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Roux-en-Y Gastric Bypass, Laparoscopic Surgery Discharge Instructions


About this topic


This procedure is done to treat obesity. It helps you lose weight by making your stomach smaller. When there is less space for food, you will be encouraged to cut down on the amount of food you eat. You will absorb fewer nutrients when a part of the small bowel is cut. ‚  
Your doctor will compute your body mass index, or BMI, based on your height and weight. BMI is used as a tool to identify possible weight problems. A high BMI puts you at greater risk of health problems. This procedure is done for people with BMI of 40 or higher. This may also be done for people with BMI of 30 to 39 who have very bad health conditions such as diabetes, high cholesterol, osteoarthritis, or heart disease. ‚  


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What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Talk to your doctor about how to care for your cut site. Ask your doctor about:
    • When you should change your bandages
    • When you may take a bath or shower
    • If you need to be careful with lifting things over 10 pounds
    • When you may go back to your normal activities like work or driving
  • Be sure to wash your hands before and after touching your wound or dressing.
  • Your doctor may have you wear special stockings. These will help prevent blood clots.
  • Drink water slowly. To help with belly fullness, do not take fluids when you eat. Drink 30 minutes before or after meals.
  • Ask your doctor about taking products that contain aspirin or ibuprofen. These drugs could bother your stomach.
  • Keep a food journal. Take note of what you eat. Learn how to count calories. Foods may give you an upset stomach after the procedure. Write down those that make you throw up or have loose stools.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.

What lifestyle changes are needed?


  • Start an exercise program when cleared by your doctor.
  • Stay away from beer, wine, and mixed drinks (alcohol). Drinking them can cause serious health problems after surgery. Avoid sodas and drinks that are carbonated.
  • If you are a smoker, stop smoking.
  • Your body will adjust to the smaller amount of food you eat. You may feel tired, anxious, and depressed. Keep yourself active and busy while you get used to this change. Get help from your counselor or doctor if your feelings are getting in the way of your daily routine.

What drugs may be needed?


  • The doctor may order drugs to:
    • Help with pain
    • Fight an infection
    • Prevent gallstones
    • Lessen stomach acid
  • Your doctor will talk to you about the food and mineral supplements that you need after surgery. Chewable vitamins may be easier for you to take and are absorbed more easily. You may need to take them 2 times each day.
  • Take drugs by crushing them. If they cannot be crushed, take in liquid form.

Will physical activity be limited?


  • You may need to limit your activity for a while. Talk with your doctor about the right amount of activity for you.
  • Once you are feeling better, start with a daily walk of 5 or 10 minutes and slowly add to the amount of time that you walk. As you become more in shape, ask your doctor about exercises to build your strength.
  • Regular exercise must become a part of your daily routine for you to lose weight.

What changes to diet are needed?


  • Food must be pureed for the first 6 weeks after the procedure.
  • Eat small meals more often (4 to 6 each day). Each meal will be about 2 ounces of food.
  • When you are allowed to eat solid food, CHEW your food properly. Eat slowly and take small bites.
  • Eat a healthy balanced diet with enough protein.
  • Avoid foods high in sugar. These can cause upset stomach and bloating and lower your blood sugar later.

What problems could happen?


  • Infection
  • Bleeding or blood clots
  • Signs of low blood sugar. These include anger, shaking, a fast heartbeat, confusion, or sweating.
  • Leaks or blocks where the bowels were sewn together
  • Dumping syndrome: Fullness, upset stomach, cramping, loose stools, and feeling faint after eating
  • Throwing up if you eat too much or too fast
  • Vitamin and mineral deficiencies
  • Loose stools
  • Anxiety
  • Hernia
  • Gallstones or kidney stones

When do I need to call the doctor?


  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine.
  • Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
  • Upset stomach and throwing up
  • Very loose stools
  • Blood in vomit or stool
  • Pain in the belly, chest, or legs
  • Low mood
  • You are not feeling better in 2 to 3 days or you are feeling worse

Helpful tips


  • Gastric bypass alone is not a solution to lose weight. Control what you eat and exercise to have success in losing weight and keeping the weight off.
  • When you weigh yourself, do it in the morning in your underwear.
  • Put a pillow on your belly when you cough to lessen the pain.
  • You may feel a lot of changes in your body. Your menstrual cycle may change after the surgery. Your skin and hair may feel brittle or fall out if you dont eat enough protein-rich food. Talk to your doctor about these changes.
  • Continue to work with your doctor for any other health problems. Your diabetes and high blood pressure may improve. Your doctor may need to change how much of your drugs you are taking as you lose weight.

Teach Back: Helping You Understand


The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚  
  • I can tell you about my procedure.
  • I can tell you how to care for my cut site.
  • I can tell you what changes I need to make with my diet or activities.
  • I can tell you what I will do if I have a fever, chills, belly pain, upset stomach, or throwing up.

Where can I learn more?


American Society of Metabolic and Bariatric Surgery ‚  
http://asmbs.org/benefits-of-bariatric-surgery/ ‚  
Weight-Control Information Network ‚  
http://win.niddk.nih.gov/publications/gastric.htm ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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