Please remember that this post is for educational purposes only and it is not intended to substitute a consultation with your surgeon. If you are experiencing some of the issues outlined below please feel free to contact us for a consultation or reach out to your surgery team for help.

Eating Too Fast

We are used to living our lives in the fast lane. Eating is one of those things. I definitely include myself here.

In our program, we constantly remind our patients to eat slowly. This is particularly true the first few months after the procedure.  After bariatric surgery, your stomach food capacity is significantly diminished.  If you eat too fast you are not giving the smaller stomach enough time to empty the food.  Because the food is not going down you will end up vomiting.

It is very important that you slow down while eating. Consider not having any distractions when eating. A lot of times if you are multitasking you will forget to slow down and you will eventually eat too fast and then run into issues.

Especially at the beginning, you should get in the habit of just eating. No talking, no watching tv, or no Facebooking while eating. Just sit down, eat and do it slowly.

Eating Too Much

Since we were little kids we were taught to overeat. I will include myself in this group too. Not only I was taught to eat every grain of rice on my plate but I am teaching my kids to do the same. You know, there are people dying of hunger, so you need to eat all of it. 

That thinking needs to be thrown out the window after weight loss surgery. Because your new stomach is less elastic, it doesn’t have the ability to expand and accommodate more food. Once you are full you need to stop eating. Otherwise, you will vomit. 

You will need to learn the new clues that your body is giving you to tell you that you are full. Some patients will feel pain in the upper abdomen. Others will get hiccups or feel like the food is up in their throat. Learn to read your new stomach and once you are full STOP.

Remember you eat when you are hungry and you stop when you are full. After all, one of the main purposes of bariatric surgery is to prevent you from overeating. 

Eating The Wrong Things

After weight loss surgery you will have to follow a diet.  The diet starts with liquids, follow by puree food, a soft diet, and then regular food. The process lasts around 6-8 weeks.

Even though we tell our patients multiple times to follow this progression there is always someone that decides to jump the wagon and start eating solid food way too quickly.

Eating chicken when you are supposed to be on a liquid diet is definitely going to cause vomiting after bariatric surgery. 

I recently had a patient that was upset because he kept throwing up a hamburger. Yes, bread and all. Well sir you are supposed to be doing a puree diet…

Do yourself a favor and follow the diet protocol. It is there for a reason. 

Not Chewing Enough

Now you are finally ready to eat normal food and you should be off the woods. Well, not so fast. The first three months after your weight loss surgery is a big adjustment. 

You will need to learn how to eat again and how fast to eat. It will get easier with time but in the beginning, you need to chew everything well and take your time. 

If you like to eat hard vegetables like carrots or broccoli you need to chew them really well. Otherwise, you will not be very happy when they get stuck in the smaller stomach. Other patients may experience similar issues with certain types of meat. Steak, white chicken meat, and pork are notorious for cause issues with vomiting after bariatric surgery. 

So remember, chew your food very well. Eat slowly and learn what you can eat and how much. Also, just because you can tolerate a type of food right now doesn’t mean that you won’t tolerate it ever again.  Give it some time and try again in several weeks or months. 

Surgical Issues

This is usually the cause of chronic vomiting after bariatric surgery. Patients could experience vomiting due to surgical issues very early after surgery or many years after the operation.

Most of the time vomiting after bariatric surgery is not normal. If you are having issues you should consult with a bariatric surgeon.

Some of the issues that can cause vomiting are, ulcers, bowel blockage (obstruction), narrowing of the sleeve, hernias, and many others.

The type of problem depends on the type of surgery.

For example, after a gastric bypass, the small stomach gets connected to the small bowel. The connection can create too much healing or scar tissue and it can get narrow. The food will have a hard time passing through this area and eventually, vomiting happens in order to clear the stomach from old food.

After a sleeve, you could have some twisting of the sleeve and this will cause similar gastric emptying issues.

These are mechanical issues that can often be repaired. That is why I encourage you to seek medical attention if you are experiencing frequent vomiting after bariatric surgery.

You also might have to find a second opinion. Not every bariatric surgeon is trained or has the experience to deal with complex complications after weight loss surgery.

Gallbladder Disease

After significant weight loss, some patients can develop gallstones and/or gallbladder symptoms. A common symptom of gallbladder disease is nausea and vomiting. If this is suspected I usually get a gallbladder ultrasound to check for stones. If the patient has stones and we already ruled out all the above causes of nausea then removing the gallbladder could be indicated and beneficial.

If the ultrasound of the gallbladder is negative then a HIDA scan can be performed. This is a special test to look for gallbladder disfunction. This condition is also called biliary dyskinesia.  A weak gallbladder can cause symptoms similar to those with gallstones.

Unknown Causes

Unfortunately, sometimes we are unable to determine the true cause of frequent nausea and vomiting. Even after an extensive workup, a true cause for the symptoms might not be found. At that point, we can only wait to see if the symptoms improve with time. 

Throughout my career I have seen many patients that have issues with chronic pain or other issues that we cannot identify the cause. This could happen to you. Fortunately, this doesn’t happen very often. 

Conclusion

Frequent vomiting after bariatric surgery is not normal. Most of the time there is a solution to the problem. Either you need to do some changes or you need to consult with a bariatric surgeon.

I hope this post answered some of your questions. Perhaps it created some more questions. Feel free to call our office or to ask your questions in the comments below.

You can also visit my YouTube Channel for more information. I will be doing more videos answering some of the questions.

I want to thank you for your time and please feel free to contact us with any questions.