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Causes of Nausea or Vomiting After Bariatric Surgery

Causes of Nausea or Vomiting After Bariatric Surgery

Nausea and vomiting are the most common problems that occur in the first few months after surgery. If you are experiencing nausea and vomiting, it may be related to your eating or drinking habits. Review these common causes of nausea and vomiting to see if any of these solutions are helpful to you.

Problem: Eating or drinking too quickly

Solution: Take 20 minutes to eat your portioned meal, from your first bite to your last bite. To help you eat slower, take nibbles the size of a corn kernel and pause between bites. Many people have found using smaller utensils to be helpful in taking smaller bites as well. Try to avoid distractions as well, as you may not be as mindful of eating speed. 

Problem: Eating and drinking at the same time or drinking too soon after a meal

Solution: Remember, it is important to avoid drinking any beverages, even water, while eating a meal. This helps ensure that the little space you have available in your stomach is reserved for food and helps to avoid feeling nauseous. Ultimately, avoid beverages for 15 minutes before a meal and 30 minutes after you are done eating.

Problem: Not chewing well enough

Solution: Chew each bite to applesauce consistency. Counting to 20 or 30 with every bite becomes tiresome, and is not sustainable for a lifetime. I find it more helpful to chew each bite to a certain consistency. Aim for chewing your food until it reaches an applesauce consistency.

Problem: Eating more than your small stomach can comfortably hold

Solution: Listening to your body is so important after surgery. When eating a meal, it is important to stop eating when you feel comfortable and satisfied, not full. For many, one bite can be the difference between feeling comfortable and nauseous. 

Additionally, throughout your journey your portion size should slightly increase over time. However, we do have recommended portions to follow based on your diet stage after surgery. 

Stage 2 (Week 2 Post Op): 1-1.5 ounces protein and 1 ounce of fruits or vegetables with each meal.

Stage 3 ( Week 3-4 Post Op): 1-2 ounces protein, 1 tsp-1 TBSP healthy fats, and 1 ounce fruits or vegetables with each meal.

Stage 4 (Week 5 Post Op until goal weight achieved): 3 ounces protein, 1 TBSP healthy fats, and 2 ounces of fruits or vegetables with each meal.

Stage 5 (Weight Maintenance):  3 ounces protein, 1 TBSP healthy fats, and 2 ounces of fruits or vegetables with each meal. Limit starchy carbohydrates to 1-3 portions each day. A serving of a starchy carbohydrate is about 1-2 ounces.

Problem: Trying a new food for the first time

Solution: After bariatric surgery, your body is digesting foods differently from the changes to your stomach. You may find that certain foods are harder to digest than others. This is why it is important to follow the diet advancement provided by your surgical center.

When your trying a new food for the first time, have about 1 TBSP at that meal. This way, if you don’t feel the best, it is not a large enough portion to cause vomiting, but enough to learn if you need to wait 1-2 weeks before trying it again.

Problem: Advancing the diet stage too quickly

Solution: If you’re struggling with the current diet stage you are in, go back to the last diet stage that was more tolerated. For example, if regular textures are giving you trouble and triggering nausea or vomiting, go back to the soft diet stage.

Once you are feeling better, and tolerating foods, slowly return to the regular textures. Protein foods like dry chicken or meats can be difficult to digest. Make sure they are moist and soft.

Causes NOT Related to Your Diet

Nausea and vomiting can also be related to mechanical problems, such as a stricture, ulceration, food impaction, or a bowel obstruction.

If nausea and vomiting is persistent and hard to control, it is important to always call the surgical center to speak with a nurse practitioner, physician assistant, or surgeon. Especially, if the above items do not apply to your situation.

When in doubt, always call the surgical center to communicate your symptoms so we can provide guidance as quickly as possible.

Katie Ott, MS, RD

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