Post-vagotomy diarrhea: Difference between revisions

Revision as of 11:36, 15 February 2025

Post-vagotomy diarrhea

Post-vagotomy diarrhea is a condition that can occur after a vagotomy, a surgical procedure where the vagus nerve is cut to reduce acid secretion in the treatment of peptic ulcer disease. This condition is characterized by frequent, watery bowel movements and can significantly affect the quality of life of patients who have undergone this surgery.

Pathophysiology

The vagus nerve plays a crucial role in the regulation of gastric motility and gastric acid secretion. When the vagus nerve is severed, there is a disruption in the normal coordination of the gastrointestinal tract, leading to rapid gastric emptying and increased intestinal motility. This can result in diarrhea as the intestines do not have sufficient time to absorb water from the chyme.

Clinical features

Patients with post-vagotomy diarrhea typically present with:

Frequent, watery stools
Abdominal cramping
Urgency to defecate
Possible dehydration if diarrhea is severe

The symptoms can vary in intensity and may be influenced by dietary factors and the extent of the vagotomy.

Management

Management of post-vagotomy diarrhea involves both dietary modifications and pharmacological interventions. Patients are often advised to:

Eat smaller, more frequent meals
Avoid foods that exacerbate symptoms, such as high-fat or spicy foods
Increase dietary fiber intake to help solidify stools

Pharmacological treatments may include:

Antidiarrheal agents such as loperamide
Bile acid sequestrants if bile acid malabsorption is suspected

Prognosis

The prognosis for post-vagotomy diarrhea varies. Some patients experience a reduction in symptoms over time as the body adapts to the changes in gastrointestinal function. However, others may continue to experience symptoms long-term and require ongoing management.

Related pages

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-{{Orphan|date=August 2015}}
+== Post-vagotomy diarrhea ==
-{{Infobox medical condition (new)
-| name            = Post-vagotomy diarrhea
-| synonyms        =
-| image           = Gray793.png
-| caption         = Course of vagus nerve
-| pronounce       =
-| field           = [[Gastroenterology]]
-| symptoms        =
-| complications   =
-| onset           =
-| duration        =
-| types           =
-| causes          =
-| risks           =
-| diagnosis       =
-| differential    =
-| prevention      =
-| treatment       =
-| medication      =
-| prognosis       =
-| frequency       =
-| deaths          =
-}}
-'''Post-vagotomy diarrhea''' is a form of [[diarrhea]] which occurs in 10% of people after a truncal [[vagotomy]], which can range from severe to debilitating in approximately 2% to 4% of patients.<ref name="surgical therapy">{{cite book|last1=Cameron|first1=John L. Cameron, Andrew  M.|title=Current surgical therapy|date=2011|publisher=Elsevier Saunders|location=Philadelphia, PA|isbn=978-1-4377-0823-3|edition=10th}}</ref> However, the occurrence of post-vagotomy diarrhea is significantly reduced after proximal selective vagotomy, specifically when [[Celiac artery|celiac]] and [[hepatic]] branches of the [[vagus]] are retained.<ref name="surgical therapy" />
-==Diagnosis==
+[[File:Gray793.png|thumb|right|200px|Diagram of the stomach and vagus nerve.]]
-{{Empty section|date=September 2017}}
-==Treatment==
+'''Post-vagotomy diarrhea''' is a condition that can occur after a [[vagotomy]], a surgical procedure where the [[vagus nerve]] is cut to reduce acid secretion in the treatment of [[peptic ulcer disease]]. This condition is characterized by frequent, watery bowel movements and can significantly affect the quality of life of patients who have undergone this surgery.
-Surgical treatment for [[refractory]] post-vagotomy diarrhea is rarely needed and at least one year from the occurrence of [[symptom]]s should be allotted to ensure all non-surgical treatments have been appropriately explored. Under severe cases, where surgical intervention does become necessary, a 10&nbsp;cm reverse [[jejunal]] interposition is usually the procedure of choice.<ref>{{cite book|vauthors = Soper NJ|veditors = Swanström LL, Eubanks WS|title=Mastery of endoscopic and laparoscopic surgery|date=2008|publisher=Lippincott Williams & Wilkins|location=Philadelphia, Pa.|isbn=978-0781771986|edition=3rd}}</ref>
-== References ==
-{{reflist}}
-== External links ==
+== Pathophysiology ==
-{{Medical resources
-| DiseasesDB     =
-| ICD10          =
-| ICD9           =
-| ICDO           =
-| OMIM           =
-| MedlinePlus    =
-| eMedicineSubj  =
-| eMedicineTopic =
-| MeshID         =
-}}
-[[Category:Neurosurgery]]
-[[Category:Diarrhea]]
+The [[vagus nerve]] plays a crucial role in the regulation of [[gastric motility]] and [[gastric acid secretion]]. When the vagus nerve is severed, there is a disruption in the normal coordination of the [[gastrointestinal tract]], leading to rapid gastric emptying and increased intestinal motility. This can result in diarrhea as the intestines do not have sufficient time to absorb water from the chyme.
-{{disease-stub}}
+== Clinical features ==
-{{dictionary-stub1}}
+Patients with post-vagotomy diarrhea typically present with:
+* Frequent, watery stools
+* Abdominal cramping
+* Urgency to defecate
+* Possible [[dehydration]] if diarrhea is severe
+The symptoms can vary in intensity and may be influenced by dietary factors and the extent of the vagotomy.
+== Management ==
+Management of post-vagotomy diarrhea involves both dietary modifications and pharmacological interventions. Patients are often advised to:
+* Eat smaller, more frequent meals
+* Avoid foods that exacerbate symptoms, such as high-fat or spicy foods
+* Increase dietary fiber intake to help solidify stools
+Pharmacological treatments may include:
+* [[Antidiarrheal agents]] such as loperamide
+* [[Bile acid sequestrants]] if bile acid malabsorption is suspected
+== Prognosis ==
+The prognosis for post-vagotomy diarrhea varies. Some patients experience a reduction in symptoms over time as the body adapts to the changes in gastrointestinal function. However, others may continue to experience symptoms long-term and require ongoing management.
+== Related pages ==
+* [[Vagotomy]]
+* [[Peptic ulcer disease]]
+* [[Gastrointestinal tract]]
+* [[Gastric motility]]
+[[Category:Gastroenterology]]