Misconceptions: What Happens When Turning a Stomach Into a Tube?
UPDATE: It’s December 31, 2023, 10 months after having a successful esophagectomy – a surgery to remove part or all of the esophagus.
The esophagus is a complex organ. It’s a tube that moves food and liquids from your throat to your stomach. After its removal, the esophagus is rebuilt from part of your stomach or part of your large intestine. I had a partial esophagectomy which changed the interior structure of my eating process. Instead of having a bowl shaped stomach to hold food in a bowl shape after eating a meal, I now have a tube shape for a stomach in its entirety which is stretched up to my throat. My tube-like stomach has been pulled up to meet my throat after removing 2/3 of my esophagus in a 7-hour robotic-assisted surgery (increased survival rates of 95-percent with robotics). The cutting edge robotic technology came from a company named “Intuitive” … located in Sunnyvale, California.
The successful operation removed a 5-inch long tumor from inside of my abdomen and the surgery was deemed as successful. The results were deemed as “fantastic” by my surgeon, Dr. Daniela Molena. MD – a Thoracic Surgeon at Memorial Sloan-Kettering in NYC. After surgery, CT scans and surgical pathology examined the results and looked precisely at the interior of my body. The changes were significant and very optimistic. No metastatic transfer of a cancerous tumor occurred. I was deemed a grade 3 patient with an excellent chance of cure. However, I will have permanent changes for my entire life with structural changes – a lifesaving solution for me. Numerous challenges will remain, but are to be expected for a surviving esophageal cancer patient. Challenges will be: How much food I can eat after this operation in one sitting? In my case, I broke the norms for most surviving EC patients, with the requirement of having to eat 6 or 8 or more small meals (only a cup of food), requiring several times per day to survive. The requirement of nutrition (ample amounts calories per day can be a significant challenge). Instead, I was able to eat 4 meals or less per day to maintain my body weight. That is simply a very uncommon result. In fact, after 9 months, I regained all of my lost weight from surgery. I found myself being able to eat a 1-pound hamburger, large fries and a large soft drink in one meal only a few weeks after surgery. That’s also very uncommon. Although, because I had a partial esophagectomy surgery and not a full removal of my esophagus (in totality) from the top of my stomach to my upper throat, I have a significantly improved chance of survival. As said above, several challenges will continue with the loss of a gateway (a doorway) that is found atop my stomach (before surgery) to keep food inside my belly for a meal. My stomach is now shaped without the protection of a pyloric sphincter “gatekeeper” valve at the top of my stomach. Today, my digestive process occurs more from inside my chest cavity (behind my heart and above my diaphragm) rather than from inside my abdomen. In fact, I have more of my stomach inside my chest cavity than in my abdomen. In a sense, I don’t have the same definition of a “stomach” any longer. I now have a continual digestive tract from my breastbone to my small intestine – uninterrupted. No gateway exists anymore to keep “stomach acid” from the possibility of moving upward and into my lungs, if I allow myself to lay down flat after a meal the serious results can be very life-threatening. If an occasion were to occur, with food or liquid or stomach acid were to enter into my lungs (an aspiration of fluids), the damage of having those fluids enter into my lungs has a very high likelihood for creating a scenario of infection damage and death (as high as 70-percent). So, while I can eat a large meal, I must stay upright and sleep at an angle (30-degrees or more) … never allowing myself to lay flat. I’m now required to sleep on a wedge (at an angle) after every meal when sleeping to keep food from ever reaching my lungs. Yet, (post surgically) I have found myself without having as much stomach acid in my digestive tract (which is greatly helpful), thus reducing the chance of damage from stomach acid reaching my lungs.
What is misunderstood or a misconception may be: how does my tubular shaped new stomach work without having the gateway (pyloric sphincter) any longer? How does my stomach (in advance) prepare itself with a variety of sugary foods or spicy foods entering my lower tubular shaped stomach quickly? Miraculously, I’ve not had any symptoms of what’s named a “dumping syndrome” occurrence, whereby I’m throwing up meals or food moving too quickly into my small intestine. It’s truly a blessing that I can literally eat any kind of food or a drink – faster than most patients, without any limitations. That’s amazing!
I can eat sugary meals (like a large piece of chocolate cake) or steak with steak sauce or even spicy foods or an alcoholic beverage without any negative symptoms! Amazing! I can drink liquids during my meals as well (a very uncommon result). I literally have a normal diet after having one of the most dangerous surgeries in modern day medicine.
For 2 years, my esophagus was like a riverbed of cancerous rocks! The amount of pain that I experienced was high and the most pain that I’ve ever experienced. I was treated continually with pain medications for 2 years. My esophagus was lined with a 5 inch long circular tumor, which once made it impossible for me to eat food, but now with 2/3 of my esophagus removed, I now don’t suffer from swaying heart rhythms (irregular heartbeats with AFIB) or a dangerously high blood pressure of 180 / 110 and higher!
My body made huge adjustments over an extended amount of time (3 years) during Covid-19. Point in fact, I’ve been blessed with modern day medicine and a miraculous outcome from brilliant scientists and a dedicated number of physicians, nurses and health professionals … and the revolutionary science from Proton-radiation and Chemotherapy was part of the triple-modality to reach cure.
It’s 5 AM: I ate a large meal last night and I filled up my tubular shaped stomach with food (I was hungry) … which means, I’m clearly risking my life by eating such a large meal: I could aspirate the contents in my tubular stomach into my lungs and die from eating a large burrito meal last night in one sitting (not allowing for a smaller portion to be digested, before eating more food at once). I’m learning all of this as time passes along – my tubular stomach is informing me of my limitations. And yes, I can feel how full I am when food or liquid fills up to my upper esophagus.
This has been a continual learning process. I will face these new challenges for the rest of my life. I hope this blog is helpful for everyone to understand that not everything is the same for me any longer! I’m a Survivor, but numerous risks will always remain! I’m very pleased with the results of having an esophagectomy! 🙂
Sincerely, Peter Searle