Gastrectomy and bile reflux

sorry TG =total gastrectomy

Hi @freeflow,

I’d like to introduce you to a few Connect members who’ve shared their or their loved ones’ gastrectomy experiences – please meet @jarnold246 @sox90vicky @rmw719 @azcyclist2018 @kamg @grandmar – although they’ve not all undergone total gastrectomy (TG), I’m certain they will return with more insights for you. I’m also tagging Mentor @travelgirl to see if she might have more information.

You may be right about bile reflux being the cause of discomfort – according to this information from Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/bile-reflux/symptoms-causes/syc-20370115 , "Gastric surgery, including total removal of the stomach (gastrectomy) and gastric bypass surgery for weight loss, is responsible for most bile reflux.”

Has your doctor recommended any medication, @freeflow? Were you given any dietary guidelines to follow after the surgery? I look forward to hearing more from you.

@freeflow I am sorry to hear of the digestive issues you have had since your TG. These symptoms sound very uncomfortable. I have had three surgeries of the upper digestive tract and I understand what digestive tract problems are like. I too have little appetite and feel full quite quickly. My surgeries were due to a rare form of cancer, neuroendocrine tumors.

I'm thinking that since you cannot eat much without these distressing symptoms starting that you must be losing weight as well. How are you feeling otherwise? Are you being checked for any nutritional deficiencies?

If you are comfortable sharing more, why was the TG performed? Was it to treat another type of digestive problem? Please share only as you feel comfortable doing so.

@freeflow
Welcome!
I am over 2 years out from the gastric sleeve. I have never heard about bile reflux. I have, however, experienced and heard about the other issues you have. First, the gurgling and bubbling is actually your stomach breaking down and digesting the food. Your entire digestive system has been disturbed. I don't know if you went through an entire program before your surgery that included post surgery diets. If you did, I apologize for being repetitive.

At 6 months out, I assume you are on all solids. Rule of thumb for eating at any point is: stop eating and drinking 30 minutes before you eat and wait 30 minutes after you eat before you drink or eat again. Your actually eating should have the following pattern: take a bite, put for fork down, chew 20 times, swallow, count to 20 before you take another bite. It should take you only 20 minutes to eat. If you are full or haven't finished you still stop at 20 minutes. Remember to eat your protein first then the rest of your food, this is in case you cannot finish.

Many people become constipated after surgery. Make sure you have a BM no longer than every other day. If you don't go, take something gentle to help. In addition, take a stool softener. As far as the gas pain and bloat, Gas X is our friend. This is why you have 'smelly wind.' In addition, it takes time for you to 'read' your body to see what it likes. Gas, bloat, nausea and 'smelly wind' is your body's way of saying it is not happy with either what you are feeding it or how you are eating. Finally, I was told that many patients have reflux after the sleeve and have to have another surgery, by-pass. Apparently, the reflux can be pretty bad.

I strongly suggest you speak with your surgeon or the nurse in the practice. Let either know what is going on. They might suggest some kind of a digestive test. Remember, one size does not fit all. Each person reacts differently to the surgery and heals differently, as well.

I hope this helps. If I can help in anyway, please feel free to write.
BTW.....If you haven't yet, join a support group. There are many things that the docs don't tell you before the surgery. It's good to know that you are not alone and others are experiencing what you are.

Ronnie (GRANDMAr)

Sorry to hear about your challenges. In a quick response to the issue of "wind", I did get a simple resolution-BUT, please be sure to ask your physician first to determine if this is all right. I use an over the counter chewable pill called Devrom. It is bismuth subgallate. I was told this was the same as Pepto Bismol- not so much. I found immediate relief of the smelly part; it does not control gas- that is some other digestive function. I get it online via amazon and it is very affordable. There are several variants of the bismuth subgallate, but I find that Devrom works best for me and choose to leave well enough alone!!
I also get the chewable version as it seems to work with all the other digestive complexities from my gastrectomy.
I have a sub-total gastrectomy, which means almost the entire stomach was removed as a result of two failed surgeries to correct acid reflux- I can give more detail about this but my surgery was not for weight loss, however it did certainly result in weight loss.
The gurgling I found to occur was very prominent early after my surgery-- was not the old "stomach growling" (no stomach!) but longer in duration, and certainly louder. I had to share with friends, colleagues, supervisors etc that it was an artifact of the surgery and not a call for food. I do need to exercise care about "slippage" and choose to excuse myself from an area just in case. I learned that since the stomach completes a major part of digestion as a result I do have some amount of undigested food getting through. Just needing to slow down, way down, the eating/chewing processes.

In terms of Devrom usage, I take three per day, one in the morning before breakfast, one around lunch time and one usually after dinner. That's the good part-staying on this routine has all but cleared up the smell. However, if I miss one, game over. I do not double dose- just get back to the schedule ASAP. To that end, I always carry pills with me- and I usually carry 3 or 4- why? Because I cannot afford to lose one or drop one is a bad place- redundancy x 2!
And the last place I want to be unpopular is in an airplane as I travel quite a bit.

I have been so pleased with the results of Devrom I am glad I found it- I always order 2 bottles at a time so I am never without.
What long answer to your question- I hope this helps.
My only other caution: I had some dental work done and the dentists gave me an antibiotic that I later found our I did not need (no aspersions on the dentist). The antibiotic pretty much destroyed the little gut bacteria I had and the odor was magnified beyond belief- needed to get some serious doses of probiotics and these corrected everything- these were very short term. I no longer take those.

Best to you- wish I had known some this before my gastrectomy, however can't rewrite history- I am happy to share my experiences with others so they may not have the same challenges--no stomach is challenge enough! As aways, keep a sense of humor- it does help in some odd way.

If TG means total gastrectomy then I had a similar issue as you regarding "wind" but my problem was its industrial strength not smell. My gastroenterologist suggested a probiotic--Align--and it worked.

Yes sorry TG =total gastrectomy

First, what isTG? I am more knowledgeable about esophagectomy problems, reflux, etc. Seldom do we have bile reflux, however.

total removal of the stomach, so people with that can and get bile reflux,sadly.

Looking for some advice and tips
I am 6 months out of TG which has seemingly gone very well on the recovery angle. Recently since a change in my medication (for fibromyalgia) I have started suffering from insomnia. I believe after doing some research that I have an increased bile production and bile reflux which is causing some problems. The main one is where I start to eat, can’t eat, literally and figuratively and then my intestines start to act as though something is fermenting in there, bubbling, gurgling getting bloated, this in turn leads to an increase of ‘smelly wind’. It is very similar to dumping syndrome but without the having to run to the toilet. Doctor is working on the problem but not fast enough Lol. Anyone got recommendations for remedies? Natural remedies like teas etc, any advice would be welcome.