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

You probably spent 3 to 5 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 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.

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. Remember to chew each bite very slowly and completely.

Drink fluids 30 minutes after you eat food. Drink slowly. Take 30 to 60 minutes to drink a cup of any fluid. Sip when you are drinking. Do not gulp. Do NOT use a straw since it brings air in your stomach.

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

See also: Your diet after gastric bypass

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

Plan to have someone drive you home from the hospital. Do NOT drive yourself home.

You should be able to do most of your regular activities in 4 to 8 weeks. Before that:

• Do not lift anything heavier than 10 to 15 pounds until you see your doctor. Also, avoid doing any activity that involves pushing or pulling.
• Short walks and going up and down stairs are okay.
• Don't push yourself too hard. Increase how much you exercise slowly.
• Your doctor will give you pain medicines to use at home. If you are taking narcotic pain medicine, do NOT drive or use machinery. These medicines will make you drowsy. Driving and using machinery is not safe while you are taking them.
• Try getting up and moving around if you are having some pain in your belly. It may help.

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

Make sure your home is set up safely as you are recovering.

See also:

• Preventing falls
• Bathroom safety - adults

You should be able to start exercising again 6 weeks after your operation. Even sooner than that, you will be able to take short walks at an easy pace, if your doctor tells you it is okay.

Your doctor or nurse will show you how to change your dressing (bandages) on your incision. Gently wash the wound (incision) area with mild soap and water. Pat the area dry with a clean towel. Do not rub dry.

See also: Surgical wound care

You may remove the wound dressings and take a shower if sutures (stitches), staples, or glue were used to close your incision.

• If tape (Steri-Strips) was used to close your skin, you may want to cover the wound with plastic wrap for the first week before taking showers. Tape the edges of the plastic well to keep water from leaking in.
• Do not try to wash or peel off the Steri-Strips or glue. They will come off on their own.

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

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

• If your doctor is worried about blood clots forming in your legs, 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.
• If your doctor is worried about you having a gallbladder attack, 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 A 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.

You will need to see your doctor fairly often in the first year after your surgery.

• Your first visit will be 2 or 3 weeks after surgery. Your doctor will check your wound and talk with you about how your diet is going.
• You will probably see your doctor 3 or 4 more times over the first year. During those visits, your doctor will be checking your physical and mental health, including any change in weight and your nutritional needs. You will likely see a dietitian during those visits as well. During those visits, your doctor will check your health, weigh you, and make sure your nutrition is good. You will probably see a dietitian during these visits to help with your nutrition. Your doctor will also check how you are doing mentally and emotionally.
• You will need blood tests for the rest of your life to make sure that your body is getting enough iron, folate, vitamin A, vitamin D, vitamin B12, and protein.

Exercise is very important to help you lose weight and keep that weight off. Joining a support group of people who have had weight-loss surgery may help you recover from surgery and keep your weight off. Getting to know people who have had the same experience as you gives you a chance to hear other people's success stories and struggles, and to share your own. Ask your doctor or nurse if there is a nearby support group for people who have had weight-loss surgery.

Call your doctor or nurse if:

• Your temperature is above 101 °F.
• 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.

Buchwald H, Estok R, Fahrbach K, Banel D, Sledge I. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery, 2007;142:621-632.

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.

Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders; 2008.