This presentation will review the recommended nutrition assessment, interventions and considerations for patients with or at risk of gastric cancer who are preparing for total gastrectomy. This presentation will draw comparisons to bariatric surgery, while highlighting the stark differences between bariatric surgery, where the goal is to promote weight loss, versus total gastrectomy, where the goal is to prevent weight loss, promote diet tolerance, and prevent the adverse consequences related to micronutrient deficiencies.
The nutrition care of patients after total gastrectomy allows the registered dietitian to integrate several aspects of medical nutrition therapy including changes in digestion, subjective and objective signs of micronutrient deficiencies, and assessment of body habitus changes, as well as to provide extensive nutrition counseling in behavior change and nutrition education on reading food labels, meal planning, and diet modification. Aspects of this presentation are applicable to a variety of patient populations and therefore will be useful to dietitians practicing in other settings.