WLS Questions – I Keep Throwing Up (Even Soft Foods…)

I know it’s a lovely topic.

Even typing out “throwing up” makes me feel queasy. Let’s start the morning off right with a  conversation about the pukes!!! #nothankyou

However, if you are reading this post, chances are you need to know.

This is a phone call I get from time to time in my office. A patient is throwing up most of his or her foods, even the soft ones. Be sure to contact your doctors office and remember my site is not meant to be medical advice – rather discussion and healthy living tips.

With that being said, here are some of the questions I work through when a patient is struggling with this.

Are liquids staying down okay?

It’s always important to rule out the most serious issues first. If a patient isn’t keeping ANYTHING down, I refer them to their doctor right away. That does not sound food related, it sounds like an issue beyond my scope of practice. However, if liquids are staying down, I move on to my next question.

What foods don’t cause any issues with vomiting?

Usually when a patient calls to tell me they “throw up everything” it’s not necessarily everything they are throwing up, though it may feel like it. Commonly the patient will report eating things like yogurt, soups, applesauce or other very soft and soupy textures. This is starting to sound like their stomach pouch has been irritated along the way and the inflammation is only allowing very liquidy things to travel through without discomfort.

How have you been doing with taking small bites and eating slowly previous to having issues with all foods?

I know this sounds like a leading question (because it is) but typically what I’ve found to be the case is at some point along the way my caller ate too fast, too big of bites or too much and then had more issues in the days following. Bite sizes are a HUGE culprit of an irritated stomach pouch because what feels like a small enough bite often isn’t what it needs to be. Take bites the size of a peanut or your small pinkie fingernail, pause in between bites and ask yourself in between each bite how you feel and if you would be satisfied if you would stop. Here is a GREAT video on visualizing your pouch and the best methods for eating your foods. 

Okay, let’s give something a try for the next few days…

When the stomach is irritated, it’s time to give it a chance to rest. Let’s take stress off that little ticked-off pouch and go back to liquids for the day. Protein shakes are fine in addition to reaching your fluid needs of 64-96 ounces of fluids (anything that isn’t carbonated, caffeinated and is under 15 calories for an 8 ounces serving). Warm liquids may go down more smoothly so try herbal tea or warm broths. After a day of that, slowly re-start your diet progression and move from liquids to softs for a couple days. Scrambled eggs, cottage cheese, plain Greek yogurt, cheese stick, deli meat, flakey fish, etc. Take VERY small bites, go slowly, stop at fullness. After a few days of success with softer foods, get yourself back up to more solid textured lean protein foods and vegetables for best success in your weight loss.

*Note: some patients experience “frothing” after surgery which is the foamy icky stuff that seems to come up into your mouth (YUCK). This is more common in the early healing months after surgery and is the collection of mucous in the top portion of your pouch. It’s gross but all you need to do is drink something warm before you start your meal to allow that mucous to break up and move through. Stop drinking liquids once the first bite goes in.

If symptoms persist, consult your doctor again. Keep a food journal and note any issues with meals.

9 times out of 10 this “re-starting” of the diet progression to give your stomach a break will do the trick to get back on a good foot. However, any persistent vomiting is a call to your doctor. FOR SURE if you aren’t keeping anything down or there is blood in the vomit. Use common sense but it’s always best to “over call” your doctors office if something isn’t going well.

Feel better soon and all my best!

Steph :)

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