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1 thing you should know about persistent vomiting after bariatric weight loss surgery

Neurologic injuries are a rare, but real, risk

Bariatric weight loss surgery is a relatively new field in medicine. Experts in this area have conducted numerous studies that have concluded that a surgical option is effective to help many types of patients maintain healthy weight and lifestyle.

Like any surgery, though, bariatric weight loss procedures are not risk-free. Some studies have found that 5–10% of post-bariatric surgery patients develop neurologic complications in the months to several years after their procedures.

In many types of surgeries, the neurologic risk is related to the possibility that a nerve could accidentally be cut or lacerated during the procedure. That’s not the principal concern in bariatric weight loss surgeries. Patients who develop neurologic issues after bariatric procedures are usually found to have a nutritional deficit that’s the culprit.

Virtually all bariatric patients have some degree of nausea and vomiting after surgery. For some, though, it’s unrelenting. These folks have difficulty holding anything down, including essential nutrients. They can’t make up the different with oral supplements because they can’t keep them down either.

Plus, patients who have a gastric bypass surgery, such as a Roux-en-Y, grapple with the effects of malabsorption, which is an intended effect of the surgery. The idea is to bypass the majority of the bowels to prevent absorption of excess calories. Yet, there has to be a happy medium to allow enough absorption for the body to get the nutrients needed for normal function.

Too little thiamine or Vitamin B1

Vitamin B1 is also known as thiamine. It’s a water-soluble vitamin and, thus, isn’t easily stored by the body. That means that we need to absorb adequate amounts through the daily diet.

Not having enough thiamine can cause a wide array of problems, the worst of which is a brain injury called Wernicke encephalopathy.

Wernicke encephalopathy brain injury

According to the medical literature, less than 1% of bariatric surgery patients develop the terrible disorder of Wernicke encephalopathy. Yet, considering that there are around 200,000 bariatric surgeries performed every year in the United States, that’s still a lot of people.

The diagnosis of Wernicke encephalopathy requires three elements:

Gait ataxia. This is an unsteady, uncoordinated, staggering type of walking.

Ophthalmoplegia. This refers to a problem with the muscles of the eye, causing unusual eye movements.

Altered mental status. This means that the person is behaving differently than normal.

Most patients who develop Wernicke encephalopathy after bariatric surgery do so within 6 months, but symptoms may begin in the 4–12 weeks post-operative timeframe.

The faster it’s diagnosed and treated, the better for the patient. The current recommended treatment is parenteral thiamine administration, meaning administering Vitamin B1 via an intravenous (IV) line. Delayed treatment can result in a permanent brain injury or even death.

Watch out for persistent vomiting

Bariatric surgery experts recommend that all patients receive appropriate follow-up care, including assessment of nutritional status. This is doubly important for patients who have significant or long-lasting vomiting, because of the difficulty created absorbing adequate nutrition, including Vitamin B1.

In our experience, some bariatric weight loss surgeons and clinics drop the ball after surgery by not providing their patients with good nutrition and follow-up instructions. For some patients, this can contribute to serious problems, including Wernicke’s encephalopathy.

If you’ve been seriously injured in Texas because of poor bariatric weight loss care, then contact a top-rated, experienced Texas medical malpractice attorney for a free consultation about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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