Gastrocolic fistula (GCF) is a rare complication following a subtotal gastrectomy, clinically presenting with diarrhea, severe malnutrition, fecal vomiting, or belching. This complication is prone to misdiagnosis and delayed treatment, significantly impacting patients' quality of life. This case report describes a middle-aged male who developed diarrhea six months after Roux-en-Y anastomosis, was diagnosed with GCF following multiple hospital visits, and was cured after surgery. For patients with chronic diarrhea, especially those with a history of gastrointestinal surgery, GCF should be considered during the dif-ferential diagnosis of digestive, endocrine, rheumatologic, neurologic, or in-fectious diseases.

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