Bariatric Surgery: Post-Surgical Care

Pre / Post Care

What Should You Expect When Undergoing Bariatric Surgery?

Bariatric surgeries are done in the hospital using anaesthesia; a patient will be administered with anaesthesia in the operation theatre and will be unconscious throughout the procedure.

While the surgery’s specifics differ from each other, they would usually require some surgical incisions in your abdomen.

Nowadays, most types of bariatric surgery are performed laparoscopically. This procedure would involve the doctor inserting a laparoscope, through small incisions in the abdomen. A tiny camera attached to the laparoscope’s tip allows the surgeon to see inside the abdomen. It will enable them to operate inside the abdomen without making traditional large incisions.

This procedure would allow a faster and shorter recovery period, although it may not be recommended for everyone.

Most bariatric surgeries would usually take several hours. After surgery, medical staff would monitor you for any complications, and you may be required to stay a few days in the hospital before you can be discharged.

What Should I Look Out For After Bariatric Surgery?

Patients are usually recommended to avoid eating in the first two days after their surgery to allow the stomach and digestive system time to heal. Following that, they will be prescribed a specific diet to follow for the next few weeks.

A liquid diet would usually be observed before progressing to soft foods or purees before resuming regular foods. Patients may also be advised about the amount and types of food they can eat and drink.

Apart from managing your diet, your doctor may also schedule frequent medical check-ups to monitor your health in the first few months after surgery. Depending on the requirement, your doctor may require laboratory testing, blood work, and various exams to be done to assess your progress.

What Is The Recovery Period After Bariatric Surgery?

For most bariatric surgery patients, they should not experience severe postoperative pain. They should also be able to consume liquid and keep it down. For most cases, they are also usually discharged within two days after their operation.

In the event of severe pain or complications after the surgery, patients are usually recommended to stay for a more extended period of observation. Depending on the surgical procedure administered, the recovery period may also differ.

Open surgery, which requires a larger incision to be made in the abdomen, requires a more extended period to heal than ones made through laparoscopic surgery.

If a patient has an open surgery, they will be required to stay in the hospital until the incision has healed enough for them to go home. This usually means 4 to 5 days of stay in the hospital.

Upon discharge, they will also require time, usually a month, to fully recover before they can resume normal activities.

Will There Be Any Dietary Changes After Bariatric Surgery?

Patients will have to follow a liquid diet for the first week after their weight loss surgery. They will then progress to eating pureed food the following week before moving to soft food within the next three weeks.

Two months after the surgery, most patients will resume eating regular food; however, due to the stomach pouch’s size, the amount they can eat would be reduced compared to before the surgery.

Your doctor may recommend you specific dietary guidelines that need to be followed after your surgery, and this includes:

Eating small amounts of food per meal
Stopping your meals once you are full
Chewing your food thoroughly
Eating slowly
Taking the recommended vitamins and supplements
Staying hydrated by drinking enough water
Sipping fluids rather than drinking quickly
Avoiding food that is difficult to digest, such as tough meat and bread
Avoiding carbonated beverages

For patients who went through gastric banding, sleeve gastrectomy (gastric sleeve) or gastric bypass (Roux-en-Y gastric bypass), the pouch will stretch over time. They may be advised to avoid overeating as the pouch can stretch to its original size, leading to possible weight gain if not managed.

Diet Before Bariatric Surgery

Your diet before the surgery should be targeted at helping you to lose weight. Losing weight before the surgery may help reduce the amount of fat around your liver and abdomen. This may also allow you to opt for a laparoscopic surgery instead of an open one.

Laparoscopy surgery involves smaller incisions, requiring less recovery time and induces less stress on the body. Losing weight before your surgery not only keeps you safer during the procedure, it also helps to prepare you for a new approach to eating healthy.

Your meal plan may begin as soon as you have been cleared for the procedure and have been advised by your doctor. Additionally, the meal plans’ purpose is to help achieve some pre-op weight loss.

If sufficient weight loss does not occur despite following the meal plans, the procedure may be postponed or cancelled. Therefore, you should start the diet plan as soon as you can.

The dietary guidelines for your meal plan may vary from person to person, but they may include the following:

Reducing or eliminating your intake of saturated fats, including whole milk products, fatty meat, and fried foods.
Reducing or eliminating your intake of foods that are high in carbohydrates, such as sugary desserts, pasta, potatoes, bread, and bread products.
Eliminating beverages that are high in sugar, such as juice and sodas.
Exercising portion control.
No binge eating.
No smoking of cigarettes.
Avoiding alcoholic beverages.
Drinking sips of water instead of large gulps
Taking supplements such as multivitamins daily.
Consuming protein shakes or protein powder.

What Should I Eat Pre-Op For Bariatric Surgery?

The pre-op diet primarily consists of a protein diet. They can come in the form of protein shakes and other high-protein, low-calorie foods that are easy to digest.

Protein acts as a fundamental booster for protecting and bolstering muscle tissue, which can help your body burn fat instead of muscle. Additionally, protein also helps keep your body healthy, which is essential for your recovery.

Leading up to the days of your surgery, you may be required to follow a liquid diet.

Depending on the weight and overall health, some patients may be allowed to consume some solids in their pre-op meal plan. This might include fish, watered-down hot cereal, or soft-boiled eggs.

Diet After Bariatric Surgery

The post-surgery meal plan consists of several phases. Depending on your healthcare provider, what you can eat and drink, and how long each phase lasts may differ.

To achieve sustainable weight loss, all phases of the meal plan would focus on portion control, which will be an essential part of your life henceforth.

Phase 1: Liquid Diet

During phase 1, your nutritional intake is geared toward helping your body heal from surgery and prevent postoperative complications.

Your diet will consist of mostly liquid in the first few days after surgery. You will only be permitted to drink a few ounces of clear liquid at a time. This helps your stomach heal without being stretched out by food.

After clear liquid, you will be to consume other forms of liquid such as:

Caffeine-free coffee and tea
Skim milk
Thin soup and broth
Unsweetened juice
Sugar-free gelatin and ice popsicles

Phase 2: Pureed Diet

A week after Phase 1, your doctor will assess if you can move on to Phase 2 of the diet. This phase would consist of food purées with a thick consistency.

To avoid irritating the stomach, you are advised to avoid spicy seasonings, fruits with lots of seeds such as kiwi and strawberries and vegetables that are too fibrous to liquefy, such as broccoli and cauliflower. You are also advised not to consume fluids with your meals at this phase.

You may choose foods that are easy to liquefy, such as:

Fruits: bananas, canned fruits, peaches, pears, melons, pineapples
Vegetables: spinach, carrots, squash, green beans
Protein: yoghurt, cottage cheese, chicken, beef, white fish, scrambled eggs

Phase 3: Soft Food

Phase 2 of your diet will last for several weeks. Once your doctor decides that your recovery is on schedule and your stomach is ready, you can start adding soft, easy-to-chew foods into your diet.

This may include:

Soft-boiled eggs
Ground meat
Baked or steamed white fish
Canned fruits, such as peaches or pears

At this point, it is essential to consume small bites of food each time. This allows you to practise portion control while avoiding putting a strain on your stomach.

Phase 4: Stabilisation

Phase 4 of your diet includes introducing solid food back into your meals. This phase would usually take about two months after surgery. Solid food introduced back into the diet would have to be diced or chopped into small bites to reduce stress on your stomach.

Due to the stomach’s reduced size, large food pieces may cause a blockage, leading to pain, nausea, and vomiting. There will also be food and beverages you should avoid. These include foods and drinks that are hard to digest, such as fibrous vegetables, tough meat, fried foods, hard, crunchy food, carbonated drinks and bread or bread products.

About four months after surgery, you may be able to resume eating normally. Portion control is still vital to the entire weight loss regime. Your diet can consist of mostly fruits, vegetables, lean protein and carbohydrates. You are advised to avoid unhealthy foods which may be high in fat and calories.

Keeping this advice may improve your health while ensuring that you do not put on the weight you lost. The guidelines for your postoperative diet will serve you throughout life.

They include:

Eating and drinking slowly
Practising portion control
Avoiding overly spicy foods
Avoiding high-fat and high-sugar foods
Enjoying beverages between meals, but not during meals
Drinking enough fluids daily to prevent dehydration
Eating only small pieces of food at a time
Chewing your food thoroughly
Taking the vitamins, your doctor recommends

What Are Recommended Lifestyle Changes After Bariatric Surgery?

Apart from making changes to their diet, patients are advised to adopt a more active lifestyle after surgery.

In the first month, low impact exercises such as walking and swimming would make good options for keeping active. As you are still recovering from your surgery, you are advised to go slow and allow your body to heal without putting a strain on yourself.

Over the next few months, you may consider building up to strength training and cardio workouts.