Six months after truncal vagotomy and pyloroplasty, a 52-year-old man reports troublesome postprandial diarrhoea. Which drug is the appropriate specific treatment for post-vagotomy diarrhoea?
- A Loperamide
- B Cholestyramine ✓
- C Octreotide
- D Metronidazole
Correct answer: B. Cholestyramine
Explanation
Truncal vagotomy denervates the pylorus and small bowel, causing rapid gastric emptying and delivery of unabsorbed bile acids to the colon, where they stimulate secretion. Cholestyramine binds bile acids and is the specific therapy. Loperamide only slows transit symptomatically, octreotide is used for refractory dumping, and metronidazole treats bacterial overgrowth, which causes different symptoms.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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