6 months post OP, throwing up only in the morning after meal. Can eat later in the day. Is this a concern?

Question

Within the first 2-3 hours after waking up any ingestion of food causes me to throw up. Is this just part of the reflux? Or is this a concern?

Babak Moeinolmolki, MD, FACS · Answer

Hello,
As curious as it sounds, some patients can experience dependent edema (tissue swelling) of their esophagus and upper gastrointestinal tract, preventing them from being able to eat until later in the day, when the edema has resolved (i.e. the fluid has redistributed). This dependent edema is similar to the ankle and foot swelling that some people experience at the end of the day.
Another possibility is that your acid reflux is worse at night and in the morning due to your horizontal body position. Sometimes this can be helped with adding a pillow and resting at at 35-45 degree angle.
Evaluation by your bariatric surgeon will help you uncover the most likely of your morning post-meal vomiting.
Best wishes,

Ali Solmaz, MD · Answer

That sounds like it could be related to reflux or delayed gastric emptying, both of which are common after weight loss surgery. Since you're able to eat later in the day without issues, it suggests your stomach might be more sensitive in the morning, possibly due to overnight acid buildup or irritation. However, persistent morning vomiting could also be a sign of something more concerning, like a stricture (narrowing of the stomach), an ulcer, or even bile reflux.
A few things to consider:
- Are you taking a PPI (like omeprazole or pantoprazole)? If not, it might help with acid-related irritation.- Have you tried starting with a warm liquid in the morning instead of solid food? This can sometimes ease the stomach into digestion.- If you experience nausea before throwing up, it could be gastroparesis (slow stomach emptying).
Since this has been happening consistently for a while, I’d recommend checking in with your surgeon or a gastroenterologist to rule out any complications.

6 months post OP, throwing up only in the morning after meal. Can eat later in the day. Is this a concern?

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