Sugar Causes Vomiting for 3.5 Year Gastric Sleeve Patient

Question Below Submitted By:  

Amy (a patient from St. Louis, MO)

I had a gastric sleeve surgery in April 2011 and have been experiencing frequent vomiting spells (1x week) usually after eating sugar. I had some episodes early on due to drinking too soon after eating but this is starting to bug me.

I did take Prilosec for 2 weeks a couple months ago and that helped, as I did not have any vomiting episodes during that time.

My questions are:

1. Is the vomiting cause for concern? Do I blame the sugar?

2. Can Prilosec be taken for an extended period of time? More than 2 weeks every 4 months?

Thank you.

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01.

Expert Responses to the Question Above

Surgeon Response to "Sugar Causes Vomiting for 3.5 Year Gastric Sleeve Patient

by: John Rabkin, M.D., Pacific Laparoscopy

Amy,

It is unusual in my experience for patients to experience vomiting episodes this long after a sleeve gastrectomy, particularly episodes 'triggered' by eating a specific food type.

On occasion, an 'hourglass' appearance to the sleeve would suggest retained food in the upper portion of the pouch after eating which may induce vomiting. This symptom is typically manifest earlier in the post sleeve gastrectomy recovery.

In your described situation of the symptom ONLY experienced after consuming certain foods, your situation is more suggestive of 'dumping' symptoms more commonly linked to patients who have undergone a Roux-en-Y gastric bypass where the pyloric valve no longer regulates the passage of food from the residual stomach into the small intestine, UNLIKE your anatomy after a sleeve gastrectomy.

On the one hand, the adverse response you experience to ingestion of sugar can potentially be seen as a benefit, discouraging that practice and helping you to avoid weight regain over time! If you truly only experience the vomiting after eating sugar, it is unlikely that you have a mechanical or anatomic problem with your sleeve.

However, to completely eliminate that prospect, you could undergo an upper gastrointestinal swallow study and/or upper endoscopy with or without mamometry to document normal post sleeve gastrectomy anatomy and physiology.

An additional study to consider would be a gastric emptying study to document the potential of abnormal gastric sleeve emptying. My expectation based on your described symptoms is that these investigations would be unremarkable in your case.

There is little evidence that long-term exposure to proton pump inhibitors (PPIs) is detrimental to your health aside from long-term bone loss (osteopenia/osteoporosis.)

Consequently, if you continue on these medications long-term you should redouble your efforts to avoid normal age-related bone loss by increasing your calcium citrate supplementation along with maintaining an optimal 25-OH vitamin D level (greater than or equal to 50) along with routine surveillance bone density studies (DEXA scans) at least every other year.

My recommendation is that you simply avoid concentrated carbohydrates (sugars) and NOT use the PPIs chronically, however, as that would be optimal for your overall health and well-being.

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:
- Bariatric Diet (What you eat)
- Bariatric Eating (How you eat)
- Bariatric Vitamins
- Complications & Risks of Gastric Sleeve Surgery

02.

Patient Responses to the Question Above

Complications

by: Shari

I just had my lap ban removed yesterday. I've had it in for about 5 yrs. I got sick quite often either by vomiting or getting food stuck. I hated always having to get up from the table to try get my food down. I chewed my food into tiny pieces as recommended but it didn't matter. I would just skip meals or barely eat anything knowing that I would probably have problems. I also developed stomach ulcers. My mom, her friend and I all have had it done and wished we hadn't. We each lost approx 20lbs but have gained it back. My mom and her friend would like there's removed also. My nurse that I had yesterday while getting my band removed told me that her friend has the lap band and vomits all of the time. I am so happy that I am rid it!

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