Can’t vomit after weight loss surgery?

How common is that?

Well, considering that many vomit post-operatively with no issues and frequently (when overeating, not tolerating certain foods, eating too much too fast and so on), this issue is not too common. But it seems to be more frequent among gastric bypass patients rather than gastric sleeve.

What is the cause?

There are two main reasons why you may not be able to vomit after weight loss surgery.  

• First of all, part of the vomiting mechanism depends on the contractions of the stomach (the stomach is basically one large muscle that contracts when needed). Your new pouch is simply too small to be able to generate a contraction strong enough to produce vomiting.  
• Secondly, the other part of the vomiting mechanism involves contraction of the abdominal muscles around the stomach to assist with expulsion. And again: your pouch isn’t big enough for that to work as well as it did before. A small stomach means less surface area for the muscles to contract around, and because it sits up high, the abdominal muscles don’t have as direct contact with it as they did with a normally sized stomach.

How to fix?

The truth is there is no fix. Some people have more control over vomiting than others, and some report that strengthening their abdominal muscles (via exercise or tummy tuck) made vomiting possible again or easier.