Gastric Band Common Problems

Image of consultant bariatric surgeon, Mr Rishi Singhal

Medically reviewed by Prof Rishi Singhal MBBS, MRCS, FRCS, MD  
By Heather Fry BSC (Hons)

Getting used to your surgery can be very daunting and you might be quite worried about any new sensations or feelings you are experiencing. We’ve listed some
common symptoms and problems below.

Wind pain

Wind pain is most felt in phases 1 to 2 when you’re recovering from your surgery. Quite typically it is felt in your left shoulder and maybe even your neck. It is very
common after any laparoscopic surgery due to the gas they use to lift your abdominal wall away from your organs. If wind pain is experienced after this time, it is normally due to a poor eating technique. Wind remedies are the most effective treatment: Wind-eze, Deflatine, gripe water or peppermint tea. Placing a hot water bottle over the shoulder may also relieve the pain. If you feel you need to, you can also take liquid analgesia such as effervescent paracetamol.

Abdominal discomfort

In phases 1 and 2, you may be aware of aches and pains in your chest wall and abdomen especially when you are moving about and taking fewer painkillers. These are referred to as musculoskeletal pains and are a normal part of the keyhole cuts healing inside. Scar tissue will be forming, and this is a bit less flexible than your
tissues were before. Your abdomen will also be adjusting to having a port sutured to it. If the pain is associated with eating or drinking, it is likely to be due to a poor technique. This discomfort is often felt underneath the breastbone. It is important to reduce the frequency of this discomfort as much as possible by following the
20,20,20,20 technique:

1. Take a 20-pence-sized bite of food.
2. Chew for 20 seconds. Even though there might not be much to chew in this phase, it is important you still wait this length of time before moving to the next step.
3. Once swallowed, wait at least 20 seconds before you prepare your next bite.
4. Repeat the above steps over a period of 20 minutes. Stop before this if you feel you have had enough.

Nausea

Nausea, or feeling sick, is a very common feeling in phase 1. It can be associated with drinking a lot of milky drinks or meal replacement shakes. Swapping to soups may be
better but it’s important to fortify these with protein e.g., skimmed milk powder (if this doesn’t cause nausea) or unflavoured whey protein powder. If you are really struggling with nausea, please let us know so we can help.

Diarrhoea

Some people might experience diarrhoea in the first few weeks after surgery. A lot of changes have occurred to your digestive system, your diet and perhaps your
medications which could be contributing to this. Make sure you drink plenty of fluids to replace what you are losing and have a bland, low-fat diet. If the diarrhoea is
particularly troublesome, get your GP to check that you do not have overflow diarrhoea or an infection. You can also talk to our medical team who might suggest
some changes to your diet.

Constipation

You might be constipated if you haven’t had a poo at least 3 times during the last week; the poo is large and dry, hard, or lumpy; or you are straining or in pain when
you have a poo. This is much more common than diarrhoea following surgery because you are now taking much smaller quantities and there is very little fibre in a
liquid and soft diet. If you suspect that you are constipated, there are 3 things to check:
1. Make sure you are drinking at least 2 litres of fluid per day.
2. Include 1-2 cups of diluted vegetable juice per day.
3. Make sure that you are active and not sitting or lying around too much!

If it is still a problem, you may require a laxative. There are a few different types: bulk-forming, osmotic, stimulant and poo-softener. Avoid any bulk-forming (e.g., Fybogel) or stimulant (e.g., Dulcolax, Senna) laxatives too soon after surgery. Try osmotic or poo-softener laxatives which help make the stool softer and easier to pass, for example, CosmoCol, Docusol, lactulose, Laxido or Movicol. Please call us if you are unsure on how to manage constipation.

Feeling tired, lack of energy

For the first 2 weeks after your surgery, you are likely to feel tired. We do encourage you to walk daily to help reduce the risk of developing a DVT, but don’t overdo things. Even when your wounds look healed on the outside, they are still healing inside. The further into your weight loss journey you go, having a lack of energy could be a
sign of a nutritional deficiency. Make sure you’re drinking and eating regularly and taking an A-Z vitamin and mineral supplement. Please refer to our information sheet
on vitamin and mineral supplements after a gastric band.

Dry mouth

Following surgery, you may notice you get a dry or a ‘furry’ mouth. This is quite common after general anaesthetic. Make sure you drink plenty of fluids and breathe through your nose more. It may be useful to use a mouthwash and make sure you brush your teeth well twice a day. You can also try sucking ice cubes, low calorie ice lollies or sugar free mints.

Pain on eating and regurgitation

If you ever have pain on eating and/or regurgitate your food, it is important to address your eating technique. If you are following the 20,20,20,20 technique and still experiencing discomfort, your band may be too tight. Please contact us so we can advise appropriately.

Reflux/indigestion/heartburn

Normally, when you have acid reflux with a gastric band it is due to the band being too tight. You can experience it during the night and wake up coughing or choking. This is called nocturnal reflux. Please contact us so we can advise appropriately.

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