Acute Abdominal Pain in the Bariatric Surgery Patient

Bariatric surgery, gastrointestinal hormones, and the microbiome: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022

“…Intestinal or small bowel obstruction may occur after RNY, BPD/DS, or open surgical procedures and can be associated with the following: [ [75] , [76] , [77] , [78] ]. Abdominal pain, nausea/vomiting, (constipation/obstipation not present if partial) Usually occurs six months or longer after surgery; but can occur anytime May be associated with an internal hernia, narrowing of the roux limb due to scarring, intussusception, and/or adhesions Evaluation: CT scan abdomen most common but can also sometimes be seen on plain flat/upright abdominal x-rays …”

“…Band obstruction issues, including band slippage, band prolapse, or bands that are too tight, can occur with LAGB and are associated with the following: [ 72 , 76 , 77 ]. Abdominal pain, reflux, and regurgitation of post-prandial undigested food May result in dependence on liquid caloric consumption Diagnostic testing: Can be clinical diagnosis, or upper GI imaging/EGD Surgery indicated for a slip which is not relieved after the complete removal of all band fluid …”

Non-pharmacological Treatment Options in the Management of Diabetes Mellitus

“…Another common complication is small bowel obstruction within the first month of surgery that presents with severe abdominal pain, nausea, vomiting, obstipation and tachycardia resulting from kinking at the jejuno-jejunostomy site, anastomotic site stenosis, external compression, or adhesions or herniation through the trocar site. 58 , 59 Early dumping syndrome associated with cholinergic symptoms such as vomiting, tachycardia and dizziness (within 30–60 minutes of food intake) occurs in several cases, especially after taking carbohydrate-rich food due to the rapid exposure of undigested carbohydrates to the distal small intestine. Late dumping syndrome, the clinical features of which results from hypoglycaemia, occurs 1–3 hours after a meal due to excess insulin release.…”