Is your stomach blocked and your food is not moving properly? Or has your doctor told you about a surgery called a "gastrojejunostomy"? It's normal to feel a little scared when you hear a name like this, and to feel a lot of weight on your mind because the words are a bit complicated. But don't worry. Let's talk about this very simply, in a way that you can understand. It's like building a new bypass road to avoid heavy traffic on a road.
What is Gastrojejunostomy?
Simply put, a gastrojejunostomy is a surgical procedure to change the way food travels. It involves creating a new connection, or passage, between your stomach and the jejunum, the middle part of your small intestine.
Imagine, the food we eat goes from the stomach to the first part of the small intestine, which we call the duodenum . But if for some reason there is a blockage in this duodenum, a disease, or a blockage in the pylorus, the food cannot go forward. That's when doctors create this bypass, that is, a new path. In this, the food does not go to the duodenum, but directly from the stomach to the jejunum. This new connection is called an anastomosis in medicine.
Sometimes, this name is also used for a minor procedure where a feeding tube is inserted into the small intestine to send food. But that's not the major surgery we're talking about, that's something else.
Why do you need to have this kind of surgery?
There are several main reasons for this surgery. Sometimes it is done as a treatment for a medical condition, and other times it is done to prevent a possible future problem.
| Condition | Simply put... |
|---|---|
| Gastric Outlet Obstruction (GOO) | Blockage of the passageway through which food exits the stomach. Food gets stuck in the stomach instead of reaching the intestines. |
| Duodenal Obstruction | Blockage of the first part of the small intestine (duodenum), which is located after the stomach. |
| Stomach or Duodenal Cancer | A cancerous tumor blocking the esophagus or requiring surgery to remove the tumor. |
| Peptic Ulcer Disease | Complications such as bleeding and scarring due to stomach ulcers can cause obstruction of the digestive tract. |
Cases of surgery as a preventive measure
Sometimes, this surgery is performed to prevent a problem before it becomes a problem.
- If the duodenum is severely injured (trauma): If the duodenum is damaged, such as in an accident, and the doctor feels that it is dangerous to pass food through it until it heals, a new route will be created to pass food until the wound heals.
- Pancreatic Cancer That Cannot Be Removed: If pancreatic cancer has grown near the duodenum and cannot be removed, this surgery can be performed to bypass it before it grows large enough to block the food pipe.
In addition, this method is also used as part of some weight loss surgeries . An example is the Roux-en-Y gastric bypass surgery. The goal is to reduce the amount of food that can be taken into the stomach and the amount of nutrients that can be absorbed from the intestines.
What happens before the surgery?
Before you go into surgery, it's important to prepare yourself well. Especially if you had a blockage in your stomach, you may not be able to eat properly for a while, may be vomiting, dehydrated , and malnourished . So the medical team will do all they can to get you back to the best health possible.
| Treatment | Description |
|---|---|
| IV Fluids | Giving saline . This helps to rebalance the electrolytes that are depleted in the body. |
| IV Nutrition | Providing necessary nutrition through a saline solution given directly into a vein because you are unable to eat. |
| Blood Transfusion | If there is anemia, give blood. |
| Antibiotics | Administering antibiotics beforehand to prevent infection after surgery. |
| Gastric Decompression | A nasogastric tube is inserted through the nose to remove any trapped material from the stomach and reduce pressure. This is also safe for anesthesia. |
What happens during the surgery?
This surgery usually takes about two to four hours. During this, the doctor will follow these steps:
1. You will be put under general anesthesia . This means you will be sound asleep until the surgery is over.
2. A tube is inserted through the nose to reduce pressure in the stomach.
3. Perform abdominal surgery, either through open surgery or laparoscopically , which means that only a few small incisions are made and a camera is inserted into the abdominal cavity. Laparoscopic surgery has a shorter recovery time and smaller scars.
4. The exact location of the problem in the digestive tract is found.
5. A suitable location is selected from the jejunum, a part of the small intestine, and it is connected at least 5 centimeters above the area of the stomach problem.
6. The newly created anastomosis is checked to see if it is working properly and if there are any leaks.
7. If everything is OK, the incisions are sutured and the surgery is completed.
What happens after the surgery and what are the risks?
You will need to stay in the hospital for a few days after the surgery. It will take some time for your stomach and intestines to start working normally again. You may feel nauseous for the first few days, and your bowels may be a little slow. Some people will need to have a nasal tube in place for a few days.
First, you will be given fluids and nutrition through saline, then gradually introduced to liquid foods, and then to a soft diet before being sent home.
Like all surgeries, there are some risks involved. Things like bleeding, blood clots, and damage to surrounding organs. But these are very rare.
There are several risks and long-term side effects specific to this surgery.
| Complication/Side Effect | What happens with this? (What happens?) |
|---|---|
| Immediate Complications | |
| Anastomotic Leak | Leaking of the newly created connection. This is rare, but serious. If an infection develops in the abdominal cavity and spreads to the bloodstream, it can be life-threatening. |
| Long-term Side Effects | |
| Dumping Syndrome | Symptoms such as nausea, bloating, and stomach pain occur after eating because food suddenly passes from the stomach into the small intestine. In most cases, this will go away after a while. |
| Marginal Ulcer | Since stomach acids go directly into the jejunum, the jejunum cannot withstand those acids, causing ulcers. |
| Bile Reflux | The backflow of digestive juices, such as bile, from the intestines into the stomach. This can damage the walls of the stomach. |
How long will it take to heal and when should I call the doctor ?
It usually takes about six weeks to fully heal. However, this can vary depending on the type of surgery you had (open or laparoscopic) and the extent of the surgery. Your medical team will give you instructions on how to care for your wound after you go home, how to manage pain, and when you can resume normal activities.
Very important: If you develop any of the following symptoms after you go home, tell your doctor or hospital immediately. Don't put this off.
- If you feel redness, pain, swelling, or warmth at the wound site (these are signs of infection).
- Fever (over 38 Celsius / 100 Fahrenheit).
- If the pain is difficult to control.
- If you have difficulty eating, keeping food down, or if you continue to vomit.
- If you have persistent diarrhea.
- If your skin or the whites of your eyes turn yellow.
This surgery will make a big difference in your digestive system. It can be a life-changing experience for your health. So don't go through this journey alone. Talk to your doctor about any questions or concerns you may have before and after the surgery. They are always there to help you.
Take-Home Message
- Gastrojejunostomy is a surgery that creates a new passageway between the stomach and the small intestine.
- This is mainly done as a treatment for conditions such as digestive tract obstructions, cancer, or severe injuries.
- It is very important to get yourself in good health before surgery, and it takes time to recover after surgery.
- After surgery, you will need to change your diet and lifestyle, and it is essential to follow your doctor's instructions.
- If you experience any warning signs such as signs of wound infection, fever, uncontrollable pain, or difficulty eating, seek medical advice immediately.
👩🏽⚕️ Additional questions (FAQs)
💬 🥩 What are iron-rich foods? Why are they important for this surgery?
Foods like red meat, peas, spinach, and lentils are rich in iron. Since the route of food intake is changed during a gastrojejunostomy, the body's absorption of iron can be reduced. That's why iron is also a major concern when discussing this surgery.
💬 🩺 Is it possible to develop anemia after this surgery (Gastrojejunostomy)?
Yes, it is possible. This is because the food passes through the main site of iron absorption during this surgery. Therefore, in addition to eating iron-rich foods, some people also need to take iron supplements as prescribed by their doctor.
💬 🍋 How should I eat to absorb iron well?
When eating iron-rich foods, add something with vitamin C, such as lemons or oranges. This will make it easier for your body to absorb iron, even after surgery. But remember, don't drink tea or coffee after eating, as they inhibit iron absorption.
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