Gastric bypass surgery - discharge

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.

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
• Have mood changes
• Have 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 months.

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 health care provider 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 at least 30 minutes after you eat food. Drink slowly. Sip when you are drinking. Do not gulp. Your provider may tell you not to use a straw, as it may bring air into your stomach.

Your provider will teach you about foods that you should eat and foods you should stay away from.

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 6 weeks if you have open surgery.

Before this time, DO NOT:

• Lift anything heavier than 10 to 15 pounds (5 to 7 kg) until you see your provider
• 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. Check with your provider about when you may start driving again after your operation.

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 provider says it is OK, 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.

You may change the dressing every day if your provider 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 provider will tell you if you have them.

Ask your provider when it is safe to shower. 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 provider says it is OK.

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

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 1 or more weeks to prevent a blood clot. Your provider 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. These usually are multivitamins, vitamin B-12, and vitamin D.
• You may need to take calcium and iron supplements as well.

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

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

By the time you leave the hospital, you will likely have a follow-up appointment scheduled with your surgeon within 1 to 2 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.

Contact your provider if:

• You have more redness, pain, warmth, swelling, or bleeding around your incision.
• You have trouble drinking the recommended amount of fluids.
• The drainage from your incision does not decrease in 3 days or increases.
• The drainage becomes thick, tan or yellow and has a bad smell (pus).
• Your temperature is above 100°F (37.7°C) for more than 4 hours.
• 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.

Bariatric surgery - gastric bypass - discharge; Roux-en-Y gastric bypass - discharge; Gastric bypass - Roux-en-Y - discharge; Obesity gastric bypass discharge; Weight loss - gastric bypass discharge

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Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, the Obesity Society, American Society for Metabolic Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis. 2020;16(2):175-247. PMID: 31917200 pubmed.ncbi.nlm.nih.gov/31917200/.

Richards WO, Khaitan L, Torquati A. Morbid obesity. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 48.

Sullivan S, Edmundowicz SA, Morton JM. Surgical and endoscopic treatment of obesity. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 8.

Updated by: John E. Meilahn, MD, Bariatric Surgery, Chestnut Hill Surgical Associates, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.