About the gastric bypass
On average we expect weight loss results for gastric bypass patients to be approx. 70% of their excess weight*. Obviously some people will do better and some not as well as this.
The gastric bypass procedure
Yes. There is invariably some discomfort following the gastric bypass operation, the main source for which is the port entry sites which are made through the abdominal wall and through which the operating instruments and camera were passed. In addition you may experience some left shoulder pain after gastric bypass, which may be an effect of the gas (carbon dioxide) used to inflate the abdomen. But overall, pain is not a marked feature and whatever discomfort does occur, usually responds well to simple painkillers.
You should not drive for 2-3 days after your operation to allow the effects of the anaesthetic and any post-operative analgesia (painkillers) to wear off. Thereafter you may find driving a little uncomfortable until the port sites have fully healed, usually around 10 days.
This depends upon what you do for a living, but if you have a sedentary occupation you can generally expect to be back at work about 2 weeks after gastric bypass, after which time the wounds should have healed and you will be feeling more comfortable. If you have a physically demanding job involving lifting etc, you may need a little longer. The bowel and stomach inside your abdomen will be healed in around 6-8 weeks, so during this period it is important that you follow the nutritional guidelines as closely as you can.
Generally there is minimal scarring with a gastric bypass. The operating ports are placed in the abdomen through 5 narrow (0.5 cm) incisions which are sutured and/or glued and will normally heal in about 10-14 days. The scars should fade gradually. Some individuals have a greater tendency to form keloid which may result in thicker and more prominent scars.
Gastric bypass complications
Possibly. As you eat less the amount of residue (especially fibre) in your diet falls and your bowel activity will decrease. If you do become constipated, there are plenty of effective remedies which can deal with the problem. You will be given advice about this later.
Yes. There is evidence to show that weight regain can occur following a gastric bypass, usually because patients return to old eating habits. It is important to remember that the Roux-en-Y gastric bypass (RYGBP) is not a “cure” for your weight problems, but a powerful tool that can be very effective in helping you to manage your weight more effectively. But if you live on “junk” food and don’t bother being physically active, you can certainly put weight back following bypass surgery (following any weight loss procedure actually). So the message is “eternal vigilance”, there are no days off with weight management!
No. Every medical treatment has a failure rate and the Roux-en-Y gastric bypass (RYGBP) is no exception. A proportion of bypass patients will fail due to a variety of reasons, including an inability to comply with the nutritional requirements, physical inactivity or a failure to attend for follow-up. They can also run into trouble if they fail to take the prescribed vitamin and mineral supplements. However, if you are really determined to get a good outcome from your bypass, most of the reasons for failure can be overcome.
Living with a gastric bypass
Usually, you will be able to continue with your regular medication after a gastric bypass operation. However, if your tablets are very large, it may be necessary to break them up (most good chemists will have a little contraption to do this easily). Try them first. If you feel they are sticking, you can crush them up and take with a spoonful of yoghurt. Before doing this, however, you should check with the pharmacist that this is OK. Some tablets are specially formulated to be released slowly or coated to protect the stomach and these properties may be destroyed if you crush them. Capsules should not be a problem because they are soft and designed to soften and melt inside the stomach.
We recommend that you wait until the second month after surgery (on soft foods) before starting supplements. Of course, it is absolutely essential for you to take vitamin and mineral supplements for life after bypass surgery. Without supplementation deficiencies of iron, folic acid, vitamin B12, calcium, zinc and vitamin D can occur, resulting in anaemia and bone disease such as osteoprosis.
Regular physical activity is very important in achieving your weight loss goals. You will be given specific information and advice about physical activity after your bypass surgery, but to begin with we recommend walking. As you become fitter you may wish to try more strenuous forms of activity and there is no exercise that must be excluded because you’ve had gastric bypass surgery.
Yes. It is usually perfectly safe to have other surgical procedures, assuming they do not involve the upper part of the stomach or digestive tract. Obviously it is essential for you to inform your surgeon and anaesthetist about your previous bypass surgery.
There are several reasons why gastric bypass surgery has a positive impact on pregnancy and childbirth. Firstly, as you lose weight* your fertility increases and you are much more likely to conceive (if you don’t want to get pregnant you need to be aware of this!). Secondly, losing weight will result in a significantly lower risk of complications both for you and the baby. And lastly, your weight loss will allow you to be much more active both during and after pregnancy which will greatly increase your enjoyment of what should be a very happy period in your life. Healthier Weight will give you all the help, advice and support you need should you become pregnant following a gastric bypass operation.
Yes, in moderation. Alcohol has a high calorific value (7 kcal/gram) and can provide a lot of unwanted calories so you need to pay attention. However, there are health benefits to a moderate alcohol intake and some evidence to suggest it may even enhance weight loss. So we are quite happy for you to have the equivalent of one unit of alcohol per day. [NB. 1 unit of alcohol = half pint of normal strength beer, half a standard (175ml) glass of wine or small single measure of spirits].
Yes. You may eat most foods that don’t cause you discomfort. However, because you can only eat small amounts, it is important to include foods rich in protein but low in fat and sugar. We encourage you to eat vegetables, fruit, wholegrains, lean meat and fish. You will be provided with detailed nutritional information following your gastric bypass surgery.
There is no reason why you should not travel as normal following gastric bypass surgery. If you are intending to travel within 6-8 weeks after the procedure, you should check with your airline to establish what their policy would be.
Possibly. The amount of lax skin depends upon your age and weight before your procedure. Generally, the heavier and older you are, the more likely you are to have lax skin. Younger patients have a greater degree of natural elasticity in the skin, so there is a lot of re-modelling as weight loss progresses.
The most common need is to have the abdominal apron removed, though some patients have more extensive “body-contouring”. Whatever your inclination, you should wait two years before making any decisions about cosmetic surgery. It is imperative that any corrective surgery be done by a specialist surgeon.