Food Getting Stuck?
Why and what you can do if food is getting stuck after Bariatric Surgery
What is happening when food is stuck?
While each bariatric surgery is different, the reason food feels stuck is because the entrance into the stomach is smaller.
Smaller stomach means smaller door so to speak. When food is stuck, it’s usually too much food trying to move from the esophagus into the stomach pouch.
(Quick rundown of basic digestion process. Chew food in the mouth, swallow and food goes into esophogus. Moves into the stomach and starts to church and break down food. Moves into the small intestine where most nutrition is absorbed, then moves to large intestine and the rest is eliminated.)
Whether you had a sleeve and you have a “small banana” sized pouch or you had a bypass and it is the “size of a large egg” the entrance into the pouch is smaller and food more easily gets stuck in the esophagus trying to enter the stomach.
Typically, it is because of too large of a bite or too quick of eating.
While the visual may differ from patient to patient, I use the top of a highlighter marker to show the size of the entrance to a post-op pouch. I recommend bites the size of a black bean or your small pinkie finger to allow food to fit comfortably into the stomach.
Why does food feel stuck after two bites?
It is such an uncomfortable and frustrating experience to have two bites of food and feel the stuck feeling right away. Ugh!
This is even more true with more solid protein like chicken, beef or pork. The more dense the protein, the harder it hits.
So why does it happen?
Primarily it is related to the size of the bite. If not that, then not waiting in between the bites and they backed up on one another.
Other times, the stomach pouch could be irritated and therefore more inflammed and even more sensitive to too large of a bite. Let’s say you had chicken breast at dinner the night before and it felt uncomfortable. The next morning you had eggs and after two bites it felt stuck again.
The chicken from the night before may have irritated and inflammed the pouch making you more sensitive to the eggs. If you have had a rough meal, consider going back to shakes and water for a few meals until you feel your stomach is settled enough to try again.
When you do “start again” after going back to liquids for a little while, start with something soft like tuna salad, beans or shaved deli meat.
Don’t get stuck on soft foods long term.
Very often I see patients feel uncomfortable with solid protein and decide they can only eat yogurt and cottage cheese. It really DOES matter to rest the pouch, try again and move back towards solid protein focusing on your bite size and speed.
Getting stuck on soft protein foods long term can limit your results.
You can eat more cottage cheese and yogurt than you can turkey burger or pork chop. This means larger portions, even if they are great protein sources. Softer food also leave the stomach pouch more quickly.
Softer protein sources mean larger portions and feeling hungry sooner.
It also limits your diet so feeling bored and food fatigued is much more likely. This makes staying away from tempting foods even HARDER. Keeping variety and excitement in the post-op diet is incredibly important to stay on track over the long haul.
(By the way, soft protein includes tuna salad, chicken salad, shaved deli meat, flakey fish, eggs, cheese, cottage cheese, yogurt…)
Why is it pain in my chest, not in my stomach?
In both my personal experience and as a bariatric dietitian, I can say that pain in the internal parts of the body can be hard to pinpoint.
Is it my stomach or my ribs? Is it my kidney or my back?
This is why doctors ask, “is it sharp or dull? Does it hurt more when you breath in?” They ask diagnostic questions to identify the source of the pain. It’s not very clear.
When food gets stuck, mostly it feels like it is in the chest. This makes some sense because the esophagus travels through the chest and goes through the diaphragm to connect to the stomach. The stomach is under the diaphragm (the large muscle that you feel expand when you breath in deeply).
As odd as it may seem, food getting backed up between the opening of the esophagus to the stomach might feel like it’s higher up in the chest.
What can I do when food feels stuck?
Here is the best question of all. Yes, when food gets stuck it is usually a lesson learned.
Too big of a bite. Too quick of eating.
But what about your options in that very moment to get relief?
First let me tell you what not to do. (You may have already learned this). Avoid drinking anything.
It might seem like sense to drink water to get it to push the food through. However, lodged food with liquid on top typically makes it worse.
Many patients will recommend meat tenderizer or papaya enzymes to help break down the stuck food. It would require a small amount of water to add the meat tenderizer to or to swallow the enzymes tablet.
You can also rub your chest, walk around, sit up in a chair for a while and wait for it to pass.
Final note on keeping moisture in meats
If meat is feeling too dry, there are ways to increase the moisture content. Keep in mind, sometimes it feels too dry because the bites are too big and hitting too heavy.
Here are a few tips on keeping moisture in meats, or you can read a full blog post here.
Cover your meats when you cook
Use stoneware when baking
Use extra broth to increase the liquid meat is cooked in
Use a meat thermometer to avoid overcooking meat
Reheat foods with a damp paper towel
You may also be interested in this blog post Why Do “Bad Foods” Go Down the Best?
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-Steph Wagner, MS RDN