Persistent involuntary vomiting plagues gastric surgery patients
Date: 07-04-2000; Publication: Medical Post; Author: Jenny Manzer


CHICAGO - Nearly 70% of patients who undergo gastric bypass surgery for obesity experience regular, involuntary vomiting-even more than a decade after surgery, North Dakota researchers have found.
Dr. Jim Mitchell, chairman of neuroscience at the University of North Dakota, discovered the prevalence of the side-effect while researching the impact of gastric bypass on Binge Eating Disorder (BED).

Dr. Mitchell and colleagues found that out of 100 patients who'd had the surgery, about two-thirds were experiencing periodic non-induced vomiting after meals.

"The literature would suggest this is a huge problem at baseline right after the surgery, but the fact that it's still prevalent at 14 to 15 years is surprising," he said.

Patients appeared to be unfazed by the side-effect, with the majority still reporting overall satisfaction with the surgery. "But you know, these people are desperate," added Dr. Mitchell, who presented the findings at the American Psychiatric Association annual meeting here.

The research was part of a retrospective study of 80 women and 20 men who had undergone gastric surgery an average of 13 years earlier. The study looked at the long-term effect of the surgery on the patient' s mental and physical health.

Patients lost an average of 47 kg following the surgery, with total results ranging from a 14 kg gain, to a 94 kg loss. They had an average pre-surgery Body Mass Index of 43, which dropped to 33 following surgery.

The majority of patients experienced some gastrointestinal side-effects, including ulcers (45%), heartburn (43%) and diarrhea (32%). A number also experienced plugging (43%), which required that they drink large amounts of water to loosen food caught in the pouch.

Approximately half the patients had BED before the surgery. The number fell to roughly 10% after surgery. Researchers dropped the BED criteria of consuming large amounts of food, and relied on other BED criteria, such as out-of-control eating, noted Dr. Mitchell.

Patients reported less dissatisfaction with their weight and shape after the operation, with almost 99% expressing dissatisfaction pre- surgery, which dropped to 70% after surgery.

Overall, study participants were satisfied with the surgery and maintained weight loss over the years, said Dr. Mitchell. He said patients need to be warned about the likelihood of long-term GI side-effects, however.

"They need to be told that upfront."

Jenny Manzer, Persistent involuntary vomiting plagues gastric surgery patients. Vol. 36, Medical Post, 07-04-2000.

I just read this article and though I believe the findings about the involuntary vomiting in a large amount of post op patients, I feel that much of the vomiting is caused by eating practices.

I am a Roux En Y patient so what I say really only applies to that procedure and they are only my opinions and experiences.
I still occasionally get nauseated but I am always aware that it was something I did. Often it is because I do not chew enough if I don't pay attention to what I am doing or maybe I try to eat just that extra bite. Occasionally I find that my pouch just is not tolerating a certain food, I do not tolerate red meat or thicker pasta and eggs are okay for me sometimes and other times I get nauseated after after just a bite or two of them.

I also read something about people having to drink large amounts of water to unplug food that became caught in the pouch. Once again, food needs to be chewed THOROUGHLY!

I think my best advice to people who are pre-op are to learn to concentrate on your eating and not what is going on at the dinner table. If you use your thoughts on keeping up a steady flow of conversation then it is highly likely you will eat too quickly or not chew properly. Also if you have eaten correctly and you still get nauseated make sure to keep track of what you have eaten and when you eat it again next time and it makes you sick again then take that food off your eating list for awhile. Try it again in a few weeks. The pouch is made at the top of the stomach which is the part that produces the mucous. So anytime a food causes even the slightest bit of irritation your pouch begins to make mucous. It does this to cause vomiting, it wants to expel the irritating object.

I know that for me I seldom actually bring up food it is usually just mucous and bits of food (sorry to be so graphic). You would think that after being a year and a half post-op I would remember these things too but sometimes it just happens.

Debbie

I can honestly say that not once since my surgery have I vomited.


Debbie

Debbie,

Lucky you. I really have a bad habit of barely chewing, my mom always was telling me "chew Debbie, you're swallowing it whole". I threw up 2 or 3 times a day for my first 3 months post-op now it is probably once every 3 months or so.

Debbie

Debbie, I think I am lucky too. I have always said I have a stomach made of steel, maybe it still is.

The other Debbie

especially after last week's vegetable bezoar [40 hours, every 1.5-2 hours like clockwork]

yes, i'd done something stupid, so i'm with you, debbiedreamsmall. and i've thought about this article for quite awhile, and i'm still stunned that the researchers didn't ASK anyone why they don't seem upset by the vomiting. it's not a big deal!!!

don't get me wrong.. it's not the most pleasant thing in the world, and i wouldn't wish it on anyone, but it happens, and life goes on.

after nearly 7 months, i'm throwing up MAYBE once a week, usually, and i can track it to something i shouldn't have done.

and eggs, especially scrambled, are often a problem. but deviled eggs made with hot chili sauce are not. there's no logic.

I hadn't gotten sick for quite awhile and now yesterday after posting on this subject I ate some noodles and within an hour I was sick as a dog. My stomach is still irritated today because every time I have eaten I have felt a bit nauseated. I guess it was my pouch having the last laugh on me!

Debbie