Unintentional Weight Loss After Oesophagectomy

The incidence of cancer of the oesophagus is increasing. While surgical removal of the tumour (oesophagectomy) may offer the best chance of cure, such major operations are associated with long-term complications such as poor appetite, unintentional weight loss and nutritional impairments. In the long-term, unintentional weight loss of 10-30% increases the risk of disease and death. However, a knowledge gap exists as there has been no comprehensive assessment of how this surgery changes the mechanisms of how the gut communicates with the brain (gut-brain pathways) and its relation to food intake and eating behaviour. The aims of this study are to test the hypotheses that: 1. Oesophagectomy induces changes in the small intestine barrier (gut mucosa) and changes in hormonal signals after food consumption. 2. Oesophagectomy reduces appetite, eating behaviour, and food intake and shifts food selection from high-fat and high-glycaemic index items (quickly digested carbohydrates) to low-fat and low-glycaemic index items (slowly digested).

Sex

All

Minimum age

18 Years

Inclusion Criteria:

A. Oesophageal adenocarcinoma group:

* Planned for oesophagectomy with gastric conduit reconstruction
* Recurrence-free at least 12 months post-operatively
* Weight loss ≥10% from premorbid weight or require ongoing caloric supplementation

B. Barrett's oesophagus group:

-Barrett's oesophagus group who are under surveillance from INCEUGIN

Exclusion Criteria:

* Pregnant or breastfeeding, or planning to become pregnant
* Unable to swallow or need frequent dilatations ("stretches")
* Unable to eat semisolid food
* Allergies or dietary intolerance
* Diabetes mellitus type 1
* Reoccurrence of disease after surgery or are having another active form of cancer
* Taking medication which may impact gut hormone physiology
* Unstable cardiovascular disease
* A significant neurological condition
* A previous upper gastrointestinal resection
* A medical condition that would limit the ability to take part, that might impact certain test results or might make it unsafe for the patient to take these treatments.
* Difficulty reading, understanding or remembering the information we have given.
* Previous abdominal surgery.
* Treatment with GLP-1 receptor agonists or DPP-IV inhibitor or insulin

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