Food Intolerance After Gastric Band Surgery

Pain in lower left abdomen: 12 possible causes

Food Intolerance After Gastric Band Surgery | Johns Hopkins Medicine

If you buy something through a link on this page, we may earn a small commission. How this works.

Pain in the lower left abdomen is often no cause for concern, but it is still not something a person should ignore. Causes of pain in the lower left abdomen may be benign, such as gas pain, or can be more serious, as in the case of an infection.

People experiencing persistent or chronic pain in the lower abdomen should seek medical attention. Similarly, a sudden onset of severe pain in the lower left abdomen may require immediate medical care.

There are several possible causes of lower left abdomen pain. Some causes are more common and benign, while others can be serious and require medical attention.

1. Diverticulitis

Share on PinterestLower left abdomen pain can have many causes.

Diverticulitis is one of the most common causes of lower left abdominal pain. Diverticulitis occurs when diverticula (small pouches) in the intestinal wall become infected and inflamed.

Diverticula form in weak areas of the large intestine, which is often referred to as the colon.

Diverticula are present in many adults. As a person ages, the number of diverticula increases, making it more ly that one will tear or swell. As a result, diverticulitis tends to be more common in older adults, although younger people can still develop the condition.

Diverticulitis pain tends to increase while a person is eating or shortly after a meal.

Additional symptoms of diverticulitis may include:

  • tenderness in the abdomen
  • fever
  • nausea
  • vomiting
  • feeling bloated

2. Celiac disease

Celiac disease is a chronic condition that occurs in the digestive tract when a person cannot digest gluten. Gluten is a protein found in wheat and is present in several foods and healthcare products.

When a person has celiac disease, their immune system attacks portions of the intestine, causing a range of digestive problems and vitamin deficiencies.

Symptoms of celiac disease may include:

  • pressure and gas
  • bloating
  • pain in the abdomen
  • fatigue
  • weight loss
  • diarrhea

Children with undiagnosed celiac disease may also suffer from malnourishment and growth impediments as a result of the condition.

3. Gas

Gas is often trapped in the digestive tract when a person swallows air while eating, as well as through natural digestion processes.

Typically, gas is not anything to worry about and will pass through either the rectum or esophagus. Gas that is temporarily trapped in the digestive tract can cause pain and discomfort until it moves the system.

Gas can be caused by:

  • digesting foods that are prone to releasing gas
  • swallowing air
  • smoking
  • chewing gum
  • overeating
  • undigested foods
  • bacteria

If the gas pain is frequent or accompanied by additional symptoms, a person may wish to speak to a doctor. Other symptoms include:

4. Lactose intolerance

A person who is lactose intolerant has trouble digesting milk and milk-based products, such as cheese and yogurt. This is because the person lacks sufficient amounts of an enzyme called lactase.

Lactase breaks down the lactose in milk, which consists of the simple sugars glucose and galactose.

When a person has high levels of lactose in their bloodstream, they may develop symptoms associated with lactose intolerance. These symptoms include:

  • loose stool or diarrhea
  • pain in the abdomen
  • bloating
  • gas pain
  • nausea
  • a growling or rumbling stomach

5. Inflammatory bowel diseases

Crohn’s disease and ulcerative colitis are chronic conditions that can cause painful inflammation anywhere in the digestive tract.

Crohn’s disease is most common in the small intestine, and ulcerative colitis is most common in the colon.

It is still not known what causes Crohn’s disease or ulcerative colitis. The most common symptoms include pain in the abdomen and bloody diarrhea. It can also cause fever and unexplainable weight loss.

6. Indigestion

Indigestion is caused by a buildup of acid after eating. For most people, indigestion pain occurs in the upper part of the abdomen. While rare, indigestion can occur in the lower part of the abdomen.

Typically, most cases of indigestion are mild. Symptoms of indigestion include a burning sensation, slight pain or discomfort, heartburn, bloating, or gas.

There is an excellent selection of indigestion relief products that may be purchased online with thousands of customer reviews.

7. Shingles

Shingles is caused by the same virus that causes chickenpox. Once a person has had chickenpox, the virus stays dormant in the body for their entire life. Sometimes, the virus reappears, causing pain and a rash that wraps around one side of the abdomen.

Vaccines are available to help reduce the risk of a person developing the disease later in life.

Symptoms of shingles include:

  • pain when touched
  • itching
  • tenderness on the skin
  • rash
  • blisters that may break open and scar

A person may feel tenderness and itchiness on one area of the skin before the rash appears. They may also experience a fever or general malaise. Once the rash appears, the pain can be severe.

8. Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that a doctor may only diagnose once they have ruled out other probable causes of a person’s symptoms.

Symptoms of IBS may include:

  • abdominal pain
  • pressure
  • constipation or diarrhea
  • gas
  • bloating

9. Hernia

A hernia occurs when an organ or other body part pushes through the abdominal wall. Sometimes, a lump may appear in the midsection or near the groin.

Different types of hernias can occur, and they vary according to the underlying cause. Because hernias can cause additional problems, it is essential to see a doctor as soon as possible.

Some additional symptoms of hernia complications include:

  • pain when lifting an object
  • pressure
  • increasing pain
  • increasing size of a bulge
  • a general feeling of fullness

10. Constipation

Constipation occurs when a person cannot pass a stool. It is often caused by poor diet and lack of exercise. Improving diet and increasing exercise are two of the most effective treatments.

Some symptoms of constipation include:

  • straining when passing stool
  • needing to apply pressure to the abdomen to help push out a stool
  • a lumpy or very hard stool
  • feeling the rectum is blocked
  • feeling not all the stool has passed
  • having fewer than three bowel movements in a week

11. Kidney stones

Most stones are formed from calcium buildup and can form in either the right or left kidney.

A person may develop a kidney stone and not realize they have it until the stone causes problems, such as blocking part of the kidney or causing great pain as it passes.

Typical symptoms of kidney stones include:

  • abdominal pain
  • pain when urinating
  • nausea or vomiting
  • blood in the urine
  • fever
  • frequent urination

12. Intestinal obstruction

When a blockage occurs in the intestine, food cannot pass through the digestive tract. This results in a painful back-up that needs immediate medical attention.

Intestinal obstructions are more common in older adults and are typically caused by other conditions, such as diverticulitis or colon cancer.

Common symptoms of an intestinal obstruction include:

  • abdominal pain
  • inability to pass stool
  • distention
  • vomiting
  • constipation

If lower abdominal pain becomes severe or prolonged enough, a doctor can use a variety of techniques to explore the possible causes and identify a course of treatment.

These include:

  • CT scans
  • ultrasound imaging
  • MRI scans
  • physical examination, including pressing on the area to identify whether the individual experiences pain when touches or locating any suspicious lumps
  • endoscopy, in which a doctor inserts a tube with an attached light and camera down the throat and into the stomach, producing an image of the lower abdomen

Identifying certain abdominal problems might require repeat visits and close follow-up.

Once a primary care physician identifies a particular diagnosis, they will often refer the individual to a specialist, such as a gastroenterologist, who will be able to provide more focused care.

If the doctor finds signs of any cancer in the lower abdomen, they will refer the person to an oncologist to work out a treatment plan.

The type of treatment will depend on the condition or disease causing the pain.

Lower abdominal pain due to an infection, such as diverticulitis, will often only require antibiotics and resting as treatment.

Other, more structural problems, such as a hernia or an intestinal blockage, may require surgery.

Treatment for constipation and gas often includes basic dietary adjustments and, in severe cases, the use of laxatives. For more chronic lower abdominal pain, such as the pain in IBS or Crohn’s, more careful, long-term dietary management can help to manage symptoms.

Treatment for food intolerances, such as lactose intolerance, often involves excluding that food from the diet.

Seeing a doctor for abdominal pain becomes important whenever the pain is unexplainable or is accompanied by additional symptoms.

A doctor will need to examine chronic or persistent pain to rule out any serious underlying causes.

A doctor can diagnose the cause of the pain and develop a treatment plan that will address the underlying cause of lower left abdominal pain.

In many cases, a person is not ly to experience any lasting effects from abdominal pain.

If the abdominal pain is caused by a chronic condition, such as Crohn’s disease or celiac disease, a doctor can help a person develop a treatment plan to improve their symptoms in the long-term.


Gastric Sleeve Surgery for Weight Loss

Food Intolerance After Gastric Band Surgery | Johns Hopkins Medicine

Are you considering gastric sleeve surgery because you've tried diets and exercise for years and still have a lot of weight to lose? You'll want to know the risks and benefits, what makes someone a good candidate for the operation, and what long-term commitments you need to make to keep the results.

In this operation, surgeons remove part of your stomach and join the remaining portions together to make a new banana-sized stomach or “sleeve.

” With just a small sack (about 1/10th the size of your original stomach), you'll feel full a lot quicker than you did before. You won't be able to eat as much as you used to, which helps you lose weight.

Plus, the surgery removes the part of your stomach that makes a hormone that boosts your appetite.

In gastric bypass, the surgeon makes a small pouch that skips most of your stomach, going straight to the intestine.

Gastric sleeve surgery is best for people who have a BMI (body mass index) of at least 40. That means you’re 100 pounds or more over your ideal weight. Some people are too heavy for gastric bypass surgery, so it may be a good alternative.

The surgery takes about an hour. Your surgeon will make a few small cuts in your belly and insert a laparoscope — an instrument with a tiny camera that sends pictures to a monitor. The surgeon will then insert other medical instruments through the additional cuts and remove 3/4 of your stomach. Finally, he’ll reattach the rest of your stomach to form the “sleeve” or tube.

You might be in hospital about 2 or 3 days. The procedure is permanent.

The first day after surgery, you'll drink clear liquids. By the time you leave the hospital, you can eat pureed foods and protein shakes and will continue to do so for about 4 weeks.

Keep in mind that you have to change the way you eat forever. After that first month, you'll switch to eating soft solid foods very slowly. Other pointers to keep in mind:

  • Everything must be chewed thoroughly before being swallowed.
  • Don't drink while you eat, as this might cause your new stomach to overfill.
  • Drink liquids a half-hour after finishing a meal.
  • Avoid high-calorie sodas and snacking.
  • Take vitamin and mineral supplements every day.

After 2 or 3 months, you can move on to regular meals. But remember, you will not be able to eat as much as you used to.

People generally lose 60% of their extra weight over 12 to 18 months. So if you are 100 pounds overweight, you'll lose about 60 pounds, though some lose more and others less. Of course, exercising and eating right add to your weight loss.

Infection, bleeding, and in rare cases, a leak along the staple line are possible. Right after the surgery, you may have nausea, vomiting, or constipation.

Certain foods may not agree with you now. You may also develop nutrition problems after surgery, which is why you have to take vitamins and supplements for life. Your doctor will advise you on exactly what you need.


Cleveland Clinic: “On-Line Seminar: Sleeve Gastrectomy,” “Laparoscopic Sleeve Gastrectomy.”

Kaser, N. The Online Journal of Issues in Nursing, January 2009.

American Society for Metabolic & Bariatric Surgery, “Studies Weigh in on Safety and Effectiveness of Newer Bariatric and Metabolic Surgery Procedure,” June 2012; “Sleeve Gastrectomy.”

UPMC: “Gastric Bypass Surgery,” “Gastric Sleeve Surgery.”

Johns Hopkins Bayview Medical Center: “Surgical Options.”

Bariatric Surgery Source: “Cost of Bariatric Surgery: 2014 Surgeon Survey & Key Findings.”

Brigham and Women’s Center for Metabolic and Bariatric Surgery: “Patient Care Manual,” “Dietary Guidelines for Laparoscopic Sleeve Gastrectomy.”

University of Michigan Adult Bariatric Surgery Program: “Sleeve Gastrectomy Surgery.”

© 2018 WebMD, LLC. All rights reserved.


Keeping a food diary doubles weight loss

Food Intolerance After Gastric Band Surgery | Johns Hopkins Medicine

Keeping a food diary can double a person’s weight loss according to a study from Kaiser Permanente’s Center for Health Research. The findings, from one of the largest and longest running weight loss maintenance trials ever conducted, will be published in the August issue of the American Journal of Preventive Medicine.

Funded by the National Heart, Lung and Blood Institute at the National Institutes of Health, the study is one of the few studies to recruit a large percentage of African Americans as study participants (44 percent).

African Americans have a higher risk of conditions that are aggravated by being overweight, including diabetes and heart disease.

In this study, the majority of African American participants lost at least nine pounds of weight, which is higher than in previous studies.

“The more food records people kept, the more weight they lost,” said lead author Jack Hollis Ph.D., a researcher at Kaiser Permanente’s Center for Health Research in Portland, Ore. “Those who kept daily food records lost twice as much weight as those who kept no records. It seems that the simple act of writing down what you eat encourages people to consume fewer calories.”

In addition to keeping food diaries and turning them in at weekly support group meetings, participants were asked to follow a heart-healthy DASH (a Dietary Approaches to Stop Hypertension) diet rich in fruits and vegetables and low-fat or non-fat dairy, attend weekly group sessions and exercise at moderate intensity levels for at least 30 minutes a day. After six months, the average weight loss among the nearly 1,700 participants was approximately 13 pounds. More than two-thirds of the participants (69 percent) lost at least nine pounds, enough to reduce their health risks and qualify for the second phase of the study, which lasted 30 months and tested strategies for maintaining the weight loss.

“More than two-thirds of Americans are overweight or obese.

If we all lost just nine pounds, the majority of people in this study did, our nation would see vast decreases in hypertension, high cholesterol, diabetes, heart disease and stroke,” said study co-author Victor Stevens, Ph.D.

, a Kaiser Permanente researcher. For example, in an earlier study Stevens found that losing as little as five pounds can reduce the risk of developing high blood pressure by 20 percent.

The Kaiser Permanente Care Management Institute’s Weight Management Initiative ( has recommended food journaling as a strategy for losing weight since 2002.

The Weight Management Initiative unites clinicians, researchers, insurers, and policymakers to identify practical, effective, non-surgical approaches for the prevention and treatment of overweight and obesity.

“Keeping a food diary doesn’t have to be a formal thing. Just the act of scribbling down what you eat on a Post-It note, sending yourself e-mails tallying each meal, or sending yourself a text message will suffice.

It’s the process of reflecting on what you eat that helps us become aware of our habits, and hopefully change our behavior,” says Keith Bachman, MD, a Weight Management Initiative member. “Every day I hear patients say they can’t lose weight. This study shows that most people can lose weight if they have the right tools and support.

And food journaling in conjunction with a weight management program or class is the ideal combination of tools and support.”

The study, coordinated by the Kaiser Permanente Center for Health Research in Portland, also was conducted at Duke University Medical Center, Pennington Biomedical Research Center, and Johns Hopkins University. In addition to Hollis and Stevens, the Kaiser Permanente research team included William M. Vollmer, Ph.

D.; Cristina M. Gullion, Ph.D.; Kristine Funk, M.S.; and Daniel Laferriere, MR. Other study co-authors included Phillip J. Brantley, Ph.D. and Catherine M. Champagne, Ph.D. at Pennington; Jamy D. Ard, MD, at the University of Alabama at Birmingham; Thomas P. Erlinger, MD, MPH, at the University of Texas; Lawrence J.

Appel, M.D., and Arlene Dalcin at Johns Hopkins; Pao-Hwa Lin, Ph.D., and Laura P. Svetkey, MD, at Duke University; Carmen Samuel-Hodge, Ph.D. from the University of North Carolina at Chapel Hill; and Catherine M. Loria, Ph.D., at the National Heart, Lung, and Blood Institute and National Institutes of Health.

Source: Kaiser Permanente, USA


Gastric Band Revision Surgery

Food Intolerance After Gastric Band Surgery | Johns Hopkins Medicine

Gastric Band surgery is both minimally invasive and completely reversible. However, the majority of patients do not have good results from this procedure because of its many disadvantages and complications. Many studies have shown that more than half of the gastric bands are removed due to inadequate weight loss or complications after 7-10 years.

Because of these complications, we do not perform Gastric Band surgeries at Long Island Laparoscopic Doctorssm .If you are experiencing any of these problems due to your Gastric Band (Realize® Band and Lap Band) our surgeons specialize in both the removal and conversion of Gastric Bands into other weight loss treatments.

The Gastric Band was once one of the most popular bariatric procedures in United States. However, due to the inadequate weight loss, weight regain, and high long-term complication rate, the use of any one of several Gastric Bands has sharply decreased worldwide and in United States.

Nowadays, the Gastric Band constitutes less than 10% of all bariatric procedures and the number of Gastric band procedures nationwide continues to go down every year. According to American Society of Metabolic and Surgery (ASMBS), about 35.4% of all bariatric procedures were Gastric band in 2011. This number has decreased to 20.

2% in 2012, 14% in 2013, 9.5% in 2014 and 5.7% in 2015

Indications of Gastric band removal:

  • Inadequate Weight Loss or Weight Regain
  • If a patient cannot lose enough weight (about 25-30% of excess their weight) or have significant weight regain, Gastric band removal and conversion to another more effective bariatric procedure may be indicated. This is the most common reason for Gastric band removal.
  • Band Intolerance
  • Symptoms of band intolerance can include excessive nausea and vomiting, difficulty swallowing and pain after eating.
  • Band Infection
  • Band or port infection indicates that the band may have eroded into the stomach. If the infection is not responsive to antibiotic treatment, further workup and ly band removal is recommended.
  • Band Slippage
  • Slippage can occur when the Gastric band moves down the stomach and creates a bigger pouch above the band. This can be treated, sometimes with removing the fluid from the band or surgical reposition. However, band removal may be necessary in some cases.
  • Severe Heartburn
  • Some patients may develop new heartburn symptoms after Gastric band procedure. If the heartburn symptoms are severe, this may lead to esophagitis (inflammation of the esophagus). For patients with severe heartburn symptoms that do not respond to anti-acid medications, Gastric band removal may relieve the symptoms.
  • Esophageal Dysmotility, Dilation or Esophagitis
  • With long-term use of Gastric band, some patients may develop esophageal dilation (expansion of tissue), dysmotility (lack of movement) or esophagitis (inflammation). Fluid removal or Gastric band removal may be required for patients with severe symptoms.

Laparoscopic Gastric Band Removal

Most Gastric band removal procures can be done laparoscopically. This is a relatively easy and safe operation depending on existing complications.

  • Slower initial weight loss (40-50% of Excess Weight.
  • Regular follow-up visits for adjustments critical for optimal results.
  • Requires an implanted device, risk of slippage
  • Less weight Loss than gastric bypass or sleeve gastrectomy procedures
  • Greater reliance on patience compliance to in eating for success

The steps of a Gastric band removal surgery are as follows:

  1. 1. Insert laparoscopic instruments through small incisions. In most cases, the surgeon can use the old incision.
  2. 2. Cut the scar tissue around the band.
  3. 3. Cut the tubing and band.
  4. 4. Pull out the band from around the stomach.
  5. 5.

    During the initial operation, the upper part of the stomach (fundus) is usually sutured to the part of the stomach above the band to prevent band migration. Some general surgeons tend to leave the adhesions and those sutures in place during the Gastric Band removal surgery.

    However, it is very important to remove those sutures and lyse the adhesions. This will restore the original anatomy of the stomach and make subsequent or later revision surgery much easier.

  6. 6.

    After removing the gastric band, removal or incision of the perigastric capsule (dense scar tissue around the upper part of the stomach or esophagus) will reduce the chance of obstruction after surgery.

  7. 7. The subcutaneous port is removed
  8. 8.

    For patients who want to convert to a more effective bariatric procedure, the surgeon may proceed with the sleeve gastrectomy or gastric bypass surgery following the removal of gastric band or perform a revision three months later.

Gastric Band Conversion to Gastric Sleeve or Gastric Bypass

If you have an intolerance and/or complication to the gastric band, such as nausea, vomiting, dysphagia, slippage, or erosion, removal of your band offers immediate symptom relief.

However, without converting to another bariatric procedure, many patients regain weight after Gastric Band removal.

At Long Island Laparoscopic Doctorssm we offer minimally invasive gastric bypass or sleeve gastrectomy surgery

The advantages of conversion to Gastric Sleeve (or Gastric Bypass) include:

  • Better Quality of Life: It is very rare to have nausea or vomiting after gastric sleeve surgery. Patients also feel less hungry after gastric sleeve surgery and many patients lose their hunger sensation.
  • Significant Weight Loss Difference: In the long term, patients have much greater weight loss with gastric sleeve than with Gastric band.
  • Low Complication Rate: The long-term complication rate of the gastric sleeve is extremely low, while more than half of Gastric Band Surgery patients need to have their gastric band removed at some time point.

To schedule a consultation with Long Island Laparoscopic Doctorssm please call us at 631-206-6924 or fill out our Request for Consultation


Food Intolerance After Gastric Band Surgery

Food Intolerance After Gastric Band Surgery | Johns Hopkins Medicine

Linkedin Pinterest Gastroenterology Gastric Surgery Obesity Treatment Overview Obesity Treatment Procedures

Food intolerance means that your body can't digest certain foods the way it should. Food intolerance is a risk after laparoscopic adjustable gastric banding (LAGB) surgery. This weight-loss surgery puts a band around the top section of your stomach.

It creates a small stomach pouch at the top, and a narrow opening down to the bottom part of the stomach. This helps you feel full with less food. But after surgery, you may have trouble eating certain foods, such as meat, fruits, or vegetables. This can cause symptoms such as nausea and vomiting. And it may lead to low levels of certain nutrients in your body.


What causes food intolerance after gastric band surgery?

The band narrows the upper stomach, and limits the amount of food you can eat in one meal. The food you eat goes into the small stomach pouch at the top, and then moves through the narrowed opening to the bottom of your stomach. But foods that aren’t chewed enough or are large or tough may have trouble moving through the narrow opening.

This can include dry foods, tough meats, bread, and fibrous fruits and vegetables. Soft, moist, well-chewed foods should go down fairly easily, and give you a feeling of fullness after a small portion. If the band is too tight, then you will have food intolerance to even soft, moist foods. Liquids should go down with no problems.

If drinking liquids gives you discomfort, then the band is ly too tight.

In some cases, the tube leading down to the stomach (esophagus) may also not move normally. Food may stick as it travels through the esophagus to the stomach.

What are the symptoms of food intolerance after gastric band surgery?

Symptoms of food intolerance can include:

  • A feeling of food backing up into your throat 
  • Nausea
  • Repeated vomiting
  • Gastroesophageal reflux disease (GERD)
  • Bloating or an overly full feeling in the upper abdomen

If the band has moved from its original position (band slip or gastric prolapse), then you may have heartburn and reflux, and vomiting. If this occurs, see your bariatric surgeon right away.

How is food intolerance after gastric band surgery diagnosed?

Your healthcare provider will talk with you about your symptoms. In some cases, you may have an imaging test such as an upper GI series or CT scan. These can let your healthcare provider look at your esophagus, stomach, and the gastric band. 

How is food intolerance after gastric band surgery treated?

Your healthcare provider may loosen your band by removing some fluid. Your bariatric surgery team will also advise you about the kinds of foods you should eat. If you can't eat high-protein foods such as meat, you may be prescribed a liquid protein supplement for a while. You’ll also need to:

  • Cook food until it’s tender
  • Cut food into small bites
  • Chew food well
  • Eat only small portions
  • Eat slowly

What are the complications of food intolerance after gastric band surgery?

Ongoing food intolerance can cause malnutrition. This should be treated as early as possible, because it can become hard to treat and even life-threatening in advanced stages.

If you have severe food intolerance, you may need to have your gastric band deflated or removed. If the band is too tight, your esophagus may become much larger than normal as it stretches to hold food.

In severe cases, the esophagus may not work normally in the future. 

Key points

  • After gastric band surgery, you won't eat as much as you used to. But the surgery may lead to a number of side effects, including food intolerance. Food intolerance means that your body can't digest certain foods the way it should.
  • You may have unpleasant symptoms, such as nausea and vomiting.
  • Nutritional problems can happen after gastric band surgery if you don't eat a diet that's nutritious. Untreated, these problems can damage the nervous system.
  • Your healthcare provider may loosen the band and advise you on which foods you should eat.
  • If you have severe food intolerance, you may need to have your gastric band deflated or removed. 

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.


Food Intolerances after Bariatric Surgery

Food Intolerance After Gastric Band Surgery | Johns Hopkins Medicine

Many patients report food intolerances, especially during the period of time immediately following surgery once you’re allowed to progress to “normal” eating.

Some foods may not sit well and cause an uncomfortable feeling or even discomfort for a while.

What should you expect if you’re a pre-op or early post-op patient? What are considered “normal” food intolerances and are there other causes of food intolerances?

Common Food Intolerances – A few foods that are commonly not tolerated well after bariatric surgery may include, but are not limited to, pasta, breads, rice, beef, chicken, pork, eggs, stringy vegetables, fruit with membranes, foods with seeds, and cow’s milk (or other dairy foods with lactose).

However, with this in mind, every patient is different with what they can and cannot tolerate. Also remember that each day may be different. One day you may be able to tolerate a food that you may not be able to tolerate a few days later. Another thing to keep in mind is that some patients experience taste changes after weight loss surgery.

You simply may no longer have a desire for certain foods that you d prior to your surgery.

Why Are Certain Foods Not Tolerated? – Some food intolerances are temporary and occur because your new “baby stomach” is not ready to handle that particular food yet.  It’s similar to feeding a new baby.  You might want to start with one new food at a time, individually, and see how it’s tolerated and then advance from there.

  By trying only one new food at a time, it helps to determine which food was not tolerated well.  Remember to eat only a bite or two of the new food initially.  It may be a good idea to try all new foods at home as well until you know better what you can or cannot tolerate.

  If you experience a food intolerance, many professionals recommend waiting a few weeks before trying it again.  

Another reason a food may not be tolerated well would include advancing in the diet stage too quickly.  Some patients may need longer than the average recommended time in a diet stage before advancing to the next stage.  This is something you can discuss with your surgeon and/or dietitian. 

From a more physiological standpoint, food intolerances (in general, not necessarily specific to weight loss surgery) may occur due to not having the proper enzymes or chemicals necessary to digest a particular food.  This may cause symptoms ranging from gastrointestinal symptoms, such as diarrhea, bloating, and gas, to headaches, changes in mood, and certain skin conditions.  Symptoms may be immediate or may take some time. 

Tips to Reduce Food Intolerances.  There are several tricks of the trade that may help with reducing your risk of experiencing a food intolerance.  Please talk to your surgeon, dietitian, and/or program before trying any of these to ensure your program is comfortable with your eating plan. 

Pasta and rice – Some patients do well with slightly undercooking or overcooking.  However, most patients do not tolerate these foods until 9-12 months post-op.

Fresh bread – Try toasting to make it more tolerable.  However, most patients do not tolerate bread until about 6-12 months post-op.

Beef, chicken, pork – Make sure you’re using a cooking method that maintains moisture.  Only cook to the safe temperature.  Overcooking dries food out making it less tolerable.   You can also try using a meat tenderizer or a marinade (watch sugar and fat content) to make meat more tolerable. 

Shrimp – Many patients have said the smaller the shrimp, the better they tolerate them.  So it maybe best to avoid these lovely prawns until you get further out from your surgery.

Eggs – This one is tricky.  Some patients can tolerate hard-boiled eggs, while others cannot.  Some patients can tolerate scrambled eggs, while others cannot.  So try varying the method of how you cook your eggs to see if that makes a difference. 

Stringy vegetables – Use a blender and a strainer to separate indigestible fiber.  Some patients may need to wait until 6-12 months post-op to eat certain foods, such as celery, asparagus, etc. 

Fruit membranes – Remove the membranes of oranges, grapefruits, and other citrus fruits to increase tolerance.

Skins of fruits and vegetables – Remove the skin of fruits until better tolerated, such as apples, plums, peaches, pears, cucumbers, potatoes, etc.

Lettuce – Lettuce also seems to not be very well tolerated for some patients.  Even though we know dark, leafy greens are more nutritious, some patients tolerate iceberg lettuce better initially and then can try the greener lettuce when a little further out from surgery.  Other patients have shared that the fresher the lettuce is the better it’s tolerated. 

Foods with seeds – Avoid eating the seed if possible or wait to eat this food until a little further out from your weight loss surgery (examples include strawberries).

Cow’s milk (or other dairy foods) – Try soymilk, lactose-free milk, rice milk, or almond milk (look for light or lower calorie options) instead of cow’s milk.

Portion size – Oftentimes it may not be the actual food itself that’s not tolerated, but the portion size of the food.  Many times the foods that seem to be “not tolerated,” are actually foods that fill us up faster, therefore requiring that you eat less of them.

  As we know, it’s difficult to ascertain exactly how much of each food you can tolerate in the beginning, as it takes time and practice to figure out what you as an individual can tolerate.  For example, chicken is a common food that’s not well tolerated.

  Even if you can eat 6 bites of yogurt, you most ly cannot eat 6 bites of chicken.  Chicken is a more solid protein and 1-2 bites may be all that you can tolerate early surgery.   Even eating 1 bite extra is considered overeating, which can cause it’s own discomfort.

  Work to retrain your mind on recognizing the feeling of fullness, so you can avoid the uncomfortable “stuffed” feeling. 

Pace of eating – It’s important to keep in mind the speed at which you’re eating.  You may be able to tolerate a certain food much better if you eat it at a slower pace and ensure that you’re chewing properly. 

While this list is not all-inclusive and every patient is different, we hope this will help make your transition to your new eating plan after surgery a little easier for you.

  Please keep in mind that every program has different recommendations and every patient is different.  Something that works for you, may not work for your bariatric buddy.

  We look forward to CELEBRATING with you as you transition to your normal eating plan!

Comments will be approved before showing up.


Problems with Digesting Fat After Weight-Loss Surgery

Food Intolerance After Gastric Band Surgery | Johns Hopkins Medicine

Linkedin Pinterest Gastroenterology Gastric Surgery Obesity Treatment Overview Obesity Treatment Procedures

If you are severely obese and haven’t been able to lose weight, your healthcare provider may recommend weight-loss surgery. Weight-loss surgery (bariatric surgery) may help you lose weight. Losing weight can lower your risk for weight-related problems heart disease, diabetes, sleep apnea, high blood pressure, and arthritis.

Most bariatric surgeries are called restrictive surgeries because they limit how much food you can eat. Another type of bariatric surgery is called controlled malabsorption.

This surgery makes it impossible for your body to break down and absorb food in a normal way.

If your healthcare provider recommends this type of surgery, you may have a surgery called biliopancreatic diversion with a duodenal switch. (BPD-DS).

What BPD-DS does

BPD-DS is a complicated type of bariatric surgery. It changes the anatomy of your digestive system in several ways:

  • It removes most of your stomach.

  • It bypasses most of your small intestine. Food you eat won’t flow through the bypassed part of the intestine.

  • It sends digestive enzymes from your pancreas to an area much farther down in your small intestine.

These changes mean that your body does not have the time or the space to break down the fats, proteins, and carbohydrates from foods you eat into smaller particles that your body can absorb. This causes you to lose weight quickly. You are also ly to keep the weight off longer than with restrictive type weight-loss surgeries. But you may also have more long-term complications.

Problems with absorbing fat

After BPD-DS, you will be at high risk for many nutritional problems (deficiencies). The surgery makes it harder for you to digest and absorb fat.

This can mean your body doesn’t get enough of vitamins. A, D, E, and K. These vitamins are fat-soluble. This means they dissolve in fat when they are inside your body.

If you cannot absorb fat, you won’t be able to fully absorb or store these vitamins.

You need vitamin D to help absorb calcium, so you can have too little calcium in your body after BPD-DS. This is a very real concern, especially for women. Women are more ly to have weak bones (osteoporosis). Studies show that 4 years after BPD-DS, about 2 3 people will be low in vitamins A, D, and K. Half will be low in calcium.

Problems with absorbing fats may cause:

  • Steatorrhea. Undigested fats cause loose and frequent bowel movements. These are often hard to control. You may have cramping, foul-smelling diarrhea, and lots of gas.

  • Vitamin deficiencies and related diseases. Symptoms of these vitamin deficiencies include rashes, bruising or bleeding, night blindness, and weak bones that are more ly to break.

  • Calcium deficiency. BPD-DS makes it harder for your body to absorb calcium and vitamin D. Both of these nutrients are important for healthy bones. Low levels of calcium in your body can cause broken bones.

  • Vitamin E deficiency. This problem is rare but it can happen with fat malabsorption. Symptoms include numbness or tingling in your arms and legs. This is because your nerves aren’t working as they should. Other symptoms include muscle weakness and vision problems. You are also less able to fight off infections.

How to live with fat malabsorption after BPD-DS

After BPD-DS you will need to follow a diet high in protein. You will need to take high doses of fat-soluble vitamins every day. You may also need other dietary supplements. Limiting the amount of fat in your diet will help prevent steatorrhea. Some people may also need to take pancreatic enzyme supplements.

The American Society for Metabolic and Bariatric Surgery recommends that you start taking vitamin A, D, and K supplements about 2 to 4 weeks after BPD-DS surgery. This will help prevent nutritional deficiencies. You may also need calcium, iron, B-complex, and multivitamins. Talk with your healthcare provider to find out what supplements you should take.

You'll need to take these supplements for the rest of your life. You will also need to be tested regularly by your healthcare provider to prevent complications. Your healthcare provider may need to change these guidelines to fit your particular condition.

Remember that fat malabsorption is the reason you lose weight after the surgery. But it could cause long-term complications. These risks can be managed, but they will last for the rest of your life.

You will need a regular, lifelong follow-up schedule with a healthcare provider. Work with your healthcare provider to look at all of the risks and benefits of BPD-DS as you get ready for bariatric surgery.