What to expect after gastric sleeve?*

Choose the topic:

• Recovery
• Diet
• Weight loss
• Pregnancy
• What to be aware of
• Comparing with other surgeries

Obesity remains a serious health- and social-life related issue. Some cases are so severe that even a combination of the most drastic diet and vigorous exercises is futile. Consequently, weight loss (bariatric) surgery is becoming more and more popular and is sometimes the only way to attain health and harmony. Gastric sleeve is a bariatric surgery in which approximately 60-80% of your stomach is removed. Your stomach will look like a tube or sleeve after this surgery. The goal of gastric sleeve surgery is to decrease the capacity of the stomach in order to make you feel full after consuming small amounts of food. As a result, you will reduce your caloric intake and start losing weight.

Recovery after gastric sleeve

Directly following the surgery, you will wake up in a ward and have five to six small covered incisions in your abdomen region. Some discomfort, nausea, or pain is completely normal after such procedures. Pain killers will be administered through the intravenous catheter when necessary. Usually, patients are required to stay in the hospital for one or two days after gastric sleeve surgery. Generally, recovery time after the gastric sleeve procedure takes about two weeks, but it depends on the type of work you do. After this period of time, you will be able to return to your routine life activities. However, you should refrain from heavy lifting for about four to six weeks after the gastric sleeve procedure. Also, you will have to change your eating habits and stick to a special dietary plan.

Food and supplements

“Relearning“ to eat is necessary after the gastric sleeve procedure in order to let your stomach heal properly and to prevent complications (for example stretching of your newly formed stomach). Solid foods have to be introduced slowly and carefully in order to let your body adjust to the new anatomy of your stomach. Also, limiting food and even beverages right after the gastric sleeve procedure is required. Milk shakes and soda drinks have to be replaced with tap or distilled water, diluted juice, tea, and coffee. You will most likely be put on a liquid-only diet for the first one or two weeks after the surgery. The next step is a pureed diet that lasts about one or two weeks. After this you will be able to try solid foods. It is extremely important that you eat in very small portions and often, about five times per day. Nutrient-absorption issues are not as prevalent after the gastric sleeve procedure as compared to some other bariatric surgeries (for example gastric bypass). However, vitamin and mineral supplements are recommended after this procedure in order to provide your body with the necessary amount of these goodies.

Weight loss

According to research, people achieve approximately 50-60% excess body weight loss at one year after gastric sleeve surgery. A long-term report from Belgian bariatric surgeons reveals very similar results in patients after six years and more. However, it is important to realise that the process of losing weight after the gastric sleeve procedure is gradual and requires an effort of will. A prescribed diet plan is one of the most crucial factors in the whole process of your weight loss. Moreover, physical activity is also very important. You should start exercising as soon as you feel no pain. Thirty minutes of walking per day within the first four weeks after your surgery would be a good start.

Pregnancy after gastric sleeve

More than half of obese women seeking gastric sleeve surgery are in their reproductive age. Losing weight before pregnancy can improve the health of both mother and baby. Being obese during pregnancy is associated with various disorders including thrombosis, infection, high blood pressure, a special form of diabetes (gestational diabetes), labor problems, and many others. Doctors from South Korea carried out a study on women who got pregnant after gastric sleeve surgery. No cases of hypertension, diabetes, or serious birth defects were recorded. Thus, gastric sleeve surgery is considered to be a completely safe procedure for obese women planning to get pregnant in the future.

What to be aware of after gastric sleeve

One of the possible side effects that might follow gastric sleeve surgery is gastroesophageal reflux disease (GERD). It is a chronic disorder in which stomach acid flows back into the oesophagus (the gullet). Acid damages the inner wall of the oesophagus, which results in such symptoms as heartburn, chest pain, dry cough, sensation of a lump in the throat (globus pharyngeus), and others. It is thought that physiological and anatomical alterations in the stomach due to gastric sleeve surgery may provoke development of GERD. Some studies show that GERD may develop between the 3rd and the 6th postoperative year. The main factor determining whether or not GERD will develop is the shape of the newly formed stomach.

The other possible risk is stretching of your new gastric pouch. Overeating, a lot of snacking, big portions, and other bad habits can overload your stomach and its stretch the walls. In order to prevent your new stomach from stretching, eat very slowly, chew thoroughly, avoid drinking during meals, and enjoy your food in small portions.

Comparing gastric sleeve with other bariatric surgeries

A recent American study compared three bariatric laparoscopic procedures including gastric sleeve, gastric bypass, and adjustable gastric banding. The results revealed that patients undergoing the gastric sleeve procedure experienced less complications than those with gastric bypass. Furthermore, patients after gastric sleeve achieved more significant excessive weight loss at one year than patients after adjustable gastric banding. According to the results of the same study, the therapeutic effect on obesity-related diseases was very similar for all three methods.