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  • Q&A with Australian Health Practitioners

    I have a gastric band. Why do I bring up mucous regularly?

    Related Topic
    Obesity
    I have had a gastric band for 2 years. I find I regularly bring up stomach juices or mucous when I try to eat something. How can I stop this from happening?
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    Amanda Clark

    Dietitian, Nutritionist

    Amanda Clark (Adv APD) is a senior dietitian at Great Ideas in Nutrition on the Gold Coast. She is the creator of Portion Perfection, a … View Profile

    An unfortunate by common side effect of gastric banding is the regurgitation of saliva when a minor blockage occurs. The saliva may be quite thick and frothy but that is all it is. When this occurs it is the result of a narrowing of the exit from the small top stomach that has been there for several hours. 

    Sometimes a few fibres of the previous meal sit around the area of the band creating a sieve like effect. You are swallowing saliva every minute of the day. The thin liquid part of the saliva moves through the seive and into the bottom pouch of the stomach, but the thicker, mucousy part of the saliva doesn't get through, so it builds up in that top pouch.

    Hours later you might eat something as safe as some yoghurt, but when it arrives in the saliva filled top stomach pouch the chances are it's all going to come up. 

    This means that regurgitation often has nothing to do with what you just ate, but comes from the previous meal.

    The way to avoid this is to ensure you can drink freely before each meal. Sip a glass of water first, to try and water down any saliva and get it through to the bottom pouch. Then drink a glass quickly, this will ensure that any blockage either gets washed down or bounces back up. It's a good strategy to carry a bottle of water with you, and go to the bathroom if you're prone to problems.

    Once you can drink freely, you should be able to eat freely but you still need to pay attention to all the other eating behaviours required to get the best tolerance with a band. They are:

    1. Postion - sit upright. Slumping creates some upward pressure which can make it difficult for food to move smoothly into your small stomach.

    2. Drink - as above

    3. Chop your food well. It should be small enough to fit through a hole the size of a 5c piece.

    4. Take small bites to ensure that there is s space for air to move up your oesophagus as food travels down. If you attempt to swallow too much food in one go, you may find it feels as though it is getting stuck part way down. This is because there is air caught underneath the food which can't get past. In milder cases this can result in excessive burping.

    5. Notice the taste, texture, temperature and aroma of the food.

    6. Chew your food well. This is no substitute for chopping however. 

    7. Relax! Tension creates upward pressure which can make it more difficult for food to go down.

    8. Slow yourself right down and enjoy!

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  • 23

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    Dr Kenneth Wong

    Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon

    Dr Ken Wong is a very experienced specialist surgeon focussing on keyhole surgery techniques for gallstones, bowel cancer, hernia and weight loss surgery. He graduated … View Profile

    I see this problem a lot in my weight loss surgery practice.

    Often the patient is eating too fast or not chewing their food well. I also find that if they are lying down or lie down soon after eating, there is a lot of regurgitation of stomach juices and mucous.

    However, often the band has slipped over time and the symptoms resolve if the band is deflated.

    If the symptoms persist after band is deflated, I would be concerned that there is some erosion of the band into the stomach or persistent enlargement of the stomach. 

    In these circumstances, I often recommend removal of the gastric band which gives instant relief. The downside of this is that weight regain will occur.

    Ken Wong
    http://www.centralcoastsurgery.com.au

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    Anonymous

    Some day I can get food down and some days I can't

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