Twisted Stomach After Gastric Sleeve [Updated 2024]: Know Everything About It.

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Stomach cramps or gastric torsion can sometimes occur after gastric sleeve weight loss surgery. This is not very common and is estimated to affect only 0.69% to 2% of people after surgery. But when this happens, it can cause vomiting, nausea, pain, or reflux.

Since many conditions can cause these symptoms, or there may be none at all, doctors may have difficulty diagnosing a twisted stomach. But if it is not caught early it can cause serious complications.

Here’s what a twisted belly is, why it happens, and what you can do about it.

Why does your stomach get twisted after gastric sleeve?

Doctors perform gastric sleeve surgery to help obese people lose weight safely. During the procedure, doctors remove almost all of your stomach, including the part that makes you hungry. The remaining part is a banana or sleeve-shaped tube that the doctor closes with staples.

Because your stomach is much smaller and sends fewer hunger signals, people usually eat less and lose weight after surgery.

Sometimes, a few days, weeks, or even a year after surgery, the tube-shaped part of your stomach may move or twist. The twist can prevent food and blood from getting into your stomach.

A 2022 study of 2,723 people who had gastric sleeve surgery found that only 1.6% experienced gastric twist. Most had no symptoms related to torsion. In those who did, symptoms were generally mild. Vomiting was the most common.

It can be difficult to diagnose at first because the symptoms of gastric twist are not very specific. However, a twisted stomach can cause serious complications. The sooner you catch it, the easier it will be to treat.

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Is this the same as Dumping syndrome?

Twisted stomach is different from dumping syndrome, although gastric surgery can cause both.

Dumping syndrome occurs when food moves from your stomach into your small intestine too quickly. Meanwhile, the folded stomach prevents food from passing from your stomach into your small intestine.

You may notice symptoms of dumping syndrome within minutes of eating or 1 to 3 hours after a high-carbohydrate meal. Your symptoms are similar to those of a twisted stomach. They may include:

  • cramps
  • burping
  • upset stomach
  • diarrhea
  • throwing up

Most of the time, you’ll be able to avoid Dumping syndromeTrusted Source by:

  • eating smaller, more frequent meals
  • waiting for 30 minutes after a meal before drinking water or other beverages
  • avoiding sugar or milk products
  • eating more foods with protein and fat and less with carbohydrates

What symptoms do you have with twisted stomach?

Gastric twist often doesn’t have any symptoms. But when you do have symptomsTrusted Source, they may includeTrusted Source:

  • vomiting
  • nausea
  • difficulty swallowing
  • pain
  • reflux

What causes your stomach to twist after a gastric sleeve?

It’s not always clear what creates a gastric twist after surgery.

Researchers think it may be caused by:

  • disruption of the ligaments that support the stomach during surgery
  • unequal traction on the different sides of your stomach when surgeons are applying staples
  • swelling
  • hematomas (collection of blood outside a blood vessel)
  • incorrect staple placement during surgery

How long does it take to heal after gastric sleeve?

Most people stay in the hospital for 1 to 3 days after weight loss surgery. Returning to normal activities usually takes between 4 to six weeks.

Are there long-term effects of a twisted stomach?

Although gastric twist may cause no symptoms at first, it can become a potentially serious complication of gastric sleeve surgery. Depending on how badly your stomach is twisted or twisted, it can block the flow of blood and nutrients.

It is important to treat it as early as possible to improve outcomes.

How do you treat twisted stomach?

Doctors can best treat a twisted stomach by catching it early and using endoscopy and laparoscopic surgery. Endoscopy is usually the first line of treatment.

Other ways to treat it include:


A folded stomach is a rare complication of gastric sleeve surgery. Stomach cramps after gastric sleeve can occur for several reasons, including problems that occurred during surgery.

Symptoms of stomach cramps, such as nausea and vomiting, do not always indicate a problem, so it can be difficult to diagnose. Doctors have many ways to treat it, but catching it as early as possible is essential for the best results.

Gastric Sleeve Diet

After gastric sleeve operation, you may need to follow a specific eating plan during recovery. This may involve consuming only clear liquids for a period of time and eventually adding other foods to your diet.

If you’re planning to have gastric sleeve surgery, you’re probably wondering how you’ll be able to learn to eat in a whole new way. Preparing for your life after gastric sleeve surgery will be exciting, but also challenging.

The diet you will need to follow before and after surgery is very specific and tailored to aid recovery and avoid complications.

As time goes on, your diet will help you achieve healthy eating habits so you can continue to lose weight and, ultimately, maintain a healthy weight throughout your life.

It is important to remember that this article is merely a rough outline of what to expect before and after surgery, and is in no way a clinical guideline that will apply to every patient. Your health care professional should closely follow your progress after surgery and tailor your diet to your needs.

Pre-gastric sleeve diet

A main, presurgery diet goal is to shrink your liver. If you are obese, you are likely to have an accumulation of fat cells in and around your liver. This makes it bigger than it should be.

Your liver is located right next to your stomach. An overly large liver makes it harder for your doctor to perform gastric sleeve surgery, and more dangerous for you to perform it.

To prepare for the procedure, you will be given a specific diet to follow, starting two weeks before your scheduled surgery date.

It is a strict diet that reduces calories as well as carbohydrates, such as sweets, potatoes and pasta. You’ll eat mainly low-fat proteins, vegetables, and fluids with low or no calories. Your doctor can give you a calorie goal to follow daily.

Two days before surgery, you will switch to a clear, liquid diet. This might include one unsweetened protein shake per day, in addition to broth, water, decaffeinated coffee or tea, Jell-O and sugar-free popsicles. Caffeinated and carbonated beverages should be avoided.

Week 1 diet

For the first week after the procedure, you will continue the same clear liquid diet that you followed in the days before surgery.

This will help avoid postoperative complications including bowel obstruction, gastric leakage, diarrhea, constipation and dehydration. Your body needs time to recover, and this diet will help with that goal. Tips to keep in mind include:

  • Make sure you drink plenty of clean fluids. If you’re having trouble staying hydrated, talk to your doctor about low-calorie electrolyte drinks like Gatorade.
  • Don’t drink anything with sugar. Sugar can contribute to dumping syndrome, a complication caused by too much sugar rapidly entering the small intestine. This results in severe nausea, fatigue, diarrhea and even vomiting. Sugar is also full of empty calories.
  • This should be avoided now and minimized in the long run.
  • Caffeine can contribute to acid reflux and dehydration, and should also be avoided.
  • Carbonated beverages, including those containing sugar, no-calorie alternatives, and seltzers can all contribute to gas and bloating. All of these should be avoided after the operation and possibly for a long time.

Week 2 diet

During the second week after surgery, you will graduate to a full-liquid diet. Options include:

  • no-sugar nutrition shakes, such as Ensure Light
  • instant breakfast drinks
  • shakes made with protein powder
  • thin broth and cream-based soups with no chunks — soft soup noodles are ok in very small amounts
  • unsweetened milk
  • sugar-free, nonfat pudding
  • sugar-free, nonfat frozen yogurt, ice cream, and sorbet
  • nonfat plain Greek yogurt
  • fruit juices with no pulp, diluted with water
  • thinned, hot cereal, such as Cream of Wheat, or oatmeal

During this time you may feel your hunger increasing. This is completely natural, but no reason not to eat solid food. Your system is still unable to handle solids. Vomiting and other complications may occur.

Drinking plenty of fluids and avoiding sugar and fat will help prepare you for the next phase of your diet. Carbonated beverages and caffeine should still be avoided.

Week 3 diet

During the third week, you can include soft, mashed foods in your diet. Make sure you eat slowly and chew food thoroughly – at least 25 times if possible. Any low-fat, sugar-free food that you can puree, including lean protein sources and non-fibrous vegetables, is acceptable.

It is important to start increasing your protein intake. If you don’t like the taste of pure protein sources, continue to drink protein shakes without sugar or eat eggs daily. Foods to eat include:

  • jarred baby food
  • silken tofu
  • cooked, pureed white fish
  • soft-scrambled or soft-boiled eggs
  • soup
  • cottage cheese
  • canned fruit in juice
  • mashed bananas or very ripe mango
  • hummus
  • pureed or mashed avocado
  • plain Greek yogurt

Continue to avoid chunked and solid foods, as well as caffeine, during this time. You should also stick to bland food with mild or no seasoning. Spices may contribute to heartburn.

Week 4 diet

Now that it has been a month since the surgery, you can start introducing solid foods into your diet. It’s time to put your new healthy eating skills into full force. Sugar and fat, including high-fat dairy products, should still be avoided, as well as difficult-to-digest foods such as steak, fibrous vegetables and nuts.

Other foods to avoid include pasta, white potatoes and other high-carb options. Caffeinated beverages can usually be reintroduced in moderation at this time. Foods you can add to your list include:

  • well-cooked chicken and fish
  • well-cooked vegetables
  • sweet potatoes
  • low-fat cheese
  • fruit
  • low-sugar cereal

Week 5 diet and beyond

Now that you can safely eat solid foods, it’s time to put your new-normal eating plan into long-term effect. Emphasize lean proteins and vegetables, incorporating one meal at a time so you can monitor your body’s response.

Foods you should avoid altogether, or eat only occasionally, from this point on include sugary sweets and soda. All other foods can be added back as long as they no longer trigger symptoms.

Choose your foods wisely, choosing nutrient-dense options and avoiding empty calories. Eating three small meals a day with at least one snack can help you stick to your plan. Also make sure you always stay hydrated.

Guidelines and tips

Post-surgical recovery tips that can help you stay on track include:

  • Use a blender or food processor to puree foods.
  • Learn to recognize the difference between hunger (physical) and appetite (mental/emotional).
  • Don’t overeat — your stomach will stretch in time and stabilize in size.
  • Chew slowly, and eat slowly.
  • Avoid non-nutrient calories.
  • Avoid concentrated sugars.
  • Avoid trans fats and fried, processed, and fast foods.
  • Avoid dehydration by sipping water or low-calorie versions of Gatorade.
  • Don’t eat and drink at the same time.
  • Talk to your doctor about bariatric vitamins and supplements to decide what you should take, and when.
  • Build movement into your life. Start with walking, and explore other exercises that you enjoy, such as swimming, dancing, and yoga.
  • Avoid alcohol. Gastric sleeve surgery and other types of bariatric surgeries may increase, and quicken, alcohol’s effects.
  • Avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen, aspirin, and naproxen. These types of over-the-counter pain medications may reduce your stomach’s natural, protective coating.


It’s important to follow the eating plan your doctor provides for you both before and after gastric sleeve surgery. The foods you are allowed are designed to help your body recover, and also to pave the way toward a healthy eating lifestyle for life. Exercise is also a vitally important element.

Is There a Connection Between Gastric Sleeve Surgery and GERD?

Gastric sleeve surgery may worsen symptoms associated with gastroesophageal reflux disorder (GERD).

GERD is a chronic condition associated with frequent acid reflux. This happens when stomach acid leaks from your stomach into your esophagus, the tube that connects your throat to your stomach.

Other symptoms of GERD include heartburn, nausea, and difficulty swallowing.

Some people experience GERD symptoms for the first time after gastric sleeve surgery. However, it is also possible for GERD symptoms to improve after this weight loss process.

This article explores the connection between gastric sleeve surgery and GERD.

How does gastric sleeve surgery increase the risk of GERD?

Gastric sleeve surgery is a type of bariatric surgery. It can help you lose weight fast. Gastric sleeve surgery is also known as:

  • Sleeve Gastrectomy (SG)
  • Vertical Sleeve Gastrectomy (VSG)
  • Laparoscopic Vertical Sleeve Gastrectomy (LVSG)

In this procedure, a surgeon cuts and removes a large part of the stomach. The surgeon then joins the edges of the remaining stomach to create a narrow, sleeve-shaped stomach that is about a quarter of its previous size.

Research has shown contradictory results when it comes to how gastric sleeve surgery affects GERD.

For example, researchers in a 2020 review analyzed two systematic reviews and one meta-analysis evaluating the effects of gastric sleeve surgery on GERD. The results were mixed in all three cases.

Researchers concluded that there is an association between gastric sleeve surgery and an increase in GERD symptoms in the long term.

The 2021 review also noted that previous reviews had shown mixed results. Researchers have cited several studies that suggest that GERD symptoms are more likely to develop, remain the same, or worsen after gastric sleeve surgery.

In another 2020 review, researchers identified three factors that may contribute to GERD symptoms after gastric sleeve surgery:

  • sleeve size
  • damage to the lower esophageal sphincter
  • presence of hiatal hernia.

The researchers suggested that it may be possible to reduce the risk of GERD after surgery by addressing these issues during surgery.

What about other types of bariatric surgery?

If you are considering bariatric surgery, it is important to talk to your doctor about GERD symptoms. Some weight loss procedures may worsen GERD, while others are more likely to help symptoms.

Research shows that gastric bypass, also called Roux-en-Y gastric bypass (RYGB), is the most effective bariatric surgery for GERD. A 2018 review found that gastric bypass is the best weight loss surgery option for people who also have GERD.

Similarly, researchers in 2020 and 2021 reviews previously noted that gastric bypass surgery is generally associated with improvement in GERD symptoms.

In contrast, adjustable gastric banding is another bariatric procedure that appears to increase the long-term likelihood of GERD.

Can GERD cause complications?

Acid reflux associated with GERD can irritate the esophagus. Over time, this irritation can lead to the following complications:

  • Esophageal ulcers: Repeated acid reflux can cause sores to develop inside the esophagus, known as esophageal ulcers.
  • Esophageal stricture: Esophageal stricture occurs when scar tissue associated with chronic irritation narrows the esophagus. These strictures can make swallowing difficult and may increase your risk of choking.
  • Barrett’s esophagus: This complication can occur when exposure to stomach acid causes changes at the cellular level in the esophagus. Barrett’s esophagus can increase your risk of esophageal cancer.

In addition to long-term complications, GERD can also impact your daily life. According to a 2020 review, GERD is associated with reduced physical and social activities as well as mental and emotional difficulties.

When to get care?

If you have had gastric sleeve surgery, you will have several appointments with your doctor in the weeks and months after the procedure. After the first year, your doctor may schedule annual or biennial follow-ups.

These appointments are a good opportunity to talk to your doctor and tell them if you’re experiencing GERD symptoms. It is worth mentioning your GERD symptoms, even if they are mild, as symptoms may worsen over time.

Your doctor can help monitor your symptoms and offer treatment options. If you don’t have a follow-up appointment scheduled and GERD is affecting your daily activities, contact your doctor to get the right diagnosis and treatment.

How is GERD treated?

According to a 2020 reviewTrusted Source, most postsurgery GERD symptoms are treatable with medication. There are a number of over-the-counter and prescription drugs available. These include:

If your symptoms don’t improve with treatment, your doctor may suggest a procedure to convert your gastric sleeve to a gastric bypass.

Although conversion to gastric bypass poses risks, it can improve GERD symptoms in people who previously had gastric sleeve surgery.

The bottom line

Gastric sleeve surgery may increase the risk of GERD. That said, not everyone who has gastric sleeve surgery experiences acid reflux after the procedure.

If you are considering bariatric surgery, it is important to talk to your doctor about your current GERD symptoms. Gastric bypass may be a better option, as it usually helps with GERD.

If you have already had gastric sleeve surgery, be sure to discuss your symptoms with your doctor at your next follow-up appointment.

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Thank you for reading this twisted stomach after gastric sleeve article.

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