WHAT TO EXPECT: Without a stomach to help digest food, your digestive system can use outside help. Mostly this involves figuring out the natural rhythms of your body, making a few changes in your eating habits, and possibly using some products that help with digestion.

WORDS OF ENCOURAGEMENT: It’s pretty amazing you can digest food without a stomach, but you can. And it’s less of a problem than one would think. Early on it is very difficult, but over time it is only a matter of learning the rhythms of your body and adapting to its needs. Though there will probably always be challenges, over time things almost return to normal.


Probiotics: Probiotics supplements are “good” bacteria that help with digestion. They can be purchased at a health or natural foods store. Most need to be refrigerated. Some people use yogurt or milk with live acidophilus cultures instead.

Probiotics may be especially beneficial right after surgery because they help replenish the “good” bacteria which occur naturally in the digestive tract but which are wiped out by the antibiotics given as part of surgery.

Some people find they have more problems with dairy products after a gastrectomy. If this is true for you, you may find it helpful to take lactase tablets when you eat dairy products. Lactase is a digestive enzyme which works on milk sugar.

We started out using a very strong probiotic recommended for after major surgery by the staff at our local natural foods store. Gary found it difficult to swallow capsules so this first probiotic was a powder which we sprinkled on his food. Later he was able to switch to capsules. Recently, he has switched to a shelf-stable probiotic since it is more convenient.

Digestive enzymes: Digestive enzymes can be purchased at a health or natural foods store. These help supplement the digestive enzymes naturally occurring in the digestive tract. They can help with digestive distress and also may improve digestion and absorption in general.

Gary has found that only the “stronger” enzyme formulations are of much help. Forget those papaya enzymes!

Because he has had some trouble with capsules, he uses a product called Chewy-Zymes which are a chewable tablet.

A short walk before eating: Walking around a little before meals stimulates movement of the digestive tract, improving both appetite and digestion. This isn’t something Gary currently does, but he found it helpful during treatment and in the early months after. Now Gary finds doing twenty push ups before eating helps with digestion.

Eat slowly and chew your food thoroughly: There are enzymes in the mouth that start the digestion of fat and carbohydrates. Eating slowly gives these enzymes a chance to start working. Chewing your food well is important because with a total gastrectomy you no longer have stomach acid to help break food down into smaller particles.

“Let your dinner settle”: This advice has been around along time, but it takes on added importance after a gastrectomy. In the early months, Gary was depressed about feeling chained to his chair for up to a half hour after he ate. This gradually got better. Now, Gary only occasionally needs to sit longer than Anne who also likes to let her dinner settle.

Acupuncture: Gary had weekly acupuncture treatments for several months after treatment and continues to get them every 2-3 weeks. They not only feel relaxing, they seem to help his digestive system stay aligned and balanced. In the early post-treatment days, Anne often noticed a difference in Gary’s digestion for a day or two after acupuncture treatments.