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Roux-en-y Gastric Bypass

AMBULATORY CARE:

What you need to know about roux-en-Y gastric bypass surgery:

Roux-en-Y gastric bypass is a type of weight loss surgery. Staples are used to make a small stomach pouch that is separate from the rest of your stomach. The new stomach pouch is connected to the middle part of the small intestine When you eat, food bypasses the rest of the stomach and goes directly into the small intestine. The surgery makes your stomach smaller so that you feel full sooner and cannot eat as much during meals. Your body will not absorb as many calories from food because part of your stomach and intestines are bypassed.

How to prepare for roux-en-Y gastric bypass surgery:

Your healthcare provider will talk to you about how to prepare for surgery. He may tell you not to eat or drink anything after midnight on the day of your surgery. He will tell you what medicines to take or not take on the day of your surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection. Arrange to have someone drive you home and stay with you to make sure you are okay.

What will happen during roux-en-Y gastric bypass surgery:

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given spinal anesthesia to numb the surgery area. With spinal anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain.
  • Your surgeon will make small incisions in your abdomen. He or she will use staples to make a small stomach pouch that is closed off from the rest of your stomach. The new stomach pouch is then connected to the middle part of the small intestine. The incisions will be closed with stitches or medical tape.

What will happen after roux-en-Y gastric bypass surgery:

  • You may need to walk around within 6 to 12 hours after surgery. This helps prevent blood clots. You will sip water or chew on ice chips after surgery when your health provider says it is okay. The next step is to drink sugar-free clear liquids. Examples of clear liquids are broth, gelatin, and clear juice. You may only be able to eat a few teaspoons of food at the beginning. Stop eating when you feel full.
  • As you begin to eat differently, you may begin to lose weight. Your weight loss will depend on how well you follow your diet and exercise plans. It may take 18 to 24 months to reach a healthy weight.

Risks of roux-en-Y gastric bypass surgery:

  • You may bleed more than expected or get an infection. Your spleen or other organs may be injured during surgery. The staples inside your stomach could break down. The new connections to your stomach and intestines could form scars, narrow areas, or leaks. Stomach juices may leak into your abdomen and you may need emergency surgery. You may develop gallstones or an incisional hernia (a weak area near your surgical incision). You may need a larger incision than expected during laparoscopic surgery. After surgery, you may not lose any weight. You may lose weight and then gain it back.
  • If you eat sweet foods, or foods high in fat, you may get dumping syndrome. Dumping syndrome happens when high-sugar or high-fat foods and drinks go into your intestine too quickly after a meal. Dumping syndrome may also occur if you drink liquids during a meal. Dumping syndrome may cause you to sweat, or feel faint, weak, and dizzy. It may cause you to feel full, have a fast heart rate, or have stomach cramps. Dumping syndrome may cause you to have an upset stomach and loose bowel movements.
  • If you often eat too much and do not follow instructions, you may stretch out your stomach pouch. If you eat too much, too fast, or do not chew well enough before you swallow, you may vomit. You may have abdominal pain, heartburn, or a stomach ulcer. You may get a blood clot in your arm or leg. This may become life-threatening.

Call 911 for any of the following:

  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.

Seek care immediately if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • Blood soaks through your bandages.
  • Your stitches or incisions come apart.
  • You cannot stop vomiting.

Contact your healthcare provider if:

  • You have a fever higher than 100°F (37.8°C).
  • You have pain or pressure in your abdomen or back, hiccups, and you feel restless.
  • You have redness, swelling, or pus coming from your incisions.
  • You have nausea and are vomiting.
  • You feel your heart beating faster than usual.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow your nutrition plan:

Ask your dietitian or nutritionist any questions you have about what foods to eat and how much.

  • Eat slowly. Chew your food well before you swallow. Large bits of food may cause choking or may block your stomach.
  • Eat 3 small meals each day. Do not eat snacks between meals unless your healthcare provider says it is okay. Stop eating when you feel full, even if you have not eaten all of your meal.
  • Eat nutritious foods. Eat plenty of protein. You may need to protein drinks for the first week after surgery. Foods that contain protein include chicken, fish, eggs, and dairy products. Avoid candy, cookies, ice cream, and fried foods.
  • Drink liquids between meals. Wait at least 1 or 2 hours after a meal before you drink liquids. Do not drink liquids with meals. Drink water, diet drinks, or other drinks that have few or no calories. Do not drink carbonated liquids, such as soda.

Self-care:

  • Care for your wound as directed. When you allowed to bathe, carefully wash the wound with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty.
  • Do activity or exercise as directed. Ask your healthcare provider about the best exercise plan for you.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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