I had gastric sleeve surgery 5 years ago. Why now am I throwing up after eating very little?

It’s concerning that you’re experiencing vomiting five years after your gastric sleeve surgery, especially after eating only a few bites. While some food intolerances can persist or develop over time, consistent vomiting should never be ignored.
From what you’ve shared, it seems the episodes may be triggered by certain fried or salty foods. These types of foods can be difficult to digest for some post-bariatric patients, even years after surgery. The high fat and salt content can irritate the stomach lining or cause a delayed emptying response, which might explain your symptoms. However, since not all fried foods cause the reaction, there could be other underlying issues at play, such as gastritis, a stricture, or even bile reflux. Sometimes, the way the food is prepared—how greasy it is, how much oil is absorbed, or what type of oil is used—can make a difference.
Given the frequency and severity of your symptoms, it’s important to consult with your bariatric team or a gastroenterologist. They may want to do an upper endoscopy to check for inflammation, narrowing of the sleeve, or other complications. In the meantime, keeping a detailed food and symptom journal could help identify more specific triggers and patterns. It's also wise to avoid any foods that consistently cause problems, even if you’ve tolerated them before, as your digestive system can change over time.

Unusual to have these symptoms five years after the gastric sleeve.  It could have been the change in diet or food but it could be other things.  Do you still have your gall bladder?  Gall bladder issues can present with nausea and vomiting after eating.  It can also be gastritis or inflammation of the sleeve pouch.  Good idea to consult with a bariatric surgeon, you may need to have an EGD or endoscopy to check the status of the sleeve.  He or she may also want to do an ultrasound to check for gall stones.  

I would touch base with your surgeon to make sure all is well. It may just be the sleeve is swollen and a simple round of antacids would suffice but it’s always better to make sure that all is well. I hope you find this useful. warm regards, Dr. Alvarez