It’s common for weight loss surgery patients to develop stomach pain after bariatric surgery. Indeed, a large part of adjusting to life after having weight loss surgery (regardless of the type of bariatric operation) is developing abdominal symptoms after eating too much.
Your stomach pain may develop in a variety of ways.
Common Abdominal Symptoms
Following weight loss surgery, the “feeling of fullness” that you might experience after eating too much solid food is different from the “feeling of fullness” experienced by those who have not had a bariatric operation. Your post bariatric “feeling of fullness” could feel more like the discomfort that is occasionally associated with nausea.
Some patients will also develop watering in the mouth or even the eyes. Typically this will decrease and become more controllable as time passes.
Note that these are common abdominal symptoms. As a post-op patient, you’ll learn how to adapt to or accommodate the changes caused by your bariatric operation. However, persistent or excessive symptoms that do not improve should be evaluated by your bariatric surgeon. Such symptoms could indicate a serious problem.
Dangerous Abdominal Symptoms
There are a variety of abdominal symptoms that can occur after bariatric operations that are of great concern. Several of these more troublesome or “red flag” symptoms are mentioned below in association with the different types of bariatric surgery.
Laparoscopic Banding (LAP-BAND Surgery)
Consult your surgeon immediately if you experience the following symptoms after having LAP-Band surgery in NJ:
- Excessive or unrelenting vomiting
- Inability to drink or keep liquids down
- Severe gastro esophageal reflux (GERD)/heartburn
At a minimum, these symptoms suggest that the band should be deflated immediately. If the symptoms don’t resolve quickly after deflation, it’s possible that the band has “slipped.” A slipped band might require urgent surgery, especially if you cannot keep liquids down.
Gastric Sleeve
Consult your surgeon immediately if you experience the following symptoms after having gastric sleeve:
- Excessive or unrelenting vomiting
- Inability to drink or keep liquids down
- Severe gastro esophageal reflux (GERD)/heartburn
- Severe progressive abdominal pain
- Left shoulder pain
Vomiting and/or the inability to drink suggests blockage or severe narrowing (stricture) of the sleeve. This condition may require emergency hospital admission and endoscopy. Progressive abdominal pain and/or left shoulder pain within the first few weeks after sleeve gastrectomy could be caused by a late leak or perforation. These types of leaks can develop “late” after a gastric sleeve and require emergency admission to the hospital. In some cases, urgent surgery is required.
RY Gastric Bypass
Consult your surgeon immediately if you experience the following symptoms after having gastric bypass surgery:
- Excessive or unrelenting vomiting
- Inability to drink or keep liquids down
- Severe gastro esophageal reflux (GERD)/heartburn
- Severe progressive abdominal pain
- Left shoulder pain
- Sharp, burning pain below the breast bone
- Nausea, cramps and bloating
Excessive vomiting and the inability to keep liquids down can occur following gastric bypass. These symptoms are typically caused by a stricture (narrowing of the stoma from scar tissue) or ulcer. Again, hospital admission and endoscopy are likely necessary.
A stricture can usually be successfully treated by endoscopic balloon stretching of the stoma. An ulcer will require antiulcer medication in conjunction with endoscopy/dilatation. Most ulcers will respond to this treatment over a few weeks to several months. Patients who have ulcers that don’t respond to drug treatment may require revisional bariatric surgery, which can usually be done electively rather than as an emergency.
In the case of intermittent nausea, vomiting, cramps, and abdominal bloating, frequently these symptoms are followed by loose stool/diarrhea. Such symptoms are typical of an intestinal or bowel blockage. If you have these symptoms for several hours, you should go to the nearest hospital emergency room. Often diarrhea accompanies resolution of these symptoms. More than one episode of abdominal pain, nausea, and bloating followed by diarrhea warrants a prompt appointment with a bariatric surgeon.
Complete blockage/obstruction of the bowel are characterized by nausea, cramps, bloating, and vomiting but NO passage of gas or diarrhea. This may represent a surgical emergency and is potentially life-threatening.
The Bottom Line
The most important take-away message regarding stomach pain after bariatric surgery is that these symptoms should be evaluated by a bariatric surgeon.
It’s common for patients to want to take these symptoms to their primary physician. But usually your primary care doctor has very little knowledge of the side effects of bariatric operations. There have been cases in which serious, even potentially life-threatening symptoms are treated by primary physicians with either over the counter medications or with prescription medications without performing appropriate diagnostic tests.
If you’ve had bariatric surgery, it’s important that you continue to follow up with your bariatric surgeon. Follow up is particularly crucial when new (or more severe) abdominal symptoms develop.