Early Dumping Syndrome, Severe Nausea & Vomiting, Daily Diarrhea One Year After Gastric Sleeve

Question Below Submitted By:  

Lori D. (a patient from Cameron, NC)

I had my Lap Band removed in March 2014, and in May 2014 I was sleeved. Since I came home from the surgery I have had severe nausea, vomiting and watery diarrhea. So much so that I can’t eat if I am not right at a restroom.

I have lost down to 117 lbs, which is making my bones show. My life is changed forever, and not like I wanted it to be. Can you help?

My surgeon doesn’t know what to do to help me, I am scheduled for another EGD on July 13th, to see if there is tissue damage that might be causing this.

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Expert Responses to the Question Above

Surgeon response to "Early Dumping Syndrome, Severe Nausea & Vomiting, Daily Diarrhea One Year After Gastric Sleeve Surgery"

by: John Rabkin, MD

Lori,

The symptom complex that you describe is consistent with "dumping" most often seen after Roux-en-Y Gastric Bypass procedures.

It is unusual to experience these symptoms after a Vertical Gastric Sleeve procedure because the pyloric valve at the end of the stomach typically remains competent.

I wonder if your symptoms are more pronounced after consuming specific types of food calories: concentrated carbohydrates (refined sugars) and fats more commonly trigger dumping symptoms more often than other caloric types.

Assuming that your scheduled EGD is unremarkable, if you haven't already undergone a gastric emptying study for both liquid and solid phase meals, I'd recommend that your additional evaluation start there.

Following that study, you may benefit from a referral to and evaluation by a neurogastroenterologist, a gastroenterologist (medical GI specialist) who has a special expertise in GI motility disorders.

In the interim, I'd do whatever you can to arrest any further weight loss by eating more frequently and trialing different protein and caloric sources that you may tolerate better than others.

Also, if you have any evidence of steatorrhea or "fatty diarrhea" (as evidenced by fat globules in the toilet bowel when you have a bowel movement), taking pancreatic enzymes with your meals and snacks may help by decreasing the diarrhea and arresting further weight loss.

Once you become underweight and/or malnourished, your symptoms may worsen and it will be even more difficult to get back on track.

Consequently, even beyond eliminating the inconvenience that you've suffered this past year, from your overall health perspective, addressing your symptoms and rectifying your problem promptly is very important in your case.

John Rabkin,
M.D. Pacific Laparoscopy

(click here for Dr. Rabkin's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Complications & Risks of Gastric Sleeve Surgery

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