Feb 2021
Jacqui Lewis - BHSc Nutritional and Dietetic Medicine
Digestive Health After Weight Loss Surgery
Before your Weight Loss Surgery, you may encounter varying digestive issues related to the health of your digestive system. Overall, the foods and drinks you choose, your stress levels, the mechanical function of your system, and the types of bacteria housed in your gut will all have an impact on the symptoms you experience.
Symptoms of Digestive Issues
Common digestive symptoms include: Burping and belching Bloating Early satiety (feeling full even after eating only a small amount) Insatiable hunger Gas Constipation Diarrhoea Vomiting Burning sensation after food These signs can be linked to the foods you eat, your current BMI, the efficiency of your supporting organs, and the balance of bacteria in your gut. Some of these indicators can also signal that something isn't functioning optimally, perhaps a hernia is contributing, or there aren't enough digestive enzymes present to effectively process and absorb the nutrients your body needs.
After Surgery: Ruling Out Complications First
If you're experiencing digestive discomfort after Weight Loss Surgery, the first step is always to rule out a surgical complication — such as a hernia, stricture, or scar tissue. Once these have been eliminated by your surgical team, you can then look at what you're choosing to put into your body as a way to support optimal digestive health. A healthy digestive system is widely recognised as a foundation for overall health and general wellbeing. Getting it right after surgery, when the digestive system has been reconfigured, is one of the most important things you can do for your long-term health. One of the most common digestive concerns WLS patients encounter is ongoing reflux, a situation where stomach contents travel back up into the oesophagus, creating a burning, uncomfortable sensation.Reflux is more common in people carrying excess abdominal weight, as this can increase pressure within the abdominal cavity. The good news is that for many patients, WLS significantly reduces or resolves reflux symptoms. Results can vary depending on the type of procedure, your surgical team is the best resource for understanding what to expect for your individual situation.If you're experiencing persistent reflux or digestive discomfort after surgery, speak with your surgeon sooner rather than later. In many cases, dietary adjustments (reducing coffee, alcohol and sugar in particular) can make a meaningful difference. But it's always worth getting a professional assessment to ensure nothing else needs to be addressed.
Dietary Support for Digestive Health
Food choices play a significant role in how your digestive system functions after WLS. Here are some key areas to focus on: Reduce digestive triggers. Alcohol, refined flour, pastry, gluten, sugar and coffee are all known to contribute to digestive discomfort and reflux symptoms in many people. Assessing whether specific foods trigger symptoms, and reducing or eliminating them for a period, can be a practical first step. Increase whole foods. Fruits, vegetables and healthy fibres from oats, bananas, onions and asparagus all contribute to a healthy gut environment. These foods support the growth of beneficial gut bacteria, which plays an important role in overall digestive comfort and general wellbeing. Stay well hydrated. Water supports the movement of food and waste through the digestive system and helps maintain a healthy gut environment. Sipping consistently throughout the day — rather than drinking large amounts at once — is particularly important after WLS.
Supporting Your Gut: The Weed, Seed, Seal and Feed Approach
A comprehensive approach to digestive health after surgery can be thought of in four stages:
Weed
Create a less favourable environment for disruptive gut bacteria by reducing the foods they thrive on — primarily refined sugars, alcohol, white bread and heavily processed foods. Certain whole foods including pumpkin seeds, pomegranates, beetroot, carrots and raw garlic have traditionally been used to support a healthy gut environment.
Seed
Introduce and support beneficial gut bacteria through a varied, fibre-rich diet. Each bacterial strain brings different benefits and feeds on different components of food, which is why dietary variety matters so much. A broad-spectrum probiotic supplement may also be an option worth discussing with your healthcare professional if dietary sources alone aren't sufficient.
Seal
The integrity of the digestive tract lining plays an important role in overall health. Supporting this lining with nourishing foods and nutrients can help maintain the healthy barrier function of the gut wall. Bone broth, collagen, and anti-inflammatory foods like turmeric are commonly used as part of a gut-supportive dietary approach.
Feed
Once the environment has been prepared, it's time to feed the beneficial bacteria with prebiotics — the fibre that good bacteria need to thrive. Think of fibre as the food supply that allows your gut's beneficial bacteria to grow and maintain healthy colonies. Good sources include vegetables, legumes, whole grains, oats and seeds.
Jacqui Lewis
BHSc Nutritional and Dietetic Medicine
