Causes of dizziness after bariatric surgery

There can be many causes for dizziness after bariatric surgery. It is not uncommon for patients who undergo bariatric surgery to experience episodes of dizziness or light-headed following the operation. The word “dizziness” can be used to describe feelings that range from feeling faint or lightheaded to feeling weak or unsteady. 

Chemical Imbalance

Many clinical trials have provided evidence that chemical imbalances within the body can result in temporary dizzy spells. For patients who have undergone bariatric surgery, the feeling of dizziness is commonly associated with the restricted diet that accompanies the lifestyle change following the surgery.

For many bariatric surgery patients, dizziness occurs because patients allow too much time to go by in between meals or by not drinking enough water.

The human body requires adequate food and water to function properly, if undernourished and dehydrated, the body does not function properly, electrolytes become unbalanced, and the end result is a feeling of weakness or dizziness.

Electrolytes

Potassium, sodium, and chlorine are the dominant electrolytes in the body. For patients who have undergone bariatric surgery, as well as all patients, it is of extreme importance to eat correctly and drink plenty of water to allow these crucial electrolytes to remain balanced within the body and reduce the chance of feeling dizzy.

If a chemical imbalance is the cause of dizziness for patient who has undergone bariatric surgery, immediately drinking water or small sips of a sports drink such as Gatorade or Powerade may be helpful in treating dizziness.

Reactive Hypoglycemia

Reactive hypoglycemia is condition that can plague patients who have undergone bariatric surgery for more than a year after the procedure. Shakiness, dizziness, confusion, and possibly complete loss of consciousness are symptoms that are associated with reactive hypoglycemia.

Reactive hypoglycemia is defined as low blood sugar that occurs typically 1.5-3 hours after a meal. It should be noted that reactive hypoglycemia is completely unrelated to a diabetes insulin reaction or even a diagnosis of diabetes mellitus prior to the surgical procedure. This condition is simply a side effect of bariatric surgery that occurs in a small percentage of patient who undergo a bariatric procedure. 

Prior to the surgical procedure, the excess weight that is carried by bariatric patients can lead to increases in hormones that increase the production of insulin. Once the patient undergoes a bariatric procedure, patients become more sensitive to insulin, sugar is cleared more rapidly from the bloodstream, which results in the condition of reactive hypoglycemia.

Treatment

Treatment for reactive hypoglycemia should depend on how severe the symptoms are. If you feel a little shaky or a little weak and it is not time for your next meal, try eating a small carbohydrate with a small protein (e.g. 5 crackers and a string cheese). However, if you are close to passing out, you will need to raise your blood sugar rapidly by drinking 4-6 ounces of regular juice.

Prevention

If a bariatric patient is suffering from reactive hypoglycemia, the goal is to maintain a constant blood sugar level throughout the day. Patients who suffer from reactive hypoglycemia need to make sure they are eating well balanced meals and snacks, space 3-4 hours apart. 

Meals and snacks should include a lean protein and high-fiber grains, fruits, and vegetables. Foods that are high in sugar should be avoided as these foods will allow the body to over-secrete insulin which will result in a drop in blood sugar.

It should be noted that consumption of alcoholic beverages should also be avoided because consumption of alcoholic beverages can also lead to low blood sugar levels.

Orthostatic Intolerance

Orthostatic intolerance is associated with patients feeling lightheaded or dizzy after standing up, blurry vision, weakness, fainting, confusion, and nausea. Obesity is associated with increased sympathetic nervous system activity that contributes to blood pressure regulation.

  • After bariatric surgery, many patients experience a significant and sustained reduction in sympathetic nervous system activity at 3 and 6 months after the procedure.
  • Recently, multiple clinical trials have reported orthostatic intolerance after bariatric surgery characterized by chronic pre-syncopal symptoms (dizziness and lightheadedness), syncope (fainting), and orthostatic hypotension.

Many patients may undergo bariatric surgery as a treatment option for uncontrolled hypertension, however, exaggerated reversal of obesity-related hypertension can result in orthostatic hypotension.

Dizziness, Symptom of Staple Line Leak

The gastric sleeve surgery involves removing a portion of the stomach followed by the creation of a thin sleeve of stomach approximately the size of a banana. This is accomplished by the surgeon stapling the stomach using a stapling device. This staple line can cause leaking of gastric contents and gastric juices outside of the gastrointestinal tract.

  • Dizziness is one of the main symptoms a patient may experience if there is leaking along the staple line. Staple line leaking should be especially considered if dizziness is accompanied by other symptoms such as abdominal pain, abdominal swelling, fever, rapid heart rate, or shortness of breath.

Treatment

Staple line leaks can only be treated by undergoing an additional surgery or by the patient having a drainage tube inserted. The additional surgery will aid in strengthening the staple line of the gastric sleeve. Having a drainage tube inserted will redirect stomach acids to allow the stomach to heal so the leak will stop and will help prevent the stomach acids from reaching any other organs.

Dizziness After Bariatric Surgery Caused by Dumping Syndrome

Dumping syndrome occurs when food gets “dumped” directly from the stomach pouch into the small intestine without being digested. Dumping syndrome can also be a cause of dizziness for patients who have undergone bariatric surgery.

  • Dizziness due to dumping syndrome occurs because the intestines sense that the food is too concentrated and releases an increased amount of gut hormones.
  • As a result, the intestines become fuller and bloated which results in diarrhea after 30-60 minutes. Certain substances released by the intestines can affect heart rate and blood pressure which can lead to dizziness and even fainting.

Treatment

The primary treatment for dumping syndrome revolves around dietary changes. Dietary suggestions to alleviate dumping syndrome include avoiding liquids until at least 30 minutes after a meal and dividing the daily caloric intake into 6 small meals.

In addition, avoiding foods high in simple carbohydrates and adding more protein and fat into meals can help alleviate dumping syndrome. If dietary changes prove to be ineffective, slow-release prescription medications have been found to alleviate dumping syndrome.

Dizziness After Bariatric Surgery Caused by Nutritional Deficiencies

The term “dizziness” can also refer to feelings of weakness or unsteadiness. Bariatric surgery can cause deficiencies of vitamins and minerals that can cause patients to feel weak and unsteady on their feet.

Deficiencies of copper following bariatric surgery can lead to difficulty walking and a variety of neurologic and psychiatric disorders.

Iron deficiency is the most commonly known nutritional deficiency among adults. This is no different for patients who have undergone bariatric surgery. Iron deficiency following bariatric surgery can lead to feelings of fatigue and generalized weakness.

Treatment

Dietary vitamin and mineral supplementation is suggested for all patients who undergo bariatric surgery. Due to the re-routing of the gastrointestinal system following bariatric surgery, absorption of many vitamins and minerals is drastically reduced. Daily vitamin and mineral supplementation can help replace the vitamins and minerals that fail to be absorbed and allow patients to feel more energized and clear headed.

It is not uncommon for patients to experience dizzy spells, weakness, or unsteadiness for weeks, months, or longer than a year following bariatric surgery. Several factors associated with bariatric surgery can result in dizzy spells ranging from nutritional deficiencies to bleeding along the staple line.

Although dizziness and weakness may not seem like a life-threatening symptom associated with bariatric surgery, if patients begin to feel weak and dizzy in the weeks and months following bariatric surgery, a physician should be consulted to rule out or confirm a potentially life-threatening situation.

 

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