The Rehab Dietitian

03/08/2026

If you’ve had an oesophagectomy and are still struggling to eat months later, this post is for you.

Many people assume symptoms such as diarrhoea, weight loss, bloating or fatigue are simply part of recovering from cancer surgery.

Sometimes they are.

But sometimes they’re a sign that food isn’t being digested properly.

One possible cause is pancreatic exocrine insufficiency (PEI), which the latest European guidelines recommend clinicians should consider after upper gastrointestinal surgery.

As a specialist oncology and gastrointestinal dietitian, I often help people who have been living with these symptoms for months—or even years—before they receive the right support.

Small changes can sometimes make a big difference:

✔ Optimising pancreatic enzyme replacement therapy (PERT)
✔ Improving meal timing
✔ Preventing further weight and muscle loss
✔ Helping you enjoy food again

You don’t have to accept ongoing digestive symptoms as “normal.”

📩 If you’re looking for specialist support after oesophageal or stomach cancer treatment, I’d be happy to help.

30/07/2026

Persistent digestive symptoms after cancer treatment aren’t always IBS.

One possible cause is Small Intestinal Bacterial Overgrowth (SIBO)—a condition where excessive bacteria grow in the small bowel instead of the large bowel.

Cancer treatment can increase the risk by changing:
✔️ Gut motility
✔️ Bowel anatomy after surgery
✔️ Nerve function
✔️ Stomach acid production
✔️ The gut microbiome

The tricky part is that SIBO can look very similar to other conditions such as bile acid malabsorption, pancreatic enzyme insufficiency, pelvic radiation disease and IBS.

That is why careful assessment is so important. Treatment is different depending on the underlying cause, and identifying the right diagnosis can make a real difference to symptom control and quality of life.

If you’re continuing to struggle with bloating, diarrhoea, wind or abdominal discomfort after cancer treatment, don’t feel you simply have to live with it.

📍Save this post for later.
📍Share it with someone living beyond cancer.
📍Follow me for evidence-based advice on managing bowel problems after cancer treatment.

28/07/2026

28/07/2026

Persistent bloating after cancer treatment isn’t always “just IBS.”

Sometimes it can be Small Intestinal Bacterial Overgrowth (SIBO).

SIBO occurs when excessive bacteria grow in the small bowel, where they shouldn’t normally be present in large numbers.

Cancer treatment may increase the risk by affecting:
✔️ Gut motility (how food moves through the digestive tract)
✔️ Bowel anatomy after surgery
✔️ Nerve function
✔️ Stomach acid production
✔️ The gut microbiome

Common symptoms include:
🔹 Bloating (often worse later in the day)
🔹 Excess wind
🔹 Abdominal discomfort
🔹 Diarrhoea
🔹 Nausea
🔹 Nutrient deficiencies
🔹 Unexplained weight loss

The challenge is that SIBO symptoms often overlap with IBS, bile acid malabsorption and pancreatic enzyme insufficiency.

That’s why getting the right assessment matters.

27/07/2026

Have milk, ice cream or yoghurt started causing symptoms during or after cancer treatment?

You may have developed secondary lactose intolerance.

Unlike lifelong lactose intolerance, this can occur when the lining of the small bowel becomes irritated or damaged, reducing production of the enzyme lactase.

This may happen during or after:
✔️ Chemotherapy
✔️ Abdominal or pelvic radiotherapy
✔️ Gastrointestinal surgery
✔️ Gut inflammation or infection

Symptoms can include:
🔹 Bloating
🔹 Excess wind
🔹 Stomach cramps
🔹 Diarrhoea
🔹 Feeling uncomfortable after dairy foods

The good news? For many people, treatment-related lactose intolerance improves as the gut heals.

Before cutting out all dairy, seek advice from a dietitian. Dairy foods provide important nutrients including protein, calcium and iodine, and there are often ways to manage symptoms without unnecessary restriction.

27/07/2026

Clinic appointments in MELROSE and HADDINGTON now available to book throughout AUGUST and SEPTEMBER.

Home visits and and individual evening appointments can be arranged on request.

🎯 Mole checks - single lesions or full skin
🎯 Skin assessment
🎯 Cryosurgery

For professional, bespoke care book directly on

www.accessdermatology.co.uk

or contact me with any questions.

[email protected]
☎️ 07877 041298