Nutritional History in Gastrectomized Patients
The term “agastric dystrophy” implies that following partial or total gastrectomy maldigestion with consecutive malabsorption causes severe impairment of the nutritional status. Henning et al.  could demonstrate in patients with Billroth II resection that 80% had fat malabsorption, 77% functional pancreatic insufficiency, 64% carbohydrate malabsorption, and 52% iron deficiency anemia. Further analysis of the pathophysiology of pancreatic secretion in these patients revealed that maldigestion phenomena were not due to inactivity atrophy of the pancreas, but rather due to a decreased release of secretin and pancreozymin from the jejunum . In comparison with maximal exogenous stimulation, the endogenous release of these two hormones following food intake amounts only to 25% of the bicarbonate production and to 50% of the enzyme output. In addition, pancreatic asynchrony with rapid emptying of the stomach and delayed flow of the pancreatic juice contributes to the process of maldigestion.
KeywordsTotal Gastrectomy Iron Deficiency Anemia Pancreatic Juice Pancreatic Secretion Food Intolerance
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