The Center For Bariatric Surgery

It is important for you to understand that not only must your calorie intake be less
but the quantity of food, consistency and type of foods you choose in the future are essential to your success.

It takes about a month for your new stomach to heal 95%. During this time you need to be very aware that excessive eating is possible but dangerous to your health, as well as your goal of weight loss. Before your stomach is properly healed you could cause a leak by stretching the staple line to the limits, or by stretching the pouch to a size so large that the benefit of the surgery is lost.Your new stomach holds about an ounce. This space should be filled with nutritious liquids only for the first two weeks. After that you may add soft pureed foods such as baby food, mashed potatoes, Cream of wheat, etc.

Early dumping syndrome is caused by rapid entry of hyperosmotic foodstuffs into the intestine, by either washing down solid meals with high calorie liquids diet soda, coffee or tea with sugar, milkshakes) or overfilling the pouch. Your bloodstream sends fluids to dilute the food, causing a rapid decrease in the volume of circulating blood and a rapid increase of fluid in the intestine. The distention of the intestine may cause nausea, cramps, diarrhea, and abdominal rumbling. The loss of volume from the blood, may lead to low blood pressure with faintness and compensating release of adrenaline which causes pallor, sweating, a rapid pulse and anxiety.

Late dumping is when the foodstuffs enter the intestine rapidly, any glucose that results from their digestion enters the bloodstream rapidly. This results in an unusually high amount of insulin sucreted to deal with the glucose load. After the glucose has all been absorbed, insulin production may suddenly be too high for the decreased amount of glucose that is entering the circulation. The result is hypoglycemia, causing pallor, sweating, rapid pulse, anxiety and sometimes even confusion. The digestive symptoms of cramping and diarrhea are usually avoided with late dumping.

The absorption of vitamins and minerals may be changed, because food is bypassing most of the stomach and duodenum. You will need lifelong supplements of vitamins and minerals. For this reason regular monitoring of your vitamin and mineral levels are essential.

Mild sugar (lactose) is sometimes difficult to digest. Milk lactose passes into the colon which is not designed to deal with it and where it is subject to fermentation by cooling bacteria. Nausea, cramps, gas and diarrhea may result. For this reason milk and milk products can be added only cautiously two weeks after your surgery. If they do not cause symptoms they may be taken freely.

A normal stomach grinds food up into tiny particles less than a sixteenth of an inch, but this is done in the lower part of the stomach where your food no longer goes. If you don't thoroughly chew your food it may block the outlet of the pouch and make you vomit or have to be removed by special techniques such as gastroscopy. You must also not put anything indigestible into your mouth, like a coin or gum. If accidentally swallowed this could be disastrous.

We have tried to cover as many of your questions about your post operative diet as possible. Please do not hesitate to ask Dr. Felix or his staff if you are unsure about anything regarding your surgery or recovery.