Gastrointestinal surgery: post-vagotomy diarrhoea: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: post-vagotomy diarrhoea

Sample item

A man who had truncal vagotomy and drainage years ago has episodic explosive watery diarrhoea. Which drug often helps?

AMetoclopramideBPancreatic enzymesCOmeprazoleDCholestyramine

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cholestyramine

Truncal vagotomy causes rapid intestinal transit and bile acid malabsorption, giving postvagotomy diarrhoea. Cholestyramine and loperamide help. Prokinetics make it worse.

Option by option

A. Metoclopramide
Metoclopramide speeds transit and worsens the diarrhoea.
B. Pancreatic enzymes
Pancreatic enzymes are for exocrine insufficiency.
C. Omeprazole
Omeprazole does not affect bile or transit.
D. Cholestyramine (correct)
Correct. Cholestyramine binds bile acids.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Cholestyramine. Truncal vagotomy causes rapid intestinal transit and bile acid malabsorption, giving postvagotomy diarrhoea.

Why is "Metoclopramide" not the answer?

Metoclopramide speeds transit and worsens the diarrhoea.

Why is "Pancreatic enzymes" not the answer?

Pancreatic enzymes are for exocrine insufficiency.

Why is "Omeprazole" not the answer?

Omeprazole does not affect bile or transit.

What concept does this question test?

It tests Gastrointestinal surgery: post-vagotomy diarrhoea in General Surgery. Cholestyramine and loperamide help. Prokinetics make it worse.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: post-vagotomy diarrhoea?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.