Explain about the Oesoplzageal Carcinoma?
Management of patients with oesophageal carcinoma includes surgery, radiation and combination chemotherapy. Radiation to the lower neck can induce oesophagitis, fistulas and haemorrhage may also occur due to re-growth of the cancer. Chemotherapy may induce nausea, anorexia, sore mouth, and odynophagia. All these inhibit food intake and decrease the acceptance of tube feeding. Surgical treatment usually involves total or distal oesophagect.omy (procedure lo remove a portion of the tongue).
Easy regurgitation, rapid satiety, decreased rate of gastric emptying of solid food, diarrhoea and steatorrhoea are common results of this surgery. Weight loss is another great problem. Preoperative parenteral feeding is indicated to improve nutritional status. This is found to reduce postoperative complications. Oral or tube feeding is often inadequate to meet the nutritional needs in the period of radiation and chemotherapy because of interference with the feeding programme, nausea, pain or combination of all these. Once the oral intake by the patient is normal, the dietary prescription should provide for frequent meals high in carbohydrate and adequate in protein and fat. In some cases, steatorrhoea occurs with increased frequency and foul smelling stools along with abdominal discomfort. For these patients partial substitution of long-chain triglycerides (LCT) by medium chain triglycerides (MCT) can be tested and may be helpful.
Postoperative stricture (narrowing of a passage due to scar tissue or tumor) may occur and requires dilation. Oral or tube fed liquid formulas can be given to assure adequate intake until the stricture is over come. Carcinoma of the oesophagogastric junction creates similar problems like those described of above. Production of gastric juice may be reduced there by resulting in decrease of vitamin B12 absorption.