Causas da desnutrição pós-gastrectomia / Causes of malnutrition in post-gastrectomy patient

RESUMO

The stomach through its mechanical and chemical processes has an unique role in the food processing and bioavailability. Hence gastrectomy has predictable and modifiable nutritional consequences depending upon its knowledge and the post-surgery therapies. OBJECTIVE: To point out the impact of gastrectomy on the nutritional status focusing on both mechanical and chemical actions of stomach on intaked foods. RESULTS: The protein-energy malnutrition and consequent body-weight loss follow reversely the remainer gastric volume and post-operatory length and have anorexy and intestinal malabsorption as their main causes. Lower food intake is probably due to either emotional factors or chemical mediators acting centrally on hypothalamus. The diarrhea may be due to either increased peristalsis or bacterial overgrowth both aggravated by exocrine-pancreas deficiency and gallbladder overflow. The intestinal malabsorption leading to fecal losses of fat and or nitrogen as well as lower utilization of dietary calcium and liposoluble vitamins. The gastrectomy-related anemia is consequent to lower secretion of both HCl and intrinsic factor leading to a decreased solubilization of iron and lower absorption of vitamin B12, respectively. CONCLUSION: Body-weight loss and anemia are the protein-energy malnutrition findings often found in these patients whose severity and lasting depend upon the type of surgery, post-surgery length and received nutritional care, being strongly recommended a supervisioned dietary care