Nutritional impairment often occurs after gastrectomy. In a recent review article, Randall1 estimated that about one-half of all patients subjected to subtotal gastrectomy have sufficient nutritional problems to prevent their regaining normal preoperative weight, and from 2 to 10% are severely disabled as a result of their operation. With total gastrectomy, at least two-thirds of the patients have nutritional problems, one-third of which are severe. Few such patients regain their preoperative weight.
Nutritional impairment after gastrectomy implies either inadequate intake of food, malabsorption of ingested food, increased metabolic requirements, or a combination of all of these factors. The object of this discussion is to evaluate each of these factors in order to present a more comprehensive program for care of the nutritionally disabled patient after gastrectomy.
Inadequate Intake of Food
There is evidence that gastrectomized patients eat far less than they did prior to surgery. In a study of
Vanamee P. NUTRITION AFTER GASTRIC RESECTION. JAMA. 1960;172(18):2072–2076. doi:10.1001/jama.1960.63020180028011f
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