After Care :: Eating Smart (Post Surgery)

After Care following Weight Loss Surgery

Medications on discharge
Antacid therapy to reduce ulceration at the joinup between the pouch and the bowel (gastrojejunostomy) Analgesia (pain relief), generally panadol elixir and other medications as required on discharge

Postoperative diet following gastric bypass
In the early post operative phase, days 1-42, there will be swelling around the staple lines which will slowly settle as healing occurs. It is most important to follow your post operative diet sheets very carefully. Failure to do so may result in severe pain and delay your progress. You must chew your food very well ( 25 x/ mouthful )and eat very slowly, ( 30 minutes for each meal).

Following surgery you will begin clear fluids, sipping very small amounts of water.
Day 2 after surgery you will be able to sip OPTIFAST® (high in protein, minerals and vitamins), you will remain on OPTIFAST® for 2 weeks after surgery. Week 3-6 will move up to a puree diet.

At 6 weeks you will move on to solids. By 3 months you will be able to eat a wide range of foods Bread and dry pieces of meat which are often difficult to digest, and may stick at the entrance to your new " "stomach pouch” are still avoided at this stage. You will gradually be able to introduce most foods, avoiding the fatty and sugary foods.

Your dietitian will advise at each step and help you make long term healthy food choices

Our dietitian (Nikki Talacek) will work with you preoperatively and postoperatively. In general you will eat tiny amounts, a tablespoon or so at a time. It is important to stop eating as soon as you feel full to avoid stretching the pouch. Once you are on solids, do not drink with your food. Drink water between meals, this provides the necessary intake and will help suppress hunger. Do not snack. Minimise alcohol intake.

Nutritional Requirements following gastric bypass
All patients will need to take Multivitamins. These can be bought from the chemist. We recommend Centrum multivitamins. We do not generally start these until one month after surgery. They can be crushed or swallowed whole. Vitamin B12, folate and iron levels need to be monitored and supplemented by your family doctor as required. Iron supplements are often required by about 6 months, particularly in women, as you are unlikely to be eating very much meat at this stage. Sometimes vitamin B12 injections are necessary. Calcium supplementation is advisable in women particularly around the menopause.

Post-op diet following adjustable band
Pureed / soft diet for 6 weeks to allow band to bed into surrounding tissues prior to adjustments being made.

Nutritional requirements following adjustable band
Multivitamins during periods of weight loss - generally not required long term.

Band adjustment
Will begin at 6 weeks after surgery on a 4-6 weekly basis as required.

Reduction in comorbidities and medication requirements following weight reduction surgery

There is an 80% chance of in curing maturity onset (Type II) diabetes with gastric bypass. Most patients will be able to get off all diabetic medication or have a substantial reduction in medication requirements. Antihypertensive medication is often substantially reduced as is the need for antigout medication and antinflammatories. Breathing difficulties including sleep apnoea and snoring are generally resolved or substantially improved. Exercise tolerance is improved and bothersome symptoms such as reflux and joint pain will frequently resolve. Patients are more likely to exercise and develop more confidence as they see the results of surgery.