The initial stages of bariatric surgery recovery take several weeks. This is the time period when the internal and external incision areas are healing. Gastric banding often has the shortest recovery time since the intestines and stomach are not cut and stapled. Laparoscopic gastric bypass and sleeve gastrectomy have a shorter recovery time than open gastric bypass since the incisions are much less extensive. The amount of time it takes to adjust to changes in the digestive system is typically much longer. However, many patients find the first four to eight weeks the most challenging. Here’s a general overview of this time period.
Immediate Bariatric Surgery Recovery
All forms of weight-loss surgery are currently done with the patient under general anesthesia. This means you will feel the after-effects when you wake up. These include nausea, dizziness and confusion. After these symptoms wear off, you will be assisted in getting out of bed to walk as soon as possible to help prevent blood clots. Other than light walking, you will spend your time resting for the first several days whether in the hospital or at home. With gastric bypass, you will have a catheter in place to collect urine as well as a drain in your stomach. These will be removed after a day or two. After any weight-loss surgery, you should have someone available to drive you home and stay with you for the first couple of days. After gastric bypass or duodenal switch, you will need to rely on friends or family members for transportation during the first 10 days after your surgery while you are using pain medication.
Eating During Bariatric Surgery Recovery
For the first couple of days, you won’t be eating anything so your stomach can have a chance to heal. With gastric bypass, you will be given a barium liquid to drink so that your stomach can be x-rayed. This test is done to check for leaks. With all types of weight-loss surgery, you can expect to be on a diet of liquids (broth, non-fat milk, protein shakes, etc.) for one to two weeks as the swelling in the stomach continues to subside.
Pureed foods come next. These include low-fat meats, grains such as oatmeal, cooked vegetables such as squash, soft cheeses, beans and fruits such as unsweetened applesauce. You’ll work your way up to eating small portions of solid food over the next couple of months. The type of foods you eat will be carefully controlled so you get adequate nutrition. As you progress, the list of foods you can eat will continue to grow. However, your new diet will be consistently low in fat, sugar and simple starches (white flour, white rice, etc.).
With gastric bypass, you may not feel hungry at all during the early days of recovery. You will need to watch the clock carefully to schedule your mealtimes and keep up with your food intake so you don’t become weak or malnourished. With gastric banding, you may feel ravenously hungry since your mind and body haven’t adjusted to your new stomach size yet. You will need to manage your portions carefully to avoid overeating. You should take small bites, chew each bite thoroughly and remember to eat slowly.
Drinking Fluids During Bariatric Surgery Recovery
Throughout your recovery, hydration will be just as important as managing your food intake. You will be expected to drink eight 8oz glasses of water or other approved liquids per day, but you’ll have to sip slowly since your new stomach is much smaller. You will be instructed to avoid drinking water half an hour before or after each meal. Soft drinks, alcohol, coffee and many other beverages will be off limits during recovery. You will receive special instructions about any medications and supplements you take during this time. Some of the pills may need to be crushed so they don’t irritate your stomach.
Activity During Bariatric Surgery Recovery
Your surgeon will give you specific instructions about activity levels based on your health and the extent of your operation. Walking is okay to start out. Lifting, pulling and pushing will be restricted for several weeks. Showering may be discouraged for the first couple of days to limit the risk of infection in the incision sites. Gym exercise will typically be off limits for the first six weeks. You may return to work after a week or two, or you might need more time off. This depends on how fast you heal and the activity level required by your job.
Side Effects During Bariatric Surgery Recovery
Some side effects are normal during the recovery period. However, you should be aware of the warning signs of potentially serious complications. These include:
- Chest pain or shortness of breath
- Fever (101 degrees or higher)
- Pain, redness or swelling in either or both legs (sign of a blood clot)
- Vomiting after gastric banding (this is a sign of potential food blockage)
- Swelling around incisions (may be a sign of trapped fluid or infection)
- Fluid leaking from incisions
- Severe pain in the stomach
- Back and shoulder pain
- Excessive urination (after gastric bypass)
Soreness is expected after the operation. This is typically worst over the first few days and gets better over the following weeks. The incision sites may be red. As long as the redness isn’t spreading and there is no swelling or fever, this is usually not a sign of infection. The incision marks will fade to scars over the next year or two.
Dumping syndrome is a common side effect you may experience as you adjust to your new stomach size and rerouted intestinal tract. This problem occurs after gastric bypass as the stomach empties too quickly. Dumping causes lightheadedness, rapid heart rate, hearing your pulse pounding in your ears, stomach cramps, diarrhea, sweating, skin flushing, nausea and vomiting. Additional side effects of weight-loss surgery include:
- Burping and passing gas
- Flu-like symptoms including tiredness, body aches and chills
- Mood changes (anxiety, depression, etc.)
- Changes in skin, hair and nails from poor nutrition
Many of these side effects will subside as you learn to manage your diet better.
Follow-Up Visits During Bariatric Surgery Recovery
All weight-loss surgery patients require careful monitoring during recovery. External sutures may be removed after seven to 10 days. You should always follow up with your surgeon if you experience any complications or if you are unsure how to manage side effects. Your surgeon may want to see you every week for the first month or two. If you have gastric bypass, you will continue to have ongoing visits for lab work every three to six months at first to ensure that your body is getting enough vitamins and minerals. With a gastric band, you will need office visits to fill the band for the first time (this happens after four to six weeks) and for several more adjustments over the first year. You may also need to follow up with a nutritionist as you adjust to your new diet.
Emotional Aspects of Bariatric Surgery Recovery
It is normal to have a lot of mood changes in the days and weeks after weight-loss surgery. Your body is getting used to surviving on a lot less food. You may feel that the procedure isn’t working because you still feel hungry. Or, you may feel disappointed if you don’t lose weight as quickly as you want. The dramatic changes in the way you eat can be difficult to deal with. As you do lose weight and your body changes shape, it can be hard to accept the way your body looks – especially if some areas become saggy. You may find it beneficial to join a support group for WLS patients. You will learn that what you are feeling is normal. Patients who have gone through the procedure are a great source of information on coping strategies to help you stay positive as you move closer and closer to your weight-loss goal.