Patient-Reported Symptom Changes Following Structured Intake Advice for Multivitamin-Associated Nausea After Bariatric Surgery.

Introduction Adherence to post-bariatric supplement intake may be affected by tolerability issues. This study aimed to characterize nausea associated with supplement intake and explore the patient-reported symptom course following structured intake instructions in a real-world customer-support context. Methods This retrospective observational study with prospectively collected data consisted of two parts. Part one: a cross-sectional survey of 540 FitForMe customers after bariatric surgery who reported nausea, assessing the timing of supplement intake, the onset and triggers of nausea, and the impact on daily functioning. Part two: a single-arm, uncontrolled follow-up of a separate sample of 75 French FitForMe customers experiencing nausea, who received structured intake instructions during standardized telephone interviews. Recommendations included switching from capsules to chewable tablets, taking supplements with meals, dividing doses, and allowing slower dissolution. The presence of nausea (yes/no) was reassessed by telephone one week later. Results Part one indicated that a large percentage of individuals did not take the supplement according to intake instructions; 256 (47.4%) took it on an empty stomach. Nausea occurred in 93 patients (17.2%) before the actual intake of the supplement. Overall, 365 patients (67.6%) reported a score of 5 or higher on a 0-10 scale measuring the impact on daily life, where 0 indicated no restriction, and 10 indicated being unable to do anything. In part two, at the one-week follow-up, 55 of 75 patients (73.3%) reported resolution of nausea (within-patient comparison, p<0.001). The recommendation most frequently endorsed by patients as perceived to have contributed to their symptom course was switching from capsule to chewable tablet, reported as helpful by 41 of 44 patients who made this switch (93.2%; 54.7% of the total follow-up cohort, n=75; p<0.001). Taking supplements with lunch or dinner was also commonly endorsed (n=42, 56.0%). Additional complaints were common, including potentially dumping-related symptoms (n=30, 40.0%), food intolerance (n=28, 37.3%), and altered taste or smell (n=31, 41.3%). Conclusion In a selected sample of bariatric patients who reported nausea during multivitamin use, incorrect intake practices and multifactorial symptom patterns were common. In a follow-up cohort, structured intake advice was associated with patient-reported resolution of nausea in many participants. While these observational findings do not establish causality, the recommendations are simple, low-cost, and easy to implement, and may be considered as a pragmatic first step in routine post-bariatric care.