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Gastric bypass surgery - discharge

Alternate Names

Bariatric surgery - gastric bypass - discharge; Roux-en-Y gastric bypass - discharge; Gastric bypass- Roux-en-Y - discharge

When You Were in the Hospital

You had gastric bypass surgery to help you lose weight. Your surgeon used staples to divide your stomach into a small upper section, called a pouch, and a larger bottom section. Then your surgeon sewed a section of your small intestine to a small opening in this small stomach pouch. The food you eat will now go into your small stomach pouch, then into your small intestine.

You probably spent 1 to 3 days in the hospital. When you go home you will be eating liquids or puréed foods. You should be able to move around without too much problem.

What to Expect at Home

You may have a catheter (tube) coming from the larger part of your stomach that was bypassed. It will come out of your side and will drain fluids that build up in your belly. This will be taken out in about 4 to 6 weeks.

You will lose weight quickly over the first 3 to 6 months. During this time, you may have body aches, feel tired and cold, have dry skin, mood changes, and hair loss or hair thinning. These problems should go away as your body gets used to your weight loss and your weight becomes stable. Because of this quick weight loss, you will need to be careful that you get all of the nutrition and vitamins you need as you recover.

Weight loss slows down after 12 to 18 months.

Diet

You will remain on liquid or puréed food for 2 or 3 weeks after surgery. You will slowly add soft foods and then regular food, as your nutritionist told you to do. Remember to eat small portions and chew each bite very slowly and completely.

Do not eat and drink at the same time. Drink fluids 30 minutes after you eat food. Drink slowly. Sip when you are drinking. Do not gulp. Your doctor may tell you not to use a straw, as it may bring air into your stomach.

Your doctor, nurse, or dietitian will teach you about foods that you should eat and foods you should stay away from.

Activity

Being active soon after surgery will help you recover more quickly. During the first week:

  • Start walking after surgery. Move around the house and shower, and use the stairs at home.
  • If it hurts when you do something, stop doing that activity.

If you have laparoscopic surgery, you should be able to do most of your regular activities in 2 to 4 weeks. It may take up to 12 weeks if you have open surgery.

Before this time, do NOT:

  • Lift anything heavier than 10 to 15 pounds until you see your doctor
  • Do any activity that involves pushing or pulling
  • Push yourself too hard. Increase how much you exercise slowly
  • Drive or use machinery if you are taking narcotic pain medicine. These medicines will make you drowsy. Driving and using machinery is not safe when you are taking them.

DO:

  • Take short walks and go up and down stairs.
  • Try getting up and moving around if you are having some pain in your belly. It may help.

Make sure your home is set up for your recovery, to prevent falls and make sure you are safe in the bathroom.

If your doctor says it is okay, you may start an exercise program 2 to 4 weeks after surgery.

You do not need to join a gym to exercise. If you have not exercised or been active in a long time, be sure to start off slowly to prevent injuries. Taking a 5- to 10-minute walk every day is a good start. Increase this amount until you are walking 15 minutes twice a day.

Wound Care

You may change the dressing every day if your surgeon tells you to do so. Be sure to change your dressing if it gets dirty or wet.

You may have bruising around your wounds. This is normal. It will go away on its own. The skin around your incisions may be a little red. This is normal, too.

Do not wear tight clothing that rubs against your incisions while they heal.

Keep your dressing (bandage) on your wound clean and dry. If there are sutures (stitches) or staples, they will be removed about 7 to 10 days after surgery. Some stitches can dissolve on their own. Your doctor will tell you if you have them.

Unless you are told otherwise, do not shower until after your follow-up appointment with your health care provider. When you can shower, let water run over your incision, but do not scrub or let the water beat down on it.

Do not soak in a bathtub, swimming pool, or hot tub until your doctor tells you it is okay.

Press a pillow over your incision when you need to cough or sneeze.

Drugs

You may need to take some medicines when you go home.

  • You may need to give yourself shots underneath the skin of a blood-thinning drug for 2 or more weeks. Your doctor or nurse will show you how.
  • You may need to take medicine to prevent gallstones.
  • You will need to take certain vitamins that your body may not absorb well from your food. Two of these are vitamin B-12 and vitamin D.

Aspirin, ibuprofen (Advil, Motrin), and some other drugs may harm the lining of your stomach or even cause ulcers. Talk with your doctor before you take these drugs.

Follow-up

To help you recover from surgery and manage all the changes in your lifestyle, you will see your surgeon and many other health professionals.

By the time you leave the hospital, you will likely have a follow-up appointment scheduled with your surgeon within a few weeks. You will see your surgeon several more times in the first year after your surgery.

You may also have appointments with:

  • A nutritionist or dietitian, who will teach you how to eat correctly with your smaller stomach. You will also learn about what foods and drinks you should have after surgery.
  • A psychologist, who can help you follow your eating and exercise guidelines and deal with the feelings or concerns you may have after surgery.
  • You will need blood tests for the rest of your life to make sure that your body is getting enough important vitamins and minerals from food after your surgery.

When to Call the Doctor

Call your doctor or nurse if:

  • Your temperature is above 101°F.
  • You see any of these changes around your incision:
    • More redness
    • More pain
    • Swelling
    • Bleeding
    • The wound is larger or deeper
    • The wound looks dried out or dark
  • The drainage coming from or around your incision:
    • Does not decrease after 3 to 5 days
    • Is increasing
    • Becomes thick, tan, or yellow, or smells bad (pus)
  • Your temperature is above 100°F for more than 4 hours.
  • Your incision is bleeding, red, warm to the touch, or has a thick yellow, green, or milky drainage.
  • You have pain that your pain medicine is not helping.
  • You have trouble breathing.
  • You have a cough that does not go away.
  • You cannot drink or eat.
  • Your skin or the white part of your eyes turns yellow.
  • Your stools are loose, or you have diarrhea.
  • You are vomiting after eating.

References

Leslie D, Kellogg TA, Ikramuddin S. Bariatric surgery primer for the internist: keys to the surgical consultation. Med Clin North Am. 2007;91:353-381.

Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, et al. American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity (Silver Spring). 2009 Apr;17 Suppl 1:S1-70.


Review Date: 10/14/2012
Reviewed By: Ann Rogers, MD, Associate Professor of Surgery; Director, Penn State Surgical Weight Loss Program, Penn State Milton S. Hershey Medical Center. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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