What To Look Out for After Bariatric Surgery

1. Keep an Eye on Your Incisions

Before you’re discharged from the hospital or surgery center, your surgeon or nurse will give instructions on caring for your incisions. Depending on the type of surgery you’ve had, you may have several small incisions from a minimally invasive laparoscopic procedure. The incisions may be a few inches long with stitches and glue covered by gauze and adhesive. The stitches will dissolve on their own over time, and the glue will peel as your body repairs the incision.

Be sure to keep a close eye on your incisions and keep them clean. Don’t try to peel off the glue on your own or pick off the stitches. Your body will take care of them itself as you heal. Avoid submerging your incisions (taking a bath, swimming, or sitting in hot tubs) until they’ve completely healed. Keep the areas clean with gentle soap and warm water. If the incisions start to itch, you can apply Aquaphor or Vaseline to help.

Some clear discharge draining from your incisions is normal. Call your doctor if you notice any signs of infection, including:

As your incisions continue to heal, they may form red, purple, or dark pink scars. They usually fade within a year of your surgery. Be sure to put sunscreen on your surgical scars and cover them as needed to protect them from sun damage.

2. Some Bloating and Constipation Is Normal

During your bariatric surgery, the surgeon pumps air into your abdomen to help separate your stomach from your other organs. Your body will naturally get rid of this gas in the days following your surgery, but you may notice you’re more bloated or gassy than normal. Abdominal pain can also accompany the bloating, causing more discomfort. Doctors usually recommend walking around to help air move through your body.

You may also find yourself more bloated even after healing from bariatric surgery. Your stomach is much smaller now, meaning ingesting air while eating can cause more discomfort than before. Your stomach may also not digest food as well, leaving more for your gut bacteria to digest. This can create gas that makes you feel bloated and full sooner. Sage Bariatric Institute recommends:

Anesthesia from surgery can also affect your gastrointestinal system, leaving you constipated and in discomfort. You’ll be drastically changing your diet as well, meaning you’re eating less fiber and food in general. Many people have fewer bowel movements after bariatric surgery or become easily constipated. University of California San Francisco (UCSF) Health recommends adding a powdered laxative to your daily routine to help. Dairy products with cow’s milk can also cause constipation, so you may want to try limiting your daily consumption of yogurt, cheese, and milk.

3. Make Sure You’re Getting Enough Protein

After bariatric surgery, your body needs the right fuel to heal properly. Your surgeon has likely talked to you about the importance of getting enough protein in your diet daily. This is especially important when healing because your body needs protein to repair the incisions and heal your stomach/intestines. The recommended amount of protein varies per person following bariatric surgery. Your doctor or a registered dietitian has likely given you a healthy range of protein to eat or drink per day. Be sure to stick to this range as closely as possible.

While healing, it’s important to drink protein shakes throughout the day to hit your protein goal. (See my article on protein powders for the best one to take.) After you’ve transitioned to your soft food and regular diets, it’s best to get protein with foods like lean meats, eggs, cottage cheese, and tofu. Your doctor or dietitian can help you re-evaluate your protein goals to stay healthy.

4. Persistent Nausea and Vomiting Requires Medical Attention

As you might expect, bariatric surgery usually causes some nausea and vomiting as your stomach adjusts. You may become nauseous after surgery if you’re not chewing your food well enough or you’re dehydrated. Certain pain medications and smells may also make your stomach churn when eating. Your surgeon will likely send you home with anti-nausea and anti-vomiting medications to help within the first few days after surgery. It’s important to take slow sips of your protein shakes and drink plenty of water to stay hydrated. You can also help calm your stomach and get added hydration by sipping on green or peppermint tea or drinking cold water with a squeeze of lemon.

After you’ve switched your diet to soft foods and eventually work your way back to your regular diet, it’s important to stay mindful while eating. You may become sick to your stomach and vomit if you’re eating too much too fast, trying to eat solid foods before you’re ready, or you’re not chewing your food well enough. Here are some tips to help avoid vomiting:

While some nausea and vomiting are normal, you should let your doctor know if it happens more often than not around mealtimes. If you’ve recently switched to soft or regular foods and you’re vomiting, move back to your liquid diet for a few days. Your stomach might not be ready for those foods yet. If you’re vomiting several times within 24 hours, it may be a sign that you’re not digesting food and moving it into your intestines. Call your surgeon or bariatric healthcare team and let them know what’s happening. Excessive vomiting can lead to dehydration, which may be dangerous if left untreated.

5. Expect Some Hair Loss

It can be alarming to see more hair falling out in the shower or in your brush after your bariatric surgery. Hair loss is common in people who rapidly lose weight, especially after a weight loss procedure. In fact, studies show that just over half of people who have bariatric surgery experience some sort of hair loss while healing. The good news? This hair loss is usually temporary and will improve on its own within 6 months to 1 year after surgery.

Penn Medicine recommends getting a minimum of 60-80 grams of protein per day to help stave off hair loss. You can always add an extra protein shake or powdered protein to your diet to boost your intake. After you’ve fully healed, be sure to eat a variety of nutrient-dense foods like fruits and vegetables to boost your vitamin levels.

Your body may also not be getting enough vitamins and minerals to support healthy hair growth. Taking your bariatric multivitamins and supplements is an important part of staying healthy after surgery, and they’ll help with hair loss as well. Your surgeon or dietitian can recommend a bariatric vitamin that’s made with more than the recommended daily intake (RDI) of vitamins and minerals. You’ll also need daily vitamin D, vitamin B12, and calcium supplements. Your bariatric surgeon may also recommend a multivitamin and folic acid or folate. It’s important to get vitamins and supplements formulated with bariatric surgery in mind, as your stomach can’t absorb nutrients as well as before.

6. Drink Plenty of Water To Avoid Dehydration

People who have had bariatric surgery are more likely to become dehydrated, as their stomachs can’t hold as much liquid as they used to. You’ll need to adjust your water intake after surgery by taking small sips constantly throughout your day. Your surgeon will likely recommend getting at least 64 ounces (8 cups) of water and low-calorie/sugar-free beverages every day. This goal may seem lofty at first, but your body will adjust over time.

Here are some tips to help you avoid dehydration:

If you notice any signs of dehydration — such as feeling thirsty, dark urine, fatigue, nausea, or a white coating on your tongue — call your surgeon or healthcare provider. You may need intravenous (IV) fluids to rehydrate.

7. Be Wary of Dumping Syndrome

You may have heard your surgeon mention “dumping syndrome” at some point during your bariatric surgery education. As the name suggests, this condition occurs when your stomach “dumps” undigested food into your intestines too quickly. During an episode of dumping syndrome, you may notice symptoms within:

Early dumping tends to occur after a larger, concentrated meal, causing your intestines to release hormones that move circulating blood to your intestines. This causes bloating, diarrhea, a racing heartbeat, and sometimes fainting. Late dumping typically happens after eating foods with too much sugar. Your body releases more insulin to use the sugar, which leads to rebound low blood sugar later on. Signs of late dumping syndrome include confusion, hunger, sweating, and tremors.

To avoid dumping syndrome, be sure to eat small meals and snacks throughout the day and avoid sugary foods. If you continue experiencing symptoms, talk to your bariatric surgeon or healthcare team.