Pain after surgery

Because surgery, even minimally invasive, is by definition still invasive, pain after a bariatric procedure is expected. However, our experts’ experience with the latest surgical techniques and post-operative management will ensure that in most cases, it is mild. Pain medication is routinely available to ensure our patients’ comfort for the first 2 days, as that is the typical period where they feel discomfort. We will of course work with you to ensure your wellbeing as needed.

24 hours after surgery

It is important to give the body time to heal on its own, without being burdened too quickly by our normal physoiological functions. This is why, during the first 24 hours after the surgery, you should refrain from eating and you will only receive intravenous drips to keep you hydrated and comfortable. You can drink small amounts of fluids under medical supervision. If you require orally administered drugs, you can swallow them with a few sips of water. The day after the procedure, you can start drinking fluids and gradually increase their volume. Please note that these should be calorie-free drinks, e.g., still mineral water or weak tea without sugar, and the amount of fluid consumed during the day should not exceed 500 ml in 15 ml portions. On this day, you can also spend up to 8 hours out of bed, your dose of painkillers can be reduced, and your dressings will be changed.

First week after surgery

On the second day after surgery, in the case of sleeve gastrectomy and bypass surgery, some patients undergo an anastomotic leak test. This is for screening purposes to ensure the connections our surgeons created are functioning optimally. For this purpose, an X-ray image is taken with an oral contrast liquid that you will swallow. Not all patients require this examination.

During this period, the total fluid volume you can ingest increases to about 1000-1500 ml and we recommend you consume about 60 ml every hour. Our experts recommend to avoid using a straw because swallowing too much air may cause gas and abdominal discomfort in the early post-operative period.

3-5 days after surgery, the patient can usually leave the hospital. On discharge, in addition to the list of recommendations, the patient also receives a prescription for medications and sick leave for 2-4 weeks. Your success is our mission, so every bariatric patient at the Szpital na Klinach receive a personalized nutritional guide, a diet plan written for up to 8 weeks, and relevant contact numbers for advice in the event of any discomfort, unpleasant symptoms, or other concerns.

By the end of the first week after your surgery, the stomach and intestines heal sufficiently to allow you to replace more than half of the total fluids with nutritional drinks such as skimmed milk or yogurt, light broth with lean poultry meat and vegetables such as celery, carrots or parsley, diluted semolina, barley or rice, and unsweetened fruit and vegetable juices diluted with water.

Physical activity after bariatric surgery

Physical activity certainly helps in the quick recovery of patients undergoing bariatric surgeries, and is especially beneficial in the first few days after your surgery. You will start off slow but can gradually increase effort with the help of our advisors. In the beginning, it is best to start with walking, and then, approx. 6 weeks after the surgery, gradually implement activities such as Nordic pole walking, cycling, or swimming. There are no long-term restrictions for any specific type of physical activity after most bariatric surgeries (except for some sports when wearing a gastric band).

Medical checks

During hospitalization, you will be under the constant care of the attending physician. After leaving the hospital, your first visit will be 7-10 days after surgery to check your overall health and remove stitches. Your next visit is planned 2-3 months after the surgery to analyze your progress in losing body weight, correct eating habits, discuss any problems or ailments, and to recheck the integrity of the anastomoses using an X-ray and oral contrast. Your long-term progress will be checked during 6 and 12 month post-operative.

Our team of experts at Szpital na Klinach stress the importance that all our bariatric patients be aware that bariatric treatment does not end when follow-up visits are completed. Every one of our patients requires regular supervision, long-term care, and continued education in the field of proper nutrition, as well as proper supplementation of nutrients. We will help you achieve your goals.

24 hours after surgery

During this time, you will receive only intravenous drips – however you cannot eat solid foods as doing so may cause damage to the operative location because not enough time passed for healing to begin.

1-3 days after surgery

Following approval by the attending physician, you may drink water. The bariatric dietician will also include a clear broth, high-protein medical preparations, and natural yogurt.

4-14 days after surgery

A liquid diet should be continued for the next few days after you return home. In addition to clear soups and yogurts, you can have blended cream soups, well-cooked porridge with skimmed milk, naturally fermented products, and small amounts of easily digestible fruit. It is recommended to supplement the diet with high-protein nutritional supplements recommended by your dedicated dietician at discharge from the hospital.
After about a week, a mushy diet is gradually introduced, depending on your health status and individual tolerance. Recommended products include delicate cheese, cottage cheese, dishes based on scrambled eggs, meat, fish, cooked vegetables, and fruit. This approach is necessary to allow time for your body to adjust to the new mechanisms in place, and minimize the risk for developing unwanted symptoms such as diarrhea, bloating, and abdominal pain.

3-6 weeks after surgery

Gradually, in accordance with your tolerance, new, nutritional products are introduced to your diet. Although initially they must be soft or blended, over time you will be able to ingest more solid foods just be very mindful to thoroughly and carefully chew them. This is because the mechanisms to break down solid foods have been reduced or bypassed as a consequence of your operation. Meals will be planned by your dietician so that you provide your body with the necessary protein, healthy fats, complex carbohydrates, vegetables, and fruits while getting into the habit of managing your own lifestyle successfully. The daily intake of protein should be at least 60 g. Meals should be eaten regularly – every 3-4 hours – and your dietician will provide you with clear instructions on an individual basis because there is no universal standard. Remember proper hydration is essential.

Nutrition in the longer term

Since everyone may have a different tolerance to individual products, dishes, ingredients, or consistency, it is not possible to estimate target values in the early stages of diet expansion. You should be under the constant guidance of a bariatric dietician who constantly monitors your progress and helps your master new eating habits, correct any mistakes, and ensure your proper nutritional status by ordering regular blood tests. Ultimately, you have to eat a regular, healthy diet adapted to your individual preferences and tolerance. You should spend enough time eating in a relaxed atmosphere, not rushing but instead chewing every bite thoroughly. It is recommended to drink between meals but avoid sugary carbonated drinks, juices, alcohol, and sweetened coffee or tea (sugar can be replaced with an artificial sweetener). Sweets and salty snacks should be strictly limited and instead be replaced with homemade desserts or fruit (always eaten with a product that provides proteins and healthy fats. It is not recommended to choose products that are light or 0% fat.