Why Am I So Cold After Bariatric Surgery

Life After Gastric Bypass Surgery
Little known side effect – Flatulence

What is it?

Gastrointestinal surgery such as gastric bypass is often the best option for someone that is severely obese and is unable to lose weight with traditional diet options. Gastric bypass and other weight loss surgeries work by restricting the food intake. Gastrointestinal surgery for obesity, also called bariatric surgery, alters the digestive process.
Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. In a gastric bypass, the part of the intestine where many minerals and vitamins are most easily absorbed is bypassed. They restrict both food intake and the amount of calories and nutrients the body absorbs.
Most people who have open gastric bypass surgery quickly begin to lose weight and continue to lose weight for up to 12 months.

What To Expect After Surgery

Patients are typically notified up front of the possible side effects and severe risks of the surgery, such as fatality. The patient needs to decide if this surgery is right for them because the gruesome side effects may not outweigh the benefits.

Side Effects

One of the biggest side effects of gastric surgery results from the reduction of calorie and nutrient absorption. Because gastric bypass operations cause food to bypass the stomach and parts of the small intestine, where most of the iron and calcium from food is absorbed, women run the risk of anemia, developing osteoporosis, and other nutritional deficiencies. Nutritional supplements can counteract these deficiencies, but they must be taken life-long. The more extensive the operation, the greater the risk is for complications and nutrient deficiencies.

Documented side effects of gastric bypass include:

  • An iron and vitamin B12 deficiency occurs more than 30% of the time. About 50% of those with an iron deficiency develop anemia.
  • The connection between the stomach and the intestines narrows (stomal stenosis) 5% to 15% of the time, leading to nausea and vomiting after eating.
  • Ulcers develop 5% to 15% of the time.
  • The staples may pull loose.
  • Hernia may develop.
  • The bypassed stomach may enlarge, resulting in hiccups and bloating.

Ten to 20% of people who choose this option have to have follow-up operations to correct complications (abdominal hernias being the most common), and more than one third develop gallstones from the rapid weight loss. The risk of developing gallstones can be countered though by taking supplemental bile salts for a short time after surgery. If a woman for any reason believes she might be pregnant, she should avoid such severe weight loss, or wait to become pregnant until her weight has stabilized.

This is clearly a difficult decision, and one that should only be made after receiving all available information on the potential risks and benefits. There are many online resources available on gastric bypass surgery and obesity.

Other common side effects of gastric bypass:

  • Nausea and Vomiting
  • Dehydration
  • Food Intolerance
  • Changed Bowel Habits
  • Cold Intolerance

An unpublicized side effect of gastric bypass surgery is excessive flatulence odor.

It is understandable why these patients have highly malodorous flatus. The surgery causes them to have a malabsorptive syndrome. Their systems don’t absorb the food and nutrients as well anymore and when the undigested food gets down to the colon, the enzymes and bacteria go crazy digesting the food. One of the by-products of their digestion is gas (flatulence).

Most post surgery patients are desperate for a solution to this side effect, which actually causes embarrassment and most of these individuals have been dealing with embarrassment for most of their lives. The majority of these patients will try over- the -counter medications, only to be disappointed to find out they’re ineffective and very costly.

Helpful solution

More and more gastric bypass patients are contacting a company called Flat-D Innovations, which specializes in odor control (caused by flatulence). Flat-D Innovations is the manufacturer and distributor of a non-drug, non-invasive and simple solution to your odor problems called the Flatulence Deodorizer. It is an activated charcoal cloth pad that is placed in the underwear next to the buttocks. When intestinal gas passes thru the pad, it deodorizes and neutralizes it.

Flat-D Innovations has been contacted by many gastric bypass patients and has worked with them to develop several different products to meet their special needs.

May 2011
New Testimonial – " Thin and Happy- no problems! ".

I thought I’d go back into hiding after my bypass surgery. I was so isolated when I was obese – then, this horrible gas problem afterward! Even my daughter wouldn’t go shopping or eat out with me! And meeting my son-in-law-to- be or his family. I fasted for a week! I don’t know what it is about flat-d. When I put it on, I have LESS gas! I think it’s because I’m not as nervous. It really WORKS! It doesn’t take ALL the problems away – I still have to be careful with some veggies and beans, especially when I work or have meetings – but my confidence and HAPPINESS is 150% better. I would never be without flat-d! Now I’m thin and HAPPY! And I had a marathon shopping day with my daughter – no problems! THANK YOU!
I.S. – Seattle, WA

February 2008
" You have changed my life! ".

Just one weekend of using your product and I am no longer a social pariah! There’s no point in trying to be delicate about a problem like this I had gastric bypass surgery about 9 months ago and have beyond awful gas. There is nothing I can take (Beano – Gas-X, etc) that works. I have tried being very careful with what I eat (and I don’t eat much!) My coworkers have been pretty nice about it for the most part, but I know it was hard to work in a small office with someone like me. I never went anywhere without a bottle of air freshener. My family complained all the time and I know I was an embarrassment to them. I sat at home in a room by myself a lot. In social situations, I would have to leave and find someplace to hide and pass gas. Fine if it’s a public restroom, but not so discreet if you’re in someone else’s home. Then I ordered your product. My first day using it, and it was unbelievable. I’m at work and my colleagues are laughing with me, not running away! I can ride in the car with my family and keep the windows up! It’s absolutely amazing. A bonus is the protection it also provides against feminine odor. I’m a new person and can walk free and confident in public now without fear of embarrassment. THANK YOU.

We highly recommend the website content. BariatricPal support site

Here is a wonderful resource for information before or after surgery Bariatric Surgery Source

Click below to order the Flatulence Deodorizer pad:

Alcohol Consumption after Bariatric Surgery

What Happens When You Drink?

We have all experienced the effects that come with drinking an alcoholic beverage or two. Drinking alcohol can come with considerable costs also. Moderate amounts of alcohol can feel socially beneficial, but an excessive amount can cause a variety of negative consequences. Impaired judgement from excessive alcohol can cause people to over-consume empty calories and perhaps drive when they shouldn’t. It is important to remember that weight loss surgery cannot protect you against gaining weight from liquid calories and alcohol relaxes the esophagus and stomach, allowing you to eat even more. The combination of impaired judgement and a relaxed stomach can be a dangerous combination!

Risks of overconsumption of alcohol can stem beyond calorie surplus and have even more serious consequences. After bariatric surgery, even 1 drink could place someone at risk of getting a DUI. Obviously, this is never worth it!

Why do you get drunk faster after bariatric surgery?

Weight loss surgery makes all of the consequences of drinking alcohol come a lot faster. When the stomach is smaller, there is less of the enzyme alcohol dehydrogenase present in the body. This enzyme is responsible for breaking down alcohol, therefore alcohol lingers in the system longer and peaks higher. Because of reduced stomach size, alcohol also moves more rapidly into the small intestine, causing it to be absorbed more quickly.

Tips to plan ahead for social gatherings

  • Eat your meal before you drink
  • Rule of thumb- 1 drink before surgery = 3-4 drinks after surgery – know your limit!
  • If you do drink, consider options that are low in sugar and avoid mixed cocktails that contain juice or soda
  • If you are to drink, have your 1 drink after other people have had a few too so that you feel the effects at a similar pace and you are less pressured to overconsume as the night goes on
  • You may carry around some water in a cocktail glass with some lime and sip on it at the beginning of the night so that you do not need to repeatedly explain yourself why you do not have a drink in your hand
  • Be aware of the possibility of addiction transfer. If you have been addicted to food in the past you want to be aware of the risks of becoming addicted to alcohol and keep yourself out of situations that put you at risk.

Non-Alcoholic Mint Mojito

1/2 cup natural sweetener ex: Stevia or Swerve

1/2 cup fresh mint leaves

1 oz lime juice (approx half a lime)

Instructions Simple Syrup

Boil water and natural sweetener over the stop for about 5 minutes or until thickens into a syrup.

Instructions for Mojito

  1. Add mint leaves to a glass container with a lid (such as a mason jar). Pour syrup over mint leaves and let steep at least 20 minutes. Use immediately or can save for later.
  2. Add ice to drinking glass. Pour 1 tbsp of mint syrup and 1/2 cup cold water. Add 1 oz lime juice. Stir and serve.
  3. Add more mint syrup or lime juice per preference. Recipe Notes This recipe makes one mojito with additional simple syrup to make 4 glasses.

This recipe provides an estimated 32 calories, 0 grams protein, 3 grams carbohydrate and 0 grams fat.

With the holiday season upon us, we encourage you to have fun and enjoy social functions with friends, family and co-workers. Just be careful and remember, “everything in moderation”!

Sources:

Dr. Duc Vuong on “Alcohol after weight loss surgery”

After Weight Loss Surgery

Common Questions after Bariatric Surgery

After surgery, there are a number of common questions and concerns that come up with patients. Southern Nevada Bariatrics has compiled a list of the most common ones. Should you experience any of these and do not see them getting better as you heal, please contact the office to discuss so that we can help you.

After surgery many people experience hiccoughs. They are common but they can be annoying so be sure that you are eating small portions and be careful when beverages are too hot or too cold as this may trigger them. The most common reasons are drinking carbonated beverages since they create gas, drinking too much alcohol, eating too fast and even stress and excitement.

Hair loss is very common in the first few months for anyone who has had surgery, but it is especially true for bariatric patients due to the lack of vitamins and minerals. Remember you are eating less and your body is not able to absorb all that you need with the small portions you are eating. Dr. Ahmed encourages you to follow the dietary supplementation requirements for your surgery type and get your lab work done regularly to make sure deficiencies can be addressed to keep you healthy.

Even though we don’t like to discuss this, it is important to know that it is normal to get air in your digestive tract. When you eat or drink some, air is swallowed, which can cause gas. Be sure to eat slowly with your mouth closed, don’t gulp or drink beverages with a straw and abstain from carbonated beverages to minimize gas. You can also document what foods are causing you discomfort and gas and take them off of your list for a while.

After you have a bariatric surgery, diarrhea can occur. It is usually within the first week or two after surgery but if it persists or you are not feeling well because of it, please contact the clinic to discuss.

There are a number of reasons why patients experience heartburn. One reason is based on the surgery you had. For instance, if you had the gastric band it might be too tight. Other reasons are related to the food you are eating so write down the foods that bother you and avoid them and re-introduce later to see how your body responds. Avoid overeating, chew your food and abstain from spicy, acidic foods. Do not lie down after eating and Dr. Ahmed suggests that you not eat at all within a few hours of going to bed.

Alcohol Consumption/Tolerance

Alcohol should be avoided for at least 3 months after surgery. A little goes a long way as it goes into your system much quicker and can remain for quite a while. Alcohol also has calories so even though it is a liquid, it is not calorie free. Do not drink and drive.

After bariatric surgery, you cannot get the same amount of vitamins and minerals through your diet alone due to the small portions you are eating. It is so important to follow the vitamin and mineral supplementation instructions given to you by the dietitian. Nutritional deficiencies can occur and that is another reason we have you draw labs at 6 months and annually for the rest of your life, to ensure that your body remains healthy.

Dining Out After Surgery

It’s really not too difficult and a number of patients have shared some great ideas that can help take the stress out of what can be a great time. You can order from the healthy section plates or chose a meal that you know you can split and eat later. Immediately split your plate and put it in a to-go box first. Chose your meal around your protein and substitute white starches for fresh vegetables. Get all sauces, gravies, and dressings on the side. Eat slowly and enjoy the social experience with friends and family. You can actually be more engaged in conversation with those around you. Take your time and be sure to sit back and place your fork on your plate between bites. People will be impressed by your self-control. It’s amazing how fast we eat and don’t even enjoy our food. With a few easy changes, you will enjoy your time dining out.

That Hungry Feeling

Bariatric surgery is a tool to help you control hunger and portions so that it limits the amount of calories you are consuming. Don’t eat to be full, but rather eat to be healthy! We are conditioned to eat until we feel full, but this will be uncomfortable after bariatric surgery, so eat with portion control in mind.

Constipation

Even with regular anatomy, we all can experience some constipation but there are different levels of constipation ranging from occasionally to chronic. Hard and dry stools can be painful to pass. Remember too that your diet has changed considerably so you may need to add fiber supplement. Exercise and drinking the recommended amount of water each day will also help to keep you regular.

Dumping Syndrome

After bariatric surgery, your stomach is much smaller so it is important to be mindful of what you eat. Dumping syndrome is generally caused by food and fluid consumption, especially foods that contain a high amount of sugar. If you experience this after eating a particular food, make a mental note to take that food off your list, although we think you will do that anyway as the experience itself is very uncomfortable. Each person is different, but dumping syndrome side effects include nausea, diarrhea, dizziness, weakness, sweating, immediate fatigue and just in general not feeling well.

Conclusion

Stay focused, journal your experience and follow the instructions you received from the Southern Nevada Bariatrics team. If you have any questions or concerns, please call the clinic so we can help you stay on track.

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