 diabetic and the carbohydrate malformation makes managing that illness harder. Less dumping at this stage because I am a 10 year survivor but I only get a choking sensation, not hunger. I found that I had issues with milk until I became pregnant with my youngest but can still only drink full fat milk. I got pernicious anemia due to the surgery but I did get to be a mummy which is what i always dreamed of doing.

  • Thanks for the link, good information. Could this be "simplified" and given to all patients as part of an after care package?

  • Good question! I think it is fair to say that these issues are not always the experience of the average patient, and that there is a great range of severity of symptoms. I believe the OPA are due to revise their information booklet so it is feasible that something could be done to combine some of this information.

  • Thank you so much Alan for that information. I am having problems eating, and also reflux and stomach pain after eating. I have had a barium swallow and a gastroscopy last week, but they did not find anything untoward. This article was very informative as I was beginning to think that the doctors would think I was a hypochondriac

    Many thanks

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