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Avoiding Food-borne Illness after Weight Loss Surgery: What You Need to Know

Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses the importance of prevention and fast recovery from food-borne illness, especially after bariatric surgery. 


Contracting a food-borne illness, or food poisoning, is distressing for anyone, but it is particularly dangerous after bariatric surgery. When recovering from bariatric surgery, the pace of drinking and eating is often limited and makes rehydration difficult. For people who had the adjustable gastric band procedure, there is also an increased risk for the gastric band to slip out of position if vomiting is severe or prolonged.

Food-borne illnesses are caused by bacteria, viruses or parasites in food. They are the result of mishandling during processing or preparation, failure to cook items to the recommended temperature or improper storage. Foods from animals and unpasteurized milk are particularly at risk for food poising. This includes raw or undercooked meat, poultry, fish, shellfish and eggs. Although less common, fresh fruits and vegetables can also contain harmful bacteria from contaminated water or soil.

Food poisoning causes flu-like symptoms, including nausea, vomiting, diarrhea and fever. Symptoms usually appear four to 48 hours after eating and pass after one or two days. However, some cases of food-borne illness can be severe and even life-threatening. It is important to seek immediate medical attention if you experience any of the following symptoms:
  • Light-headedness when standing
  • Persistent vomiting
  • Fever higher than 101 degrees Fahrenheit
  • Blood in bowel movements
  • Diarrhea for more than three days
Keep in mind that after bariatric surgery, food intolerance and dumping syndrome cause similar symptoms to food poisoning, such as nausea and vomiting. The difference is that symptoms from food intolerance and dumping syndrome typically occur immediately or soon after eating and resolve within several hours. Symptoms from food poisoning tend to have delayed onset and longer duration.

To prevent contracting food-borne illness, take the following precautions:
  • Wash your hands. Make sure to wash your hands with soap and water before preparing or eating food. If you are unable to wash your hands, use an alcohol-based hand gel that is at least 60 percent alcohol.
  • Cook meat, poultry, fish and eggs thoroughly and serve hot. If a restaurant serves an undercooked item, send it back and request a new plate.
    • Meat and poultry: Cook to an internal temperature of 160 degrees Fahrenheit. Make sure the meat is no longer pink inside and the juices are clear.
      • A whole chicken or turkey should be cooked to an internal temperature of 180 degrees Fahrenheit. Make sure the poultry joints move easily.
      • Poultry breasts and roasts can be cooked to 170 degrees Fahrenheit.
    • Egg: Yolks and white should be firm, not runny. Avoid food with raw egg, including salad dressing, sauces, homemade ice cream, uncooked cake batter or cookie dough.
    • Fish: Cook fish until the internal temperature is 145 degrees Fahrenheit. Make sure the fish is opaque and easily flakes with a fork.
  • Only drink pasteurized dairy products. Avoid foods made from unpasteurized milk.
  • Refrigerate perishable food promptly. Food that is left out for more than two hours may not be safe to eat. Store perishable foods in a refrigerator that is below 40 degrees Fahrenheit. In the summer, when the temperature can be over 90 degrees, do not leave food out for more than an hour.
  • Wash fruits and vegetables before eating.
If you do fall victim to a food-borne illness, follow these tips for a quick recovery:
  • Hydrate with water or low-calorie fluids. Clear broths, diluted juice, weak tea, diet gelatin or sugar-free ice pops are good sources of hydration. Start with small sips and gradually increase the pace of drinking.
  • Reintroduce food slowly. Start with bland foods that are easy to chew and digest.
  • Separate drinking and eating by 30 minutes. Take several days to progress to your regular bariatric diet.
  • Talk to your doctor. Tell your provider about your symptoms to avoid a long-term impact on your health.
- Karen Buzby, RD, LDN

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