Beyond the Procedure: Understanding and Addressing Post-Bariatric Surgery Complications

Bariatric surgery is a powerful tool for overcoming morbid obesity, but it's also an extreme procedure that can come with a range of potential problems. Even after you've healed from the initial surgery, it's important to pay attention to changes in your body and seek medical attention if you notice any unexpected issues. Here are a few potential problems to watch out for in the months and years following bariatric surgery:

Vomiting: Throwing up can be uncomfortable and unpleasant, but it can also be a sign that something's wrong after your surgery. To avoid vomiting, try eating soft foods that are cut into small pieces and chew each bite thoroughly. Mindful eating can also help you avoid overeating too quickly. Call your surgeon if you experience persistent vomiting or if you can't keep water down.

Food blockages: If you swallow a piece of food that's too large or haven't chewed your food thoroughly enough, it can get stuck in the outlet between your stomach and intestines. While food blockages are usually temporary, they can be very uncomfortable and can lead to vomiting. It's a good idea to avoid drinking fluids while you're experiencing a blockage, but you can try taking a few sips of warm water to help loosen things up.

Dumping syndrome: This condition can occur after gastric bypass surgery, but it's also common in people who have been sleeved. Dumping syndrome happens when your body reacts negatively to foods that are high in sugar or fat. Symptoms can include nausea, vomiting, cramps, diarrhea, and fatigue. Avoiding foods that cause dumping syndrome can be a helpful behavioral deterrent.

Reactive hypoglycemia: Low blood sugar can develop about an hour after you eat a meal that's high in carbs. Skipping meals can also cause hypoglycemia. Common symptoms include sweating, headache, nausea, rapid heartbeat, and lightheadedness. To prevent reactive hypoglycemia, make sure you're eating three balanced meals that include protein and vegetables. Drinking a few ounces of juice or eating low glycemic foods can help you manage symptoms if they do occur.

Alcohol use: It's important to avoid alcohol for at least a year after your surgery, as your body may have difficulty processing it due to changes in your stomach. Even after a year has passed, you should use alcohol with caution to avoid potentially dangerous effects, such as alcohol poisoning or an increased risk of addiction.

Transfer behaviors or cross addiction: Many people who struggle with morbid obesity turn to food as a way to address emotional needs. After bariatric surgery, however, they may turn to other potentially harmful behaviors, such as alcohol, gambling, shopping, or promiscuous sexual behavior. If you're struggling with transfer behaviors, reach out to your surgical center for help.

Constipation: Constipation is common following surgery due to pain medications, changes to the GI tract, and a limited diet. If you experience uncomfortable constipation, it's important to address the issue before it becomes more serious. Stool softeners can help, but it's also important to restore healthy bowel movements. A laxative before bed can help your colon move softened stool out of your body. Drinking plenty of water and eating high-fiber foods can also help you address constipation.

Gas problems: During surgery, gas is used to separate organs, which can cause discomfort following surgery. Walking after surgery can help you move past these discomforts, but you may need to eliminate certain foods to address intestinal gas pains. Many people experience these pains due to lactose intolerance, so it's important to monitor your dairy intake. Yogurt can be a helpful alternative even though it's a dairy product, as the live bacterial cultures can help you digest lactose.

Gallstones: Rapid weight loss can increase the risk of gallstone formation. If you experience severe pain on the right side of your abdomen soon after eating, as well as bloating, nausea, and vomiting, you may be experiencing gallstones. Call your surgeon if you experience these symptoms.

Problematic Foods: Choosing the right foods with the appropriate texture is crucial after bariatric surgery. Avoid dry, tough, or dense foods as they may not be well tolerated. Some specific examples to watch out for include:

• Tough or stringy beef cuts
• Dense meats, such as pork chops or ribs
• Citrus membranes (eat the juicy bits only)
• Skins and seeds of certain fruits and vegetables
• Fibrous vegetables like celery and cabbage
• Raw hard vegetables (cooked versions are usually better)
• Bread, which can create discomfort or a dense feeling
• Expandable foods like pasta, oatmeal, grits, and rice, which may cause discomfort and vomiting
• Fried foods that can lead to dumping syndrome
• Chicken skin, which can be difficult to chew properly
• Casings or skins from hot dogs or sausages, which cannot be easily digested

Post-Surgical Fatigue: During the first four to six weeks after surgery, it's normal to experience fatigue, lethargy, and even depression. Your body is adjusting to the changes and limited food intake. It's important to recognize these symptoms and try to push yourself to engage in light exercise, like walking. If the symptoms persist beyond six to eight weeks or become increasingly concerning, don't hesitate to consult your surgeon.

Protein Deficiency: Consuming enough protein after bariatric surgery is essential for a successful recovery. Inadequate protein intake can lead to hair and nail changes, hinder weight loss, and result in muscle loss. Protein supplements, such as shakes, are often necessary to meet your daily protein requirements. While these drinks may not always be the most enjoyable, having a positive mindset towards them can make a significant difference. Inspire protein drinks are designed to taste good while providing the necessary nutrients.

Body Changes: After surgery, it's common for women to experience immediate menstrual cycles, sometimes even while still in the hospital. These cycles may remain irregular for a few months due to the stress placed on the body by surgery and subsequent weight loss. Women of reproductive age should consider non-oral contraceptives and avoid pregnancy for 12 to 18 months. It's also important to be mindful of the lactose content in milk and dairy products, as your body may reject them post-surgery. Additionally, symptoms like feeling lightheaded or dizzy, dehydration, and hypoglycemia may arise and should be addressed promptly.

Emotional Challenges: Losing a significant amount of weight after bariatric surgery can bring about emotional challenges. Some individuals may struggle with increased attention, body image issues, or changes in relationships. It's important to reach out for support, whether through professional counseling or conversations with trusted individuals. Recognize that the weight loss journey is more than just physical, and taking care of your emotional well-being is equally crucial.

Bariatric surgery can bring about both physical and emotional changes. By being prepared and informed about the potential challenges that may arise, you can navigate the post-surgery period more effectively. Remember to prioritize your nutrition, listen to your body, and seek support when needed. Embrace this transformative journey and celebrate the new you.