What is food intolerance after gastric band surgery?

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 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 likely too tight.

In some cases, the tube leading down to the stomach (esophagus) may also not move normally. Food may not pass easily 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

• GERD (gastroesophageal reflux disease)

• Bloating or an overly full feeling in the upper belly (abdomen)

• Upper belly discomfort

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

How is food intolerance after gastric band surgery diagnosed?

Your healthcare provider will talk with you about your symptoms. Make a list of the foods that bother you and the problems they cause. Bring the list with you to your appointment. In some cases, you may have an imaging test, such as an upper GI (gastrointestinal) 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 at a time

• Eat slowly

What are possible 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 about food intolerance after gastric band surgery

• 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 have food intolerance and can't eat a diet that's nutritious.

• 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 and when they should be reported.

• 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 healthcare provider if you have questions, especially after office hours or on weekends and holidays.