POTENTIAL PROBLEMS FOLLOWING GASTRIC BYPASS AND LAP-BAND SURGERY

Nausea/Vomiting:  

• If nausea and vomiting occur after eating a new food, wait several days to a month before trying it again.  This may be a temporary food intolerance or taste change.
  
• If the patient is chronically vomiting it may be necessary to temporarily stop eating and force more fluids to prevent dehydration.
   
• Purchase clear liquid protein drinks like Isopure to get in ample protein and still increase fluid intake.
    
• Eating too fast, eating too much, or insufficient chewing may also cause nausea and vomiting due to over-filling the pouch.
  
• Drinking fluids with solid foods will cause nausea and vomiting from overfilling the pouch.  The liquid will inflate the solid food like a sponge and hit you 10 minutes after you have done it.
  
• Lap-band patients are given anti-nausea medication to prevent vomiting.  The force of vomiting can cause the band to slip out of place.  Lap-band patients are never to vomit.

The Lap-band patients must never eat and drink together.  Remember the 30-60 minute rule.

The Gastric By-pass patients must remember the 30-30 minute rule for the first 12 months.  After 12 months you may eat and drink together.

Gastric-Bypass Dumping Syndrome: Avoid simple sugars and high fat foods by looking at food labels (see the cheat sheet for the grocery store).

Pain In Upper Chest: Stop eating if pain occurs during eating and try to eat later after the pain has resolved.  Walk around to help the food work its way out of the pouch, and do not drink anything after the food.  This will just make it worse.

Plain water will most likely cause cramping of the pouch and make the patient feel very full so that they are unable to get enough fluid in.  Try all the 10-calorie or less per serving fluids listed in the clear liquid grocery list first.  Eventually, plain water will be easier to drink.

Initially make sure all the fluids are warm or room temperature.  Very cold temperature fluids usually cause the pouch to cramp up.

Dehydration:   Dehydration may occur with inadequate fluid intake, with persistent nausea, vomiting, or diarrhea.  Drink a minimum of 6 measuring cups of clear fluids daily (48 ounces).  Do not gulp fluid, sip on fluid constantly all day long. 

Lactose Intolerance: Use Lactaid milk, lactase enzyme tablets, or drink soy, rice or almond milk.  Watch out for hidden sugars in rice/soy/almond milks (follow the sugar rule listed in the cheat sheet for the grocery store).

Constipation: Constipation may occur temporarily during the first 3 months after surgery, but generally resolves within 3 months. Patient's with Irritable Bowel Syndrome usually have chronic constipation, and may require stool softeners daily. 

The regular use of fruits, sipping on plenty of fluid throughout the day, and exercise reduces the risk of constipation.

Other Ways To Help Improve Chronic Constipation Include:

• Eat sugar-free applesauce, oatmeal, and /or unsweetened pureed prunes daily.
  
• Try � cup of prune juice and dilute it with � cup of water.
  
• Sprinkle 1 tbsp raw Miller's Wheat Bran (found in health stores) into shakes, applesauce, and hot cereal.
  
• After 4 weeks try a baked potato with skin, toasted whole grain breads, bran cereals with more than 3 grams of fiber per serving (such as Fiber One), and raw vegetables and legumes (dried beans).
  
• Drink lots of water/fluids.
  
• Exercise regularly.
  
• Smooth Move herbal tea (1-800-443-9942) or www.TraditionalMedicinals.com
  
• Natures Tea call Nancy Winslow (410-485-8028)
  
• Stool softeners can be taken daily. 

If there is no bowel movement for 5 days get an over the counter laxative so as not to become impacted.

Diarrhea:   Limit the following foods: insoluble high-fiber foods such as vegetables, wheat, and most grains, greasy foods, milk, and milk products, and very hot or cold foods.  Eat frequent meals every 4 hours, and drink plenty of fluids.  If diarrhea persists contact the Dietitian for more directions.

Chronic Gas And Bloating: Eat 1 DanActive Light Yogurt daily that contains probiotics or chew one small lemon flavored probiotic tablet called L-Reuteri daily.  This product does not interfere with any medications and can be purchased at 1-800-223-8225 or at www.naturessunshine.com, or try one Culterelle capsule daily found on www.sinaibariatricestore.com

Chronic Ketone Body Scent:   Try  Devrom banana flavored tablets or capsule daily.

Blockage Of Stoma: The stoma may be temporarily blocked if foods with large chunks are eaten without thorough chewing.  If symptoms of pain, nausea, and vomiting persist please call your physician.  An example of large chunks would be celery in tuna fish, or corn in a stew.

This usually occurs from patients not sticking to the grocery store list given for the first month.