Why can't I eat breakfast now I have a gastric band?

"Why does food get stuck first thing in the morning? It seems it is best for me to have breakfast about 10.30 - 11.00 and even then I can only have a smoothie. Anything else is difficult to get down. It is almost as if I need a throat lubricant. Is this normal?" A question from a gastric band owner. 

Answer:

A surprising number of people with a gastric band (lapband) comment that they can't 'tolerate' breakfast until about 10 or 11 am. Most people can happily drink something when they first get up. So my first concern for you would be around the tightness of your band. It may be too tight seeing that you can still only drink something at mid-morning.

Not being able to eat something solid immediately you get up is quite common, yet no-none has scientifically tested why this is so. Here are a few thoughts about why this happens and a few solutions to try.

a) You had an 'event' the night before. That means something got stuck or you had to bring something up or you felt uncomfortable after eating the evening meal or late night snack.

If the band caused you some grief the night before, you may have got some local swelling of the stomach near or inside the band area, which is causing things to be tighter than usual. It takes a while for the swelling to go down. Think back to the evening before.

b) Overnight, it appears that the body produces some really sticky thick saliva. Swallowed sticky saliva might pool above the band and create a plug. In the morning, when you rise, the thick sticky saliva has to work its way past the band into the lower stomach. Until gravity and the stomach work together to push it through, nothing else seems to want to pass through.

c) People who experience reflux may notice breakfast intolerance more. Reflux means the digestive juices and contents of the stomach are flowing up into the food pipe and back down again. This is very irritating for the lining of the stomach and throat. If you needed reflux medicine before the band was placed, then speak with your doctor. You may need to start back on the medications.

d) You ate too much the night before and you ate too close to bedtime.

If you ate too close to bedtime, then gravity may have been working against you when you went to bed. Some of this food may not have worked its way through your stomach past the band. Although this seems a little unlikely from a medical and dietetics viewpoint, some people say they bring up a sticky mass mixed with pieces of their last food when they get up in the morning so the food must be 'hanging around' in the stomach.

What to do?

1. Check your hydration. If you are a little slack on your fluid intake then you may notice that your saliva is quite ropey and sticky at other times through the day.

2. Try a hot lemon drink to break through the saliva when you get up in the morning. Add a generous squeeze of fresh lemon juice to boiled water. Drink it hot.

3. Ask someone close to you whether you are a mouth breather. If you are, you may be producing extra saliva to keep the mouth and throat moist and lubricated overnight. Even more saliva might be pooling up and causing a back-up. We can't zipper your mouth up but this might explain your problem. You may need to see a specialist doctor to help with your breathing.

4. Reduce the size of your evening meal and try not to eat too late. That includes snacks and supper. Leave at least 2 hours between your last food and bedtime.

I might add that when we explored our client files, the problem of not tolerating breakfast appears to be more common for people who said they often skipped breakfast before banding. These same people eat a lot of their fuel late in the day, even with a band on board; it may be their stomach is still 'too full'. Does that ring a bell for you?

I am certain other gastric band owners (bandsters) will have ideas to share, so let me hear about them. Email your ideas today. If you're happy for them to be published please give me permission. Include your name or nickname for publication if you wish.