Gastric Bypass Surgery: Post-Operation Care and Management

Life after gastric bypass surgery extremely changes. Management and care varies depending on the patient’s needs but constant monitoring and assessment are compulsory as mild to severe complications always come with it. You can’t just ignore recurring pains and serious discomfort because these happen when you or your surgeon did something wrong. Dumping syndrome is one of the most common symptoms that about 85% of patients have to deal with either occasionally or often especially if food choices are poor.

This dumping syndrome is just one of the many possible side-effects. With other minor to major health issues that may take take place, it is paramount to keep a close eye on diet, medication, eating habits and lifestyle.

Side effects

There is no such thing as gastric bypass without side effects and complications. Patients will always have mild to moderate to acute symptoms because of mismanagement, failure to stick to the diet, medication and/or supplements. After the operation, surgeons roll out a bunch of guidelines to keep you on track but there are times when a patient slips and experiences any of these side effects. Below you will find a list of the most common problems encountered and how you can manage them when the situation calls for it:

Dumping

There are two types of dumping syndrome — early dumping and late dumping. Early dumping takes place when sugar and carbs rapidly travel from the pouch to the stomach. when this happens, the small intestine release gut peptides, a hormone that spike blood pressure and heart rate eventually causing light-headedness, increased heart beat rate, and diarrhea. Late dumping has the same symptoms but the causes are high insulin levels and subsequently low blood sugar.

Management:

• Call your surgeon and discuss the issue. Find out what triggered it
• Rest would be the best solution to treat early dumping but make sure to stay away from refined sugar and foods high in carbohydrates the moment you’re back to your feet
• For late dumping syndrome, a glass of fruit juice will prevent the attack, preferably taken an hour after meal
• For symptoms that persist, Somatostasin or Acarbose helps lessen the effects. Seek your doctor’s advice before taking.

Remember:

Patients should stick to the recommended diet and learn more about restricted food items. Early or late dumping is not fatal but the inconvenience can impair your daily life especially if it happens frequently. Compliance and commitment with regular appointment with a doctor are the keys to eliminating the occurrence.

Diarrhea

Diarrhea is a more common side effect among Sleeve Gastrectomy with DS (Duodenal Switch) patients than Roux-en-Y patients. This is because the fatty acids from food taken pass directly through the colon or undigested food go through the gastrointestinal tract faster than normal causing irritation.

In some cases, sorbitol, a substance found in berries and fruits, causes the diarrhea. The GI tract finds it hard to absorb it so it reaches the colon fermented and induces loose stools and flatulence. Diarrhea among DS patients can go from mild to severe.

Management

• Fatty foods are the common cause of diarrhea among DS patients. Make sure that consumption of these are kept to a minimum
• Closely monitoring the diet is very important. Log your daily/weekly consumptions to determine whether you’re going beyond the recommended serving
• Short-term and long-term management of diarrhea may include a dose of Lomotil or Imodium before bedtime to prevent urgent bowel movement in the middle of the night of early in the morning.
• Take probiotics for the restoration of normal bacteria in the colon
• Seek doctor’s attention for the right medication if the issue is severe and comes with foul odor and frequent flatulence

Remember:

Diarrhea of various frequencies may take weeks or months to disappear. If it does not go away within a year, medical intervention is required.

Constipation

LAGB and RNY patients often fall victims to constipation. The number one cause of this is minimal water intake and lack of fiber, just the same as what causes constipation in non-GB patients.

Management

• Apparently, you need to increase fiber and water intake
• Minimize if not eliminate tea, coffee, or any caffeinated beverages
• Iron and calcium supplements also sometimes contribute to constipation. Ask your physician for advice

Gastric bypass surgeries as weight loss method delivers successful results but demands lifetime dedication to healthy diet and supplements. Since your body will have limited supply of nutrients after the surgery, it is very important to take supplements everyday.

• Have at least 60 grams of protein daily by consuming low- or non-fat dairy products, lean meats, fish, soy, beans, and legumes. It would help to know exactly the ideal amount of protein your system can take or you’ll end up having gallstones with too much.

• Iron, calcium, and B-complex vitamins must be taken in higher dosages because the surgery affects absorption of these nutrients. Women who have monthly period should increase their iron intake to prevent anemia. Vitamin B12 in particular is hardly absorbed by the small intestine in the form of pill so you should increase dosage as per your doctor’s recommendation.

• Some vitamins and supplements come in various formats for efficient absorption.Go for what works best for you.

Exercise

Flexing muscles everyday should be a part of the daily regimen after the operation. However, a doctor’s advice is still required to know what kind of exercises are allowed and how you should do these exercises.

• Postoperative workouts often start with walking, increasing the distance and speed as days pass.

• You can increase the activity provided you have informed your surgeon about what kind of exercises you are planning to add (e.g., swimming, riding bicycle, sit-ups, push-ups, etc)

• Some workouts including weight or strength training are physically demanding but allowed as long as they only cause mild discomfort. However, if any of these cause severe pain, discontinue and consult your doctor.

• Never skip water before, during, and after the workout to keep you hydrated but remember to drink your water slowly.

A lot of people who have undergone gastric bypass surgery complain of weight gain after a few years, leading to a second surgery. This is not necessary if you have been compliant. Mismanagement can worsen your “special” condition, so be a good follower. That’s your second shot at being healthy so eat and drink wisely from then on.

On another note, some mishaps are inevitable. Consulting your doctor every time something unusual happens still stand as the golden rule. Prepare a list of first aid responses, take note of recommended drugs, keep your stock full, and always have a plan B.