Question

Your patient has had a total gastrectomy (removal of the stomach). Which of these potential problems are you MOST concerned about?

A -Inability to tolerate fats because of absent bile salts
B -Excessive bleeding as a result of absent clotting factors in the blood.
C -Anemia
D -Inability to digest starch because of the absence of amylase

Answer 1

The most significant concern after a total gastrectomy is anemia stemming from a lack of intrinsic factor, which is necessary for vitamin B12 absorption, critical for red blood cell production and neurological function.

Step-by-step explanation:

After a total gastrectomy, the most pressing concern is anemia due to the lack of intrinsic factor production, which is crucial for the absorption of vitamin B12.

Vitamin B12 is essential for the production of mature red blood cells and normal neurological functioning. A patient lacking a stomach cannot produce this intrinsic factor and will therefore eventually develop vitamin B12 deficiency anemia unless they receive vitamin B12 injections.

Other concerns such as intolerance to fats, issues with clotting factors, or starch digestion are not as significant. Bile salts are produced by the liver, not the stomach, and amylase is secreted by the pancreas and salivary glands, so their activity is not directly affected by a gastrectomy.