Diarrhoea after sleeve gastrectomy: The 411.

Let’s do it. Let’s talk about poo! There are many benefits of a sleeve gastrectomy, but there are also common complications and side effects that you may experience from the more serious to the annoying. Diarrhoea after sleeve gastrectomy is one of the annoying common side effects, as are constipation, nausea and reflux (heartburn).Most diarrhoea will settle by itself after 4-6 weeks. It’s very normal for bowels to do all sorts of weird things immediately after surgery. Whilst diarrhoea after sleeve gastrectomy is not usually a cause for alarm, it’s not pleasant, so let’s talk through what might be the cause and what you can do about it!

The fluid post op diet

This one is simple – there’s nothing solid going in so often there is not much solid that comes out! Usually if diarrhoea is caused by the post op fluid diet, once you start eating more solid foods, it will settle down. Also make sure you are taking your fibre supplement daily – it will add some bulk and slow things down.

Anaesthetic

The anaesthetic given to you during surgery can often lead to nausea and/or diarrhoea afterwards. There isn’t much you can do for this one other than the tips above. Usually the diarrhoea will settle on it’s own over the first few weeks. If you’re still experiencing diarrhoea when you have your one-month post op appointment, speak with your surgeon about it.

Lactose intolerance

Lactose intolerance is a really common cause of diarrhoea after sleeve gastrectomy. I wrote a full post about lactose intolerance here. If you suspect dairy, and especially milk, may be causing your diarrhoea, try going for lactose free options. Lactose free milk, yoghurt and cheese is available in the supermarket (try Zymil, Liddell’s or Vaalia), add lacteeze to your normal milk, or try calcium fortified soy milk instead.

Dumping Syndrome

Dumping syndrome, though rare after gastric sleeve surgery can be another cause of diarrhoea. It is a condition characterised by diarrhoea, nausea, sweating, shaking, pain and/or abdominal cramps. Dumping syndrome is causing by rapid emptying of the stomach content into the small intestine and is usually in reaction to a sugary meal. It will usually happen within about half an hour of a meal – this will be a clue as to whether or not your diarrhoea is “dumping” or caused by something else. Read more about dumping here.  The best way to avoid “dumping” is to avoid sugary foods.

Meal replacement or protein shakes.

Along the same vein as the lactose intolerance and dumping syndrome, meal replacement shakes can be a bit too rich or high in sugar which can cause diarrhoea after sleeve gastrectomy. To reduce your reaction to these, try using a lactose free milk to base them on, or swap to a clear protein powder like Bodiez Protein Water or Beneprotein added to water instead of the sugary or milky options.

None of the above

Sometimes diarrhoea can be caused by a bug just like any stomach. If you have constant diarrhoea or are struggling to keep up your fluids, please see your GP asap so they can help rehydrate you and give you a treatment plan for the infection.

Finally… If you’re ever unsure or worried about your bowels, please don’t hesitate to contact your team. It’s much better to be safe than sorry.