Anorexia & nausea 3 months after esophagectomy

Get a dietitian

He has seen a dietician, knowing what food to eat isn't the problem. The issue is with his constant nausea and anorexia, which is the job of doctors, not dietitians.

Um, not so sure about that, r u?

I do know that dietitians can't prescribe medication, and his problem needs medication. Like I said, he's already seen a dietician as part of his hospital stay after his surgery.

Gonna be very candid with you. I am a Year and 1/2 into this situation as the wife/caregiver. There are no fixes for this problem. My dietician has spent more time explaining just HOW everything now works following this extensive surgery. Nausea that lasts for 2 hrs. Fear,depression and weight loss. Being on the feeding tube - almost a year, probably saved his life. There are options like tinctures that you control the dosage and help with appetite. I will add here, while your intentions are great, a long distance caregiver role is going to be very frustrating. Again, almost 2 yrs into this nightmare..good luck

My husband did not have the surgery, but he does have a feeding tube and it has been a God send. Saved his life. When diagnosed he could not keep food or liquid down due to a tumor blockage. He was dependent entirely on the feeding tube. Chemo and radiation shrunk the tumor and eventually he no longer needed it. He still has it, doc wants it in for a few more months just in case because he has more chemo coming up. He just needs to keep a dressing on it and flush it regularly. No big deal. Feeding tube allowed him to keep his weight and strength up. It’s not a forever thing. It can come out when he no longer needs it. I would urge him to reconsider the feeding tube.

Thanks. He does have a brother locally who is also helping. I'm his best friend and he trusts me, and does occasionally break through his stubbornness with some good coaching. I will talk to him about the feeding tube. Knowing him I can already anticipate his answer, but I will try to prepare to overcome that too. He will say, "How do I know that I won't need this for the rest of my life and I don't want that"? and "How will they know when they can take it out? When they do I might just be right back to being nauseated and not hungry again." I kind of understand the second point. That would be hard to know.

He is unhappy because he says that nobody prepared him for all the possible debilitating side effects of his surgery. For instance, his vocal cords did not close after the surgery, and therefore he had to get a tracheostomy, which he hated. Fortunately this resolved, and they've just taken out. But now his voice is extremely hoarse again. And he was someone who loved to eat, not in quantity but in quality, he's got a fantastic palate. And now he's so distressed because he is always too nauseated to eat and never feels hungry. I feel so bad for him and it's just thrown him into a deep depression. Of course he says that depression meds "don't work" on him. It's hard to get him past this fatalistic attitude, and it's frustrating because his cancer had not spread, and he has probably the best chance of many to power through this and survive. And if he has any other setback requiring chemo or radiation, I'm afraid he's just going to give up. Thank you very much for your helpful information and I hope things continue to improve for your husband.

Thank you very much for your helpful answer. I will try to encourage him to have the feeding tube. It's probably the best solution at this point.

Best wishes for you and for your husband's continued recovery.

Hi there! I’m sorry to chime in on your conversation but my husband is stubborn too but he has the PEG tube for feeding but he can’t keep water down. It’s difficult to give him his anti nausea meds and Vicodin for pain with water even though he pushes very very slowly. He feels the fluids push up against his radiated tumor in the lower esophagus and makes him hurt and nausea comes on. We go in short stages to even get the meds and water flush down. Later he will throw up. No tube feedings since last week. Lost 8 lbs since Tuesday. It may be the 4 th of July but we will end up in the ER. This is just that rough stage that he is trying to push through. He will have the surgery in august! Praying for improvement but right now it’s this trial. Trying to stay strong for him. He’s not expressive and resistant because he feels so miserable right now. 🙏

@caregivernle, I'm sorry to hear that your friend is suffering. Being a long distance caregiver is challenging, but I'm sure he is grateful to have you researching for him.

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As per the Community Guidelines (https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/) I edited your comment questioning the qualifications of another member, who also lives with esophageal cancer and has a wealth of experience to share.

Your friend sounds like he might benefit a team approach that includes physician, dietitian, speech pathologist and possibly a social worker or therapist. I'll point out that dietitians specializing in oncology do much more than suggest diets and what foods to eat. They can also provide assistance with
- managing high risk malnutrition and maintaining nutritional status during treatment
- tube feeding
- nutritional supplements
- general counseling
- providing solutions to problems, including tips for taking food when nauseated
- preventing treatment interruptions
- helping to ease side effects
- improving their overall quality of life
- advocating for the patient
- being a liaison to other team members

Do you know if your friend saw a dietitian specializing in esophageal cancer patients?