Bariatric FAQs

Please see weight loss surgery for further information,

Please see weight loss surgery risks for information.

Unfortunately, due to the COVID-19 pandemic, the wait to attend our Tier 4 MDT meeting is longer than normal. It may be over a year. Patients are often prioritised according to clinical need and therefore won’t be seen in the order that they were referred to the service. We aim to offer some of these patients non-surgical treatments whilst they are waiting for surgery.

If you are put on the waiting list for surgery at your Tier 4 multidisciplinary clinic appointment, the waiting time is about 11 months until your surgery.  You will be contacted by the admissions department to schedule a pre-operative assessment.  Following this, the Bariatric Department will call you and offer you a date for surgery and we aim to provide 4-6 weeks’ notice. Usually, we can be a bit flexible, if this date is inconvenient. Patients don’t always get a date for surgery in the same order that they are booked in clinic; for example, some operations may require the expertise of particular surgeons, and as per national guidelines written because of the pandemic, some patients are offered surgery earlier than others.

We encourage you to eat a healthy balanced diet as you wait for your surgery date. You must follow a strict diet for 2 weeks before your operation.  This will shrink the size of your liver to help the surgeon do the keyhole operation. The diet is drinking milk and not eating any food.  It is explained in our video “A guide to the pre-operative liver shrinkage diet.

It has been proven that a liquid diet is the best way to shrink your liver. This is why we recommend the milk diet. If you are unwell with vomiting or diarrhoea, please watch the video “A guide to the pre-operative liver shrinkage diet,” for tips. If you continue to be unwell, please contact your bariatric team.

Our St Richard’s bariatric surgeons are very keen to know about any bariatric concerns with their patients. If you are admitted to other hospitals, please ask your doctor to contact the bariatric surgeons (bariatric fellow or consultant) at St Richard’s through our switchboard, for specialist advice or transfer.

It’s normal to have some pain and discomfort for a week or two after bariatric surgery. However, if it is getting worse rather than better, and doesn’t settle with your regular painkillers then contact us or your GP. For pain specifically related to eating and drinking, please let us know. 

Yes after a sleeve gastrectomy, but not after a gastric bypass. Non-steroidal anti-inflammatory painkillers (NSAIDs) include ibuprofen, diclofenac, and naproxen, may cause an ulcer where the small bowel is stitched to the stomach pouch.

Anyone that has had gastric bypass surgery is at risk of internal hernias. We often treat any new moderate/severe abdominal pain as an internal hernia strangulating the small bowel (until proven otherwise). Please see a doctor if this happens to you.

Blood clots in the leg and lung (venous thromboembolisms) are more common after all operations, especially in larger patients. We reduce this risk by giving you blood thinning injections (heparin) for 14 days after bariatric surgery. We will teach you how to inject yourself. Try to stay hydrated and mobile. Seek help if:

• one of your legs becomes swollen, painful or hot,
• or you become breathless, have new chest pains, or cough up blood.

Please call us, we may need to treat this urgently with fluids or a vitamin drip, and try to find out why it’s happening.

Please take a proton pump inhibitor (PPI) such as 30mg Lansoprazole FasTab for 28 days after surgery. After this you can trial without it – if you develop reflux you will need to start taking it again.

To avoid nutritional deficiencies, you must take vitamins and minerals daily for the rest of your life. If you are struggling to take them immediately after surgery for a couple of weeks, this will not be a problem, but please re-start as soon as you can. Only take the supplements we have told you to, or discuss this at your next dietitian appointment.

Your GP or local diabetes specialist will be able to help. If you are regularly having low blood sugars (sugar levels below 4mmol/L) or ‘hypos’ (fainting, dizziness, blurred vision) after your surgery contact the Loxwood Centre on 01243 831655.

Yes, and it tends to settle down with time. If constipated, have more fluid and fibre, and buy a stool softener from your chemist eg. Movicol / Laxido.

Surgery can be unsettling. Mood changes are usually temporary. If you normally take anti-depressants, don’t stop taking them without medical advice. If you find you are more depressed than usual, especially if you have thoughts of harming yourself, please make an appointment as soon as you can to talk things over with your GP.

This is normal as there can be big changes to your hormones with bariatric surgery. Many women say their period cycle becomes more regular, and for the first few cycles their period may last longer. However, if bleeding is continuous or with clots please see your GP.

It may not be absorbed properly, and might not work as well. We suggest switching to an alternative (eg. coil, injection, implant).

Wait 12 months before trying to get pregnant as the baby might not get enough calories and may not grow properly. Make sure you use contraception during this time. If you do find you are pregnant during the first year, contact us for advice.

If you feel unwell during the post-operative period, and these FAQs don’t answer your query, please contact your GP, or telephone the hospital. If you’re very unwell you should telephone 999.