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Dr.Weight // BEFORE and AFTER bariatric operation - practical guidelines // Grand questions after gastric bypass

After gastric bypass

Grand questions after gastric bypass

Bariatric Surgery - – 2008

Eating after gastric bypass

Continue after discharge to eat the same food as in hospital, gradually expanding your diet. (A sample eating plan you can be found here.) If any particular food causes discomfort, avoid or reduce it. If you have questions on nutrition after gastric bypass, do not hesitate to contact us.

Necessary vitamins and minerals

Gastric bypass patients may suffer disturbance in vitamin and mineral absorption. After this operation it is therefore a permanent necessary to ingest additional amounts of vitamins and minerals.

It is advisable to take complex supplements, of which a wide choice is available. Choose what you like unless something specific is recommended by your doctor, but be sure that your supplement contains vitamins of the B group (especially B12) and calcium.

Iron supplements are taken routinely only by women of child-bearing age, and should be taken separately from calcium supplements.

To avoid nausea, avoid taking vitamins on an empty stomach. This is especially important for iron supplements. If you still have nausea after taking iron supplements, switch to the slow-absorption variety.

Allow a 4-hour gap between doses of iron and calcium, otherwise the calcium makes the iron inactive.

Do not swallow vitamins with coffee, tea or cola.

A few words about vitamins and minerals

Vitamin B-12

Biological role: contributes to production and regeneration of red blood cells; assists synthesis of enzymes, regulating the metabolism of proteins, lipids and carbohydrates; plays an important role in the function of the nervous system; necessary for adequate absorption of calcium and iron.

Symptoms of deficiency: anaemia; nervous breakdown; depression; weakness; fatigue.


Biological role: the basic element of bone tissue and dental tissue; regulates cardiac rhythm; takes part in cell membrane transport, blood coagulation, functioning of the nervous system and muscular tissue; participates in blood pressure regulation and renal function. Symptoms of deficiency: muscular spasms and cramps; caries and osteoporosis (weakness of the bone tissue).


Biological role: an important component of haemoglobin (the blood protein that performs oxygen transportation to all the body organs and tissues) and of myoglobin (basic muscular protein); augments general resistance of the organism to stress factors; prevents fatigue and maintains skin elasticity.

Symptoms of deficiency: general weakness; fatigue; paleness; constipation.

Potential problems after gastric bypass

Gastric bypass, like other surgical procedures, entails the possibility of complications. Right after the operation there could be a leakage of fluid around the connection between the small stomach and the intestine. In this case the draining tube routinely installed in this area must be left in place for 4 weeks to remove the leakage from the abdominal cavity. If the tube does not drain this leakage adequately, the collection of this fluid can be the cause of severe infection. This is an emergency situation, necessitating secondary laparoscopy and maybe even open exploration of the abdominal cavity.

Vitamin deficiency

Vitamins and mineral supplements are a lifelong necessity. The most frequent deficiencies are of vitamin V12, iron and calcium (see here). Narrowing of connection between the small stomach and the intestine

A possible result of oedema of tissues (immediately after the operation) or excessive development of connective tissue (scarring) in the area, this problem manifests itself as difficulty in swallowing and food passage, necessitating endoscopic dilatation (widening). If a patient has difficulty drinking water, it is a potentially life-threatening situation and emergency treatment must be initiated. Patients with such symptoms must inform the doctor as soon as possible.


Dumping-syndrome is a complex of various reactions in response to a fast intake of a specific food into the intestine (particularly very sweet, salted or fatty food). Examples include weakness, dizziness, sweating, palpitation, paleness, blood pressure decrease and tachycardia. Sometimes there is diarrhoea, nausea and vomiting.

To prevent dumping syndrome, avoid:

  • Cakes and cream
  • Sweets and chocolate
  • Jam
  • Honey
  • Sugared nuts
  • Very sweet fruits
  • Ice-cream
  • Sweet jellies and mousse
  • Sweet concentrated milk
  • High-sugar drinks

Potential problems after sleeve gastrectomy and antireflux sleeve gastroplasty

These, like gastric bypass, are performed with surgical devices leaving several lines of staples and cutting tissue between them. Accordingly there can be subsequent leakage, though as these surgical devices are fortunately very reliable, this happens relatively seldom (more seldom than after gastric bypass).

During the first several days after operation, the patient can have difficulty swallowing water if the narrow gastric tube is in postoperative oedema. Sometimes this condition requires the installation of a nasogastric bougie for several days.

Then, for 4-6 weeks after surgery, the patient may have serious problems in food passage, or suffer nausea and vomiting.