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    Surgery for peptic ulcer is effective, but it may result in a variety of postoperative complications. After gastrectomy, as many as 30% of patients have significant symptoms. An operation called highly selective vagotomy is now preferred for ulcer management, and is safer than gastrectomy.

    After a gastrectomy, several abnormalities may develop that produce symptoms related to food intake. This happens largely because the stomach, which serves as a food reservoir, has been reduced in its capacity by the surgery. Other surgical procedures that often accompany gastrectomy for ulcer disease can also contribute to later symptoms: vagotomy, which lessens acid production and slows stomach emptying, and pyloroplasty, which enlarges the opening between the stomach and small intestine to facilitate emptying of the stomach.

    Some patients experience light-headedness, heart palpitations or racing heart, sweating, and nausea and vomiting after a meal. These may be symptoms of "dumping syndrome," as food is rapidly "dumped" into the small intestine from the stomach. This is treated by adjusting the diet and pattern of eating, for example, eating smaller, more frequent meals, and limiting liquids.

    Patients who have abdominal bloating and pain after eating, frequently followed by nausea and vomiting, may have what is called the afferent loop syndrome. This is treated by surgical correction. Patients who have early satiety (feeling of fullness after eating), abdominal discomfort, and vomiting may have bile reflux gastritis (also called bilious vomiting), which is also surgically correctable. Many patients also experience weight loss.

    Reactive hypoglycemia is a condition that results when blood sugar becomes too high after a meal, stimulating the release of insulin, about two hours after eating. A high-protein diet and smaller meals are advised.

    Ulcers recur in a small percentage of patients after surgery for peptic ulcer, usually in the first few years. Further surgery is usually necessary.

    Vitamin and mineral supplementation is necessary after gastrectomy to correct certain deficiencies, especially vitamin B12, iron, and folate. Vitamin D and calcium are also needed to prevent and treat the bone problems that often occur. These include softening and bending of the bones, which can produce pain, and osteoporosis, a loss of bone mass. According to one study, the risk for spinal fractures may be as high as 50% after gastrectomy.

    Depending on the extent of surgery, the risk for post-operative death after gastrectomy for gastric cancer has been reported as 1–3% and the risk of non-fatal complications as 9–18%.

    Source: The Gale Group. Gale Encyclopedia of Medicine, 3rd ed.";

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