Deciding to have a gastric sleeve surgery is a big self-talk to go into, thinking about the preparations and the post-operative result might be overwhelming at first. The infinite questions about the different factors involved in making the decision could disappear once you start researching, learning, and most importantly, getting involved with the clinic or doctor you trust.

The gastric sleeve procedure, also known as a gastric sleeve, is a restrictive bariatric surgery that might change your eating habits since it significantly reduces the size of your stomach. You´ll have less appetite and this will encourage weight loss. It is an uncomplicated procedure with a shorter recovery time than others.

A gastric sleeve physically restricts the amount of food you can eat by reducing the size of your stomach. It is a restrictive surgery that also limits the production of ghrelin, which contributes to a reduction in appetite. This allows patients to feel satisfied with less food and helps them with portion control if it is recommended to them by a licensed dietitian.

In previous articles we´ve talked about the pre-operational requirements and the process during the surgery, how it is performed, and how our experts walk with you in every step of the process. However, in this piece, we mainly focus on the postoperative symptoms, like constipation, commonly known as bowel movements.

After having gastric sleeve surgery, your digestive system undergoes significant changes. The procedure involves removing a portion of your stomach, which leads to reduced food intake and changes in digestion as we mentioned. As in most parts of the body, your organs will start recovering slowly.

Bowel Movements and Constipation

The most common effect the patient might feel after the surgery is constipation. A 2019 study of the changes in bowel habits after laparoscopic sleeve gastrectomy found that “around 11% of people had one bowel movement or less per week 6 months after the procedure.

This compares to 5.6% of people before the procedure. Around 29% of people had 2–3 bowel movements per week, compared to around 24% of people before the procedure” [1].

This suggests that some people may experience symptoms of constipation for a number of months after the surgery. The frequency of bowel movements can vary from person to person after this surgery, but here are some general pro tips if you had your gastric sleeve and are wondering about your digestive system recovery process:

• Initial Days Post-Surgery: In the first few days after the surgery, your digestive system might be slow to start functioning. Bowel movements might be infrequent, and this can be due to reduced food intake and the effects of anesthesia. It’s essential to follow your surgeon’s and medical team’s instructions during this time.
• Recovery Phase: As you gradually recover and start consuming liquids (water and prune juice) and pureed foods, your bowel movements should become more regular. You might experience a more frequent need to go to the bathroom due to your new smaller stomach size and changes in diet.
• Long-Term: As you transition to a solid food diet, your bowel habits should stabilize over time. However, it’s important to note that the frequency of bowel movements can still vary depending on factors such as your diet, hydration, physical activity, and individual variations in metabolism[2].
• Dietary Changes: After a gastric sleeve surgery, your diet will likely involve smaller, more frequent meals that are high in protein and low in sugars and fats. The types of foods you eat can influence bowel movements. High-fiber foods can help promote regular bowel movements, but be cautious with fiber intake, as too much fiber could lead to discomfort.
• Hydration: Staying well-hydrated is crucial for maintaining healthy digestion and regular bowel movements. Drinking enough water can help prevent constipation, a common concern after gastric surgeries.

Although you might experience changes in your stomach, bowel pain or struggle in the digestive system, such as severe constipation, diarrhea, or other digestive issues, it’s important to reach out to your doctor. They will intervene, provide an analysis, guide you to a better recovery, and ensure your recovery is progressing as expected.

Gastric Sleeve Surgery Recovery

The timeline for feeling “normal” after a gastric sleeve surgery will vary widely from person to person, although studies[3] and data show that 2 and 3 months. Recovery and adjustment periods are influenced by factors such as individual health, adherence to post-surgery guidelines, and how well your body adapts to the changes.

• Week 1 and 2: Immediate post-surgery phase,during the first two weeks, your body is focused on healing from the surgery. You’ll likely be on a liquid and then pureed food diet to give your stomach time to adjust. It’s normal to experience discomfort, pain, and fatigue during this phase.
• Weeks 3 to 6: Transition to solid foods, as you gradually transition to eating solid foods, you might notice changes in how your stomach responds[4]. Your appetite might decrease due to the reduced stomach size, and you might feel full more quickly. Some patients experience bloating, gas, and other digestive discomforts (bowel movements) as their body adapts to new eating patterns.
• Months 2-6: By this point, you’ll likely have adapted to the dietary changes and your stomach’s new size. You might find that your energy levels are improving, and you’re getting used to your new eating habits. It’s important to continue following your doctors´ guidelines for diet, exercise, and post-surgery care during this phase.
• Months 6-12: Many patients start feeling more comfortable with their new eating patterns and may begin noticing significant weight loss during this period. Thus, it’s important to remember that weight loss can vary, and it’s crucial to focus on overall health and well-being.
• 1 Year and Beyond: By the one-year mark, you should have adapted to your new lifestyle and eating habits. Many people continue to experience weight loss and improved health outcomes during this time. It’s essential to continue regular follow-up appointments with your medical team to monitor your progress and address any concerns.

It’s worth noting that feeling “normal” can be subjective and might mean different things to different people. While some patients might feel comfortable and adjust relatively quickly, others might take longer to adapt to their new routines and mindset.

Throughout your recovery, it’s crucial to maintain open communication with your surgeon. If you experience persistent discomfort, digestive issues, “bowel movement” or concerns about your progress, they can provide guidance and support to ensure that your recovery is on track and that you’re achieving the best possible outcomes from your gastric sleeve surgery.

Contact our clinic today

At LIMARP® International Center of Excellence for Obesity, located in Tijuana, Mexico, we take your health very seriously. After your gastric sleeve surgery, we supervise and monitor the evolution of your recovery at our private hospital rooms and we make sure you progress safely into your new, more healthy life. If you have any doubts or questions about bowel movements or constipation after gastric sleeve surgery or are experiencing any suspicious symptoms after your treatment, please call us immediately. We will intervene and guide you through everything you need to know.

Also, at our clinic, we offer different non-surgical treatments for obesity in an integral bariatric program with a multidisciplinary approach. At LIMARP your medical intervention for obesity includes psychological and nutritional counseling, as well as the guidance of a fitness expert. We also offer all-inclusive packages for patients traveling from abroad, where we include lodging at our clinic’s luxurious next-door hotel, and transportation from the airport to the hotel and back.

If you are interested in getting to know more about our clinic and post-surgical services, or if you’re interested in knowing if a gastric sleeve surgery is the right choice for you, please call our phone number (619) 270 8823 or send us a message through this website or any of our social media pages. Our team of experts will be glad to help.

References

• [1] “What to know about constipation after gastric sleeve surgery”. https://www.medicalnewstoday.com/articles/constipation-after-gastric-sleeve. (Accessed July 29, 2023).
• [2] “Constipation is Common After Gastric Sleeve Surgery. Here’s What You Need to Know”. https://www.healthline.com/health/constipation/constipation-after-gastric-sleeve. (Accessed July 29, 2023).
• [3] “WHAT TO EXPECT DURING GASTRIC SLEEVE SURGERY RECOVERY”. https://www.bmisurgery.com/what-to-expect-during-gastric-sleeve-surgery-recovery/. (Accessed July 29, 2023).
• [4] Afshar S, Kelly SB, Seymour K, Woodcock S, Werner AD, Mathers JC. The Effects of Bariatric Procedures on Bowel Habit. Obes Surg. 2016 Oct;26(10):2348-54. doi: 10.1007/s11695-016-2100-9. PMID: 26894909; PMCID: PMC5018031.

Hiccups are spasms that can happen to anyone, adults, children, and babies. They are caused by the spasms of your diaphragm paired with a ‘hic’ sound from your vocal cords closing. Your diaphragm is a muscle under your ribcage, separating your chest and stomach area. This muscle is an important part of the breathing process. It moves downward when you breathe in and upward when you breathe out[1]. Hiccups can happen for a lot of reasons: some of them are physical, and some emotional.

That’s because the actual irritation happens in the nerve connecting the brain to the diaphragm[2]. Some common causes include:

• Eating too much or too quickly
• Feeling nervous or excited
• Drinking carbonated beverages or too much alcohol
• Stress
• A sudden change in temperature
• Swallowing air while sucking on candy or chewing gum

Saying so, and according to the one source[3], “eating a large meal, drinking alcoholic or carbonated beverages, or getting excited suddenly may cause hiccups. In some cases, hiccups may be a sign of an underlying medical issue. For most people, hiccups usually last only a few minutes. Rarely, hiccups may continue for months. When they last that long, they can result in weight loss and extreme tiredness”.

Hiccups After Gastric Sleeve

Experiencing hiccups after having a gastric sleeve surgery is not an uncommon symptom. While hiccups can occur for different reasons, they can sometimes be associated with changes in the digestive system after surgery, including gastric sleeve surgery.

Hiccups can sometimes be triggered by the use of anesthesia during surgery or the trauma that the body undergoes during the surgical procedure itself. Anesthesia and surgical procedures can affect the diaphragm, the muscle responsible for breathing, which can lead to hiccups.

Also, as we have mentioned in previous articles, during gastric sleeve surgery the abdomen is inflated with CO2 gas to create space for the surgical instruments. This gas can irritate the diaphragm or other surrounding structures, perhaps leading to hiccups.

The alteration of the stomach during gastric sleeve surgery involves the body adapting to the smaller part of it that remained after the removed portion of the stomach. Thus, the digestive system can sometimes lead to changes in how the stomach functions, which might result in hiccups as the body adjusts.

During this process of adaptation, the body might also experience Gastroesophageal Reflux Disease (GERD) after gastric sleeve surgery, according to a study in the National Library of Medicine[4]. GERD can cause irritation in the esophagus and diaphragm, potentially leading to hiccups. Also, they found that after surgery, some people might swallow air more frequently due to changes in their eating habits or the size of their stomachs. This excess air can lead to hiccups.

How to Stop Hiccups after Gastric Sleeve

• Hold your breath: In order to restore your diaphragm’s rhythm, take a deep breath and hold it for as long as you comfortably can.
• Drink water: Drink a glass of water very slowly, without pausing to take a breath. This can help stimulate the vagus nerve and interrupt the hiccup reflex.
• Breathe into a paper bag: Breathing into a paper bag (not a plastic bag) for a short period can help increase carbon dioxide levels in your blood[5], which may help stop hiccups. However, be cautious and don’t overdo it to avoid potential negative effects.
• Gargle with ice water: Gargling with cold water can stimulate the vagus nerve and potentially interrupt the hiccup reflex.
• Diaphragmatic breathing: Practice deep and slow diaphragmatic breathing. This can help relax the diaphragm and may provide relief from hiccups.

Getting rid of hiccups after surgery, including gastric sleeve surgery, involves trying various methods to stimulate the diaphragm and interrupt the hiccup reflex. You can read and try these tips to handle hiccups after your surgery. However, we encourage contacting your doctor if the hiccups continue for more than two days.

Persistent or severe hiccups after gastric sleeve surgery, it’s uncommon, and it’s important to discuss this with your doctor since it might require urgent medical attention. They will evaluate your specific situation, and determine if any additional measures need to be taken to address the hiccups.

Remember hiccups are repeated spasms or sudden movements of the diaphragm that you can’t control. The diaphragm is the muscle that separates your chest from your stomach area and plays an important role in breathing. A spasm in your diaphragm causes your vocal cords to suddenly close, producing a “hic” sound.

Therefore, if you are already experiencing symptoms of your gastric sleeve recovery and you have had hiccups for more than 2 days, reach out to your healthcare team for personalized advice. Remember everybody is different and so it is each individual response to surgery, and while hiccups might be common in some cases, they might not occur in others. If you’re concerned about hiccups or any other post-surgery symptoms, always call your doctor.

Dr. Liza María Pompa González and her team in Tijuana, Mexico, have performed almost countless gastric sleeve surgeries, which, in the context of their integrative bariatric program, can offer long-term results to patients with obesity who want to achieve a healthy weight, a healthier lifestyle, and a greater wellbeing.

Contact Us for More Information

If you have undergone bariatric surgery in the past and are experiencing symptoms hiccups, or severe pain in the diaphragm, schedule an appointment at LIMARP®. We can help you alleviate your discomfort and improve your quality of life. Call our office toll-free at (866) 313-5750 or contact us online.

References

[1] “Hiccups”. https://my.clevelandclinic.org/health/diseases/17672-hiccups. (Accessed July 28, 2023).

[2] “Why Do I Hiccup?”. https://www.webmd.com/digestive-disorders/why-do-i-hiccup. (Accessed July 28, 2023).

[3] “Hiccups”. https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613. (Accessed July 28, 2023).

[4] El-Hadi M, Birch DW, Gill RS, Karmali S. The effect of bariatric surgery on gastroesophageal reflux disease. Can J Surg. 2014 Apr;57(2):139-44. doi: 10.1503/cjs.030612. PMID: 24666452; PMCID: PMC3968207.

[5] “Stopping hiccups”. https://www.health.harvard.edu/staying-healthy/stopping-hiccups. (Accessed July 28, 2023).

Patients who are looking to have bariatric surgery often opt for having a gastric sleeve.The gastric sleeve procedure, also known as a gastrectomy, is a restrictive bariatric surgery that significantly reduces the size of your stomach and your appetite to encourage weight loss. A gastric sleeve physically restricts the amount of food you can eat by reducing the size of your stomach, as we mention in previous articles. Nevertheless, patients might find it difficult to follow a diet in the long term after having the gastric sleeve, so it is possible to regain a small amount of weight.

At LIMARP®, we take pride in the quality and excellence of our service, as well as the great soothing experience we provide our patients. Our facility is located at Tijuana’s main business district, just a few minutes away from Mexico’s International Border with the United States. Tijuana is one of the most dynamic cities in the world, as it is the point of international transit for hundreds of thousands of people every day, and is considered the most competitive, safe, and attractive destination for medical tourism in Mexico.

Tijuana receives almost 2 million medical tourists per year. The city provides quality medical care and medication at a fraction of the price in North American countries. Due to its proximity to the international border, most services in Tijuana are offered in both English and Spanish, and most medical services are available for coverage by international insurance and additional financing.

A Healthy Long-Term Diet Plan after Gastric Sleeve

A diet rich in nutrients after having the gastric sleeve is essential for the patient to fulfill the process. Gastric sleeve surgery significantly reduces the size of the stomach to limit the amount of food a patient can eat and encourage weight loss. The gastric sleeve offers fast and effective weight loss results, but it is important that patients practice lifestyle changes that will keep the weight off.

One of the most important factors to affect the long-term success of gastric sleeve surgery is a proper diet. Here, Dr. Liza María Pompa González goes over the long-term diet plan for gastric sleeve patients. Following a proper diet will help our Tijuana, MX, and San Diego, CA, area patients achieve a healthier lifestyle for years to come.

According to the latest global registry of the International Federation for the Surgery for Obesity and Metabolic Disorders (IFSO), gastric sleeve surgery is by far the most requested and practiced bariatric surgery worldwide. Out of all the bariatric surgeries that are practiced around the world, roughly 59% account for a gastrectomy, and almost all of them are done with laparoscopic techniques. This is the bariatric procedure for which experts have the most data and the most register of outcomes and results in long-term follow-ups. It is also the most standardized procedure in the bariatric community. It’s been largely documented that complications due to gastric sleeve surgery are very low and that it provides good control and great benefits over comorbidities associated with obesity.

The Pouch Reset Diet

The pouch reset diet or method was created in 2007 by a gastric bypass patient named Kaye Bailey. Like many bariatric patients, Kaye struggled with weight regain after her surgery and in her attempt to “shrink” her stomach back to its post-surgery size, she developed the five-day pouch reset. The pouch reset severely restricts and limits your food and nutrient intake. It works by “mimicking” your immediate diet after bariatric surgery[1].

How Does The Pouch Reset Diet Works?

The “5-day pouch reset” is a specific diet or plan followed by patients who have undergone gastric bypass surgery or other weight loss surgeries (like gastric sleeve) involving the creation of a small stomach pouch[2]. The goal of this diet is to help people who have experienced weight regain or a return to old eating habits after surgery to “reset” their eating behaviors and portion sizes.

This diet is structured as it is name, the patient must follow a 5-day extreme diet as follows:

• Liquids only on day 1: the patient must consume only clear liquids, such as water, broth, and sugar-free beverages. This is meant to give the stomach time to adjust and recover from any inflammation or overstretching that may have occurred due to overeating.
• Pureed foodson days 2-3: During these days, the individual consumes pureed or blended foods that are easy to digest. This might include foods like yogurt, protein shakes, baby food, and soups.
• Solid foods on days 4-5: Soft, solid foods must be introduced on these days. These could include foods like scrambled eggs, cottage cheese, and well-cooked vegetables.

However, medical researchers have not explored this type of diet, and according to a recent study[3] “there is no scientific basis for this diet”. Therefore, whether you are looking to start the 5-day pouch reset, you might consider reaching out to your doctor first.

As you see, the idea behind the 5-day pouch reset is to gradually reintroduce foods with smaller portions and healthier choices. The purpose of this diet is helping to promote healthier eating habits. Nevertheless, as we mention, the 5-day reset pouch is proven by scientific evidence, and its effectiveness can be different from person to person, considering age, gender, and genetic heredity.

Before The 5-Day Pouch Reset

As we mentioned, before considering any dietary changes, especially after your surgery, it’s crucial to consult with your healthcare provider or a registered nutritionist. They can provide personalized advice based on your individual health status, medical history, and needs.

If you already made the decision of doing a pouch reset or any weight loss strategy, keep in mind that medical knowledge and recommendations by experts are the most accurate instructions. Reach out to them and ask them for advice for a better and healthier pouch reset experience.

Contact Us to Learn More

Our nutritional consultation services, psychology and fitness department and our complete array of plastic surgery procedures are held to the best-in-class standards and are under constant revision by our experienced staff. If you are significantly overweight and have been unable to lose weight on your own, it may be time to consider bariatric surgery at our Tijuana practice. To learn more about gastric sleeves or our other surgical techniques, send us a message at your earliest convenience, or call our weight loss center. Call us at (619) 373-0222.

References:

[1, 3] “Does the Pouch Reset Test Work?”. https://emergesurgical.com.au/does-the-pouch-reset-test-work/. (Accessed July 30, 2023).

[2] “5-Day Pouch Reset: Lose Weight After Weight Gain”. https://mexicobariatriccenter.com/5-day-pouch-reset/. (Accessed July 30, 2023).

Coffee is an essential piece in the daily diet of plenty of people worldwide and there are so many reasons why people drink coffee: either to feel energized during a regular day, to drink it as a regular beverage, and according to a study made in 2022, “coffee consumption statistics show that around 30-40% of the world’s population consume coffee every day”[1].

Your Body and Coffee

What’s caffeine? It’s a stimulant that works as a cognitive enhancer, meaning that it increases alertness and reduces drowsiness. We mainly get caffeine from the coffee bean and consume it in coffee, tea, and cola whenever we need an energy boost. The amount of caffeine a person needs to remain alert depends on their body size and tolerance and its effects can last up to four hours. While we mainly consume caffeine to remain alert while we carry out tasks, it has also proven to be beneficial in the medical field. Research has found that caffeine can be effective in protecting against diseases such as Parkinson’s or Alzheimer’s.

Nevertheless, you might be wondering how coffee and bariatric surgeries are related or what happens if you drink coffee after just having a gastric sleeve. Drinking coffee after having a gastric sleeve procedure can have varying effects on patients. Recognizing that the body’s response to coffee might differ based on factors such as your body’s tolerance is important. Being aware of the amount of coffee consumed, and how far along you are in your post-operative recovery are essential factors too in order to avoid complications in the recovery process.

Before making a decision about when or how to drink coffee, keep in mind your surgeon´s prescription for your diet. But if you are determined to drink coffee, here are some of the post-operative symptoms of drinking coffee after a gastric sleeve:

Stomach Sensitivity

After a gastric sleeve surgery, your stomach size is significantly reduced (almost 80% of it), which can make it more sensitive to certain foods and beverages. Coffee is acidic and can sometimes cause discomfort, irritation, or even mild pain, especially if consumed on an empty stomach.

Digestive Effects

Coffee is a stimulant due to its caffeine content. It can increase heart rate and potentially affect blood pressure. In addition, coffee can stimulate the digestive system, potentially leading to increased bowel movements or even diarrhea[2]. Since gastric sleeve surgery can impact digestion, these effects might be more pronounced in some individuals.

Hydration

Coffee is a diuretic, meaning it can increase urine production and potentially lead to dehydration. Staying well-hydrated is particularly important after weight loss surgeries, so if you choose to consume coffee, make sure you’re also drinking plenty of water.

How Soon Can You Drink Coffee After a Gastric Sleeve?

As we mentioned, there is no exact time to start drinking coffee after a gastric sleeve surgery because it can vary based on the individual recovery progress and recommendations from the healthcare provider.

However, a study by the Surgical Association[3] indicates, “caffeine should not be consumed within the first 4-6 weeks after surgery. If you must, a small cup of decaf (black, no sugar) is fine”.

Since your diet will likely consist of clear liquids, such as water, broth, and sugar-free beverages, coffee is generally not advised during this time, due to its potential to cause irritation or discomfort to your healing stomach.

As you progress in your recovery, your surgeon will guide you through transitioning to full liquids and eventually soft foods. At this stage, you might start introducing coffee in small quantities, but it’s essential to monitor how your body reacts. Remember that your stomach is still healing, so it’s essential to avoid anything that could cause irritation[4].

After your surgeon approves the transition to solid foods, you can continue to include coffee as part of your diet, but you should still be cautious[5]. Your stomach’s capacity is reduced after the surgery, so you might be more sensitive to caffeine and acidic foods like coffee.

Drinking coffee after gastric sleeve surgery is effective for stimulating the recovery of gastrointestinal function after abdominal surgery. If you do decide to reintroduce coffee, start with small amounts and monitor how your body responds. However, always consult your surgeon or dietitian before adding coffee or any new beverage to your diet after gastric sleeve surgery[6]. If you experience any discomfort, it’s advisable to reduce or eliminate coffee consumption until you receive further guidance from your healthcare team.

Contact Us to Learn More

If you want to learn more about drinking coffee after gastric sleeve surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

[1] “World Coffee Consumption Statistics”. https://coffee-rank.com/world-coffee-consumption-statistics/. (Accessed July 29, 2023).

[2] “Coffee”. https://www.hsph.harvard.edu/nutritionsource/food-features/coffee/. (Accessed July 29, 2023).

[3, 6] “WHERE CAFFEINE FITS INTO YOUR POST-OP LIFESTYLE”. https://sampadocs.com/2021/10/15/where-caffeine-fits-in-to-your-post-op-lifestyle/. (Accessed July 29, 2023).

[4] Nehlig A. Effects of Coffee on the Gastro-Intestinal Tract: A Narrative Review and Literature Update. Nutrients. 2022 Jan 17;14(2):399. doi: 10.3390/nu14020399. PMID: 35057580; PMCID: PMC8778943.

[5] “Sleeve gastrectomy”. https://www.mayoclinic.org/tests-procedures/sleeve-gastrectomy/about/pac-20385183. (Accessed July 29, 2023).

The gastric sleeve procedure, also known as a gastrectomy, is a restrictive bariatric surgery that significantly reduces the size of your stomach and your appetite to encourage weight loss. It is an uncomplicated procedure with a shorter recovery time than others. According to the latest global registry of the International Federation for the Surgery for Obesity and Metabolic Disorders (IFSO), gastric sleeve surgery is by far the most requested and practiced bariatric surgery worldwide.

A gastric sleeve physically restricts the amount of food you can eat by reducing the size of your stomach. It is a restrictive surgery that also limits the production of ghrelin, which contributes to a reduction in appetite. This allows patients to feel satisfied with less food and helps them with portion control if it was recommended to them by a licensed dietitian.

Out of all the bariatric surgeries that are practiced around the world, roughly 59% account for a gastric sleeve, and almost all of them are done with laparoscopic techniques. This is the bariatric procedure for which experts have the most data and the most register of outcomes and results in long-term follow-ups. It is also the most standardized procedure in the bariatric community. It’s been largely documented that complications due to gastric sleeve surgery are very low and that it provides good control and great benefits over comorbidities associated with obesity.

However, as with many surgeries, the recovery process might be particular for each patient. The healing and the post-operative diet play an essential role in the whole process of the patient to have a healthy recovery. Dr. Liza María Pompa González and the nutrition specialists on her team provide expert guidance and postoperative diet plans at our bariatric center to help patients heal and achieve successful and lasting results after gastric sleeve surgery.

How Long Does It Take Gastric Sleeve Incisions to Heal?

The healing time for gastric sleeve incisions can vary from person to person and depends on several factors, including your overall health, the surgical technique used, and how well you follow your surgeon’s post-operative instructions.

First, in the initial recovery, you will spend a day or two in the hospital for monitoring and recovery. During this time, the medical team will ensure that the patient is stable and that there are no immediate complications.

During the first week after the surgery, the incisions will naturally start to heal and you might experience some discomfort, swelling, and bruising around the incision sites. The stitches, staples, or adhesive tape used to close the incisions will remain in place during this time[1].

Once the two weeks pass, you will feel the discomfort and swelling reduce. The incisions might begin to scab over, and they should be healing well. In this phase, it’s important to continue following the surgeon’s guidelines for proper care and physical activity during this period.

After three to four weeks after the surgery, the incisions should be mostly healed on the surface. The stitches or staples might need to be removed during this time, depending on the technique used. The surgeon will advise you on when it’s safe to resume normal activities and exercise[2].

At six weeks and up to three months, the incisions should be fully closed and healed. The scars might still be slightly raised and red, but they will continue to fade over the coming months. The patient can generally resume more strenuous activities and exercises as directed by the surgeon[3]. The long-term healing will start over the course of several months, the scars will continue to mature and fade. It’s important to protect the healing incisions from excessive sun exposure, as this can lead to increased pigmentation in the scars.

How Do You Know If Your Gastric Sleeve Incision Is Infected?

The gastric sleeve surgery recovery implies ensuring the incisions are healing properly. The patient will also be aware of any sign of infection because an infected incision can lead to complications if not addressed promptly.

The signs[4] that might lead to infection include and which the patient should be aware are:

• Increased pain: While some level of pain and discomfort is normal during the healing process, an infected incision site might exhibit increasing or severe pain that is not improving with time or pain medication.
• Redness and swelling: If the area around the incision becomes increasingly red, swollen, and warm to the touch, it could be a sign of infection. Some degree of swelling and redness is common in the early stages of healing, but if it worsens or persists, it may indicate an issue.
• Pus or discharge: If you notice any discharge from the incision site that is cloudy, yellow, or greenish in color, it might indicate an infection. Healthy incisions typically do not have significant discharge.
• Bad odor: An unpleasant or foul odor emanating from the incision area can be a sign of infection. If you notice an unusual smell, it’s best to have it evaluated by your medical team.
• Fever: A fever, especially if other signs of infection accompany it, can be an indicator that your body is fighting off an infection. Elevated body temperature could be a sign of a systemic response to an infection at the incision site.

Although there are several ways to reduce the risk of infection in the incisions, according to the Cleveland Clinic, you should always wash your hands before and after touching your incisions, follow your healthcare provider’s instructions, avoid removing the tape strips, picking at staples, tissue glue or stitches, and keep your incisions dry.

How Long Does it Take Incisions to Heal After Bariatric Surgery?

As we mentioned before, the gastric sleeve procedure is performed through a series of small incisions in the abdomen. These incisions are typically made using minimally invasive techniques, such as laparoscopy, which involves using small instruments and a camera to guide the surgeon. The incisions are usually around 1 to 2 centimeters in length.

The healing process after these incisions is generally straightforward, but it still requires proper care and attention to avoid complications. The better way to have a healthy recovery is to take off the incision, keeping the incision sites clean and dry is essential to prevent infection. You’ll likely be advised to avoid soaking in water (such as baths and swimming) until the incisions are fully healed. Follow your surgeon’s recommendations for cleaning and dressing the incisions.

Also, you should follow your surgeon’s prescription for the painkillers, pain and discomfort around the incision sites are common after surgery. It’s important to take these medications as directed and report any unusual or severe pain to your medical team.

While it’s important to rest and recover, gradual movement and walking are encouraged to prevent blood clots and promote healing. Physical activity is highly recommended on long-term recovery, however, strenuous activities and heavy lifting should be avoided as recommended by your doctor[5].

Following a specific diet plan, on the other hand, is crucial after the gastric sleeve procedure. Your surgeon and dietitian will guide you on transitioning from a liquid diet to soft foods and eventually solid foods as your stomach heals and adjusts to its new size.

Remember to follow-up with your appointments with your medical team because these are essential to monitor your progress, address any concerns, and ensure that your incisions are healing properly. Some degree of discomfort, redness, and swelling can be normal in the early stages of healing. However, if you’re ever unsure about the status of your incisions, it’s better to err on the side of caution and seek medical advice. Your medical team is here to support you throughout your recovery process.

It’s important to note that every individual’s healing process can vary. If you notice any of these signs or are concerned about the healing process of your incisions, contact your surgeon or healthcare provider as soon as you can.

Keep in mind that you should follow your surgeon’s post-operative instructions closely and communicate any concerns or issues with your medical team. If you’re considering undergoing the gastric sleeve procedure, consult a qualified healthcare professional to discuss the risks, benefits, and expectations associated with the surgery.

Contact Us to Learn More

If you’re interested in knowing more about the recovery process after having the gastric sleeve, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

[1, 4] “Incision Care”. https://my.clevelandclinic.org/health/treatments/15709-incision-care. (Accessed July 25, 2023).

[2] “Gastric bypass surgery – discharge”. https://www.mountsinai.org/health-library/discharge-instructions/gastric-bypass-surgery-discharge. (Accessed July 25, 2023).

[3, 5] Bellicha A, Ciangura C, Roda C, Torcivia A, Aron-Wisnewsky J, Poitou C, Oppert JM. Effect of exercise training after bariatric surgery: A 5-year follow-up study of a randomized controlled trial. PLoS One. 2022 Jul 15;17(7):e0271561. doi: 10.1371/journal.pone.0271561. PMID: 35839214; PMCID: PMC9286216.

Weight loss surgery, such as the gastric sleeve surgery, is one of the most common bariatric procedures available for patients who are dealing with morbid obesity, hypertension, and type 2 diabetes. The postoperative recovery process takes several months and if the procedure goes over smoothly, the patient should expect positive results, as long as they also follow their doctor’s recommendations on how to take care of their body.

These recommendations following gastric sleeve surgery can include a determined resting period, prescribed medication, a specific diet, and removing certain habits from your daily life that could hinder your recovery. However, it’s important to keep in mind that gastric sleeve surgery can have potential complications during and after the procedure.

There are a lot of factors that determine which bariatric surgery is right for each patient, like their medical history, their needs and goals, and the amount of fat that needs to be removed from the body. To know if gastric sleeve surgery is right for you, your doctor will go over your specific case and perform an in-person examination in order to create a treatment plan to address your needs. Once it’s established, they’ll go over it with you so that you’re prepared, both mentally and physically, for what your body is about to go through during and after the surgery. 

This means talking about the possible complications during or after the gastric sleeve surgery. To avoid or prevent them from happening, your doctor will give you a set of instructions that you have to follow, such as improving your eating habits, taking on a physical activity, and removing harming habits that may complicate not only your surgery, but your overall quality of life. However, there are some postoperative complications that may arise even if your surgery went smoothly, like obstruction of stomach, chronic nausea, and ulcers, just to mention a few. 

Another complication or side effect is acid reflux and it’s important to keep it in mind in case you start experiencing it after your procedure.

 Our team at LIMARP®, led by Dr. Liza María Pompa González, takes care of you on each step of the surgical process so that any arising complication can be treated effectively and safely. Postoperative care is part of the integrative treatment plans we offer, meaning that if you suffer any type of complication after your weight loss surgery,  such as acid reflux, our team of multidisciplinary doctors are fully equipped to treat you and ensure that you recover successfully. 

For this article we’ll talk about the possibility of having acid reflux after gastric sleeve surgery, how to identify it, and the available ways to treat it.

As always, we’d like to remind you that each case is different and that the information presented in this article may not apply to your specific situation. If you’ve recently had any type of bariatric surgery and are experiencing uncomfortable side effects or unmanageable pain, please contact your doctor right away or schedule a consultation at our Tijuana clinic.

Acid Reflux: What is it?

First of all, let’s talk about acid reflux. Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus. This can cause heartburn and other signs and symptoms and if it’s frequent, acid reflux can lead to GERD[1]. There are some weight loss surgeries, such as the gastric bypass, that can alleviate the symptoms of GERD or get rid of it altogether if the patient has been struggling with it prior to their surgery.

However, there have been some studies that found that acid reflux can develop or worsen due to gastric sleeve surgery[2]. This same study proposed some reasons as to why people can get acid reflux after gastric sleeve surgery, such as:

• The shape of the sleeve
• Damage to the lower esophageal sphincter
• The presence of hiatal hernia

When gastric sleeve surgery is performed, the pyloric valve is left intact, but the stomach is reduced significantly. Thus, the pressure within the stomach is increased, and the lower esophageal sphincter is the path of least resistance for excess pressure to dissipate; so when the pressure is released into the esophagus, stomach acid often accompanies it, causing acid reflux[3].

Acid reflux can be uncomfortable and even painful, and if it goes untreated it can cause more serious complications, such as irritation, esophageal ulcers, esophageal strictures, and Barrett’s esophagus, which can increase the chances of developing esophageal cancer. 

How to Treat Acid Reflux After Gastric Sleeve Surgery

If the patient has a hiatal hernia, it’s very important to treat it in order to reduce the reflux to up to 20%. There are also medications that can help a patient manage their acid reflux, such as antacids, H2 receptor blockers, and proton pump inhibitors. If there are no signs of improvement and the acid reflux becomes unmanageable, your doctor may propose changing the gastric sleeve to a gastric bypass. 

Contact Us to Learn More

If you want to learn more about acid reflux after gastric sleeve surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Gastroesophageal reflux disease (GERD)”. https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940. (Accessed February 20, 2023). 
• [2] Felinska E, Billeter A, Nickel F, Contin P, Berlth F, Chand B, Grimminger P, Mikami D, Schoppmann SF, Müller-Stich B. Do we understand the pathophysiology of GERD after sleeve gastrectomy? Ann N Y Acad Sci. 2020 Dec;1482(1):26-35. doi: 10.1111/nyas.14467. Epub 2020 Sep 6. PMID: 32893342.[3] “WHAT WE KNOW ABOUT REFLUX AFTER GASTRIC SLEEVE”. https://sampadocs.com/2019/12/23/reflux-after-gastric-sleeve/. (Accessed February 20, 2023).

There are a variety of bariatric procedures that are designed to help patients address their specific health concerns and lose weight. The LIMARP® International Center of Excellence for Obesity successfully performs multiple types of bariatric surgery in the context of our integrative bariatric program. 

Once our team determines that you are a candidate for bariatric surgery, we can determine the most effective type of surgery for you, like the gastric sleeve. This is a serious procedure, with the potential to change your life and our multidisciplinary team will do both physical and psychological evaluations to determine your possibility of undergoing surgery. As part of our integrative bariatric programs, you’ll also receive postoperative care, which includes a nutrition plan that ensures a successful recovery.

One of the many questions that arise during a patient’s recovery is if they can start eating solid food right after their surgery. The quick answer is no because the stomach, and your body in general, needs time to recover after such an invasive procedure.

This article will mainly focus on what the gastric sleeve is and the type of diet you will have to follow after the surgery, mainly focusing on when you can start eating solid food.

We’d like to highlight that the following information is general and that the case for each patient may vary significantly; for more detailed information and personal assistance, contact us and our team of doctors will be happy to answer any questions or doubts.

The Gastric Sleeve

First, we’d like to inform you on what gastric sleeve surgery consists of. The gastric sleeve procedure is a restrictive bariatric surgery that significantly reduces the size of your stomach and your appetite to encourage weight loss. It is an uncomplicated procedure with a shorter recovery time than others.

It physically restricts the amount of food you can eat by reducing the size of your stomach, limiting the production of ghrelin, which contributes to a reduction in appetite. This allows patients to feel satisfied with less food and helps them with portion control if it was recommended to them by a licensed dietitian.

This is the bariatric procedure for which experts have the most data and the most register of outcomes and results in long term follow-ups. It is also the most standardized procedure in the bariatric community.  It’s been largely documented that complications due to gastric sleeve surgery are very low, and that it provides good control and great benefits over comorbidities associated with obesity.

Gastric sleeve surgery is considered a restrictive procedure because what it achieves is that it restricts the size of the stomach, preventing it from obtaining big portions of food.

This procedure does not interfere with the absorption of nutrients, though, because it does not involve any alteration to the digestive process, as it leaves the intestines intact.

The recovery from a gastrectomy is faster than other bariatric procedures. Patients may expect a postoperative stay of 1 to 2 days in the hospital’s recovery room, as well as a mandatory rest for four to six weeks. During the first weeks of recovery, the patient should follow a strict only-liquids diet, which will progressively move to purees and solids.

Postoperative Diet: When to Eat Solid Food

A postoperative diet is an essential part of any bariatric treatment. After bariatric surgery, the size of your stomach gets drastically reduced, and this diet will help your body get used to its new self, helping you get on track for your new, healthier, long-term eating habits.

Dr. Liza María Pompa González and the nutrition specialists on her team provide expert guidance and postoperative diet plans at our bariatric center to help patients heal and achieve successful and lasting results after their bariatric surgery. These plans are designed to fit your own specific needs, based on the specific procedure you have undergone (a gastric sleeve in this case), your medical history, and your progress within the treatment.

Our specialists provide thorough nutrition planning for patients as part of our integrative bariatric program. As a patient at LIMARP® International Center of Excellence for Obesity, you will receive specific, individualized plans for your pre and postoperative diets. These plans will vary based on the type of procedure you receive. Our postoperative diet plans schedule a gradual introduction of foods, from liquid to solid food, to allow your stomach ample time to heal properly, which reduces your risk of future complications. Allowing your stomach to heal also increases your odds of achieving your weight loss goals and keeping the weight off in the long-term.

Postoperative diet plans are essential for all bariatric surgery patients. Those individuals who undergo restrictive procedures must learn to choose foods and supplements that ensure they receive the nutrients they need until they can eat and process solid food. With our tailored plans, all patients can discover more options that will benefit their health and unique situation.

There are different stages you must go through before your body is ready to process solid food and you must abide by what your doctor suggests to avoid any postoperative complications. Following the gastric sleeve, your diet will strictly consist of liquids throughout the first week of recovery; this includes water, but also chicken, beef or vegetable broth, popsicles, and gelatin. You may only drink two to three ounces of liquid at a time and you must drink them very slowly. When your program allows for it, you may begin drinking non-clear liquids for one week. 

There are two more phases before you can eat solid food, which consist of adding pureed and soft food to your diet. As your body becomes more tolerant, you may start introducing pureed foods. You will eat them exclusively for three to four full weeks. Pureed foods have a consistency similar to baby food. You may also have protein shakes during this time. After three to four weeks of pureed foods, you may begin to introduce soft foods. You may eat a combination of pureed and soft foods for about two weeks.

Finally, after six to eight weeks following your gastric sleeve procedure, you’ll be able to eat healthy, solid food. You should continue cutting any solid food into small, easily digestible bites. Some solid food may be hard to eat right away, such as spicy or extremely crunchy foods.

However, you may be able to incorporate them back into your diet at a later time. It is important to continue eating small meals and to make healthy choices that focus on protein, vegetables, and fruits.

Although you’ll be able to eat many different types of food after your recovery, it is still important to remember that you should still avoid certain foods that can lead you on a wrong track from your weight loss goals and away from healthy eating habits, like high-calorie, high-fat and high-carbohydrate foods, junk foods, sugary drinks, and alcohol.

Contact Us to Learn More

If you’re interested in what your diet would look like after getting the gastric sleeve, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

A healthy and successful recovery following a gastric sleeve can open countless doors when it comes to new experiences or following through with activities you gave up due to health concerns. Whether it’s returning to work and exploring new professional settings or taking up hobbies in your free time, being at your best is essential for thriving in your new lifestyle. 

One of the most important aspects of having a successful postoperative journey is exercise, since adding a workout to your daily routine, as well as a healthy diet, is key to ensuring that you don’t regain the weight that was lost after your gastric sleeve. It’s no secret that exercise has proven to show positive effects on a person’s overall health, both physically and mentally, regardless of their current weight or fitness goals. These benefits can be achieved through different types of exercise routines, such as weight training, cardio workouts, resistance training, or pilates. 

If you’re new to working out, you’re probably wondering which exercise is best for you and there are plenty of options to choose from. Cardio workouts are usually the go-to for people that are looking to shed some extra pounds because of their fast-paced, high-intensity routines. Weight training is another workout recommended for building strength and for losing weight without decreasing the body’s muscle mass.

While these types of workouts are effective, they’re not the only available options for people looking to embark on their weight loss journey.

However, there’s another workout option that can be available for you following a gastric sleeve and it’s one of the most practiced exercise methods around the world. We’re talking about CrossFit and for this article we will discuss if it’s a good option for bariatric patients who’ve had a gastric sleeve. CrossFit is a high-intensity workout regime and our team at LIMARP® is here to guide you through your recovery process so that you start going after your goals in a safe and healthy way. 

Before going any further, we recommend that you speak to your CrossFit instructor if you’re recovering from an injury or any type of surgery. This will allow them to support you at a greater capacity and prevent you from sustaining further injury or sprains, especially if you’re starting at a beginner level.

The Gastric Sleeve: What Is It

The gastric sleeve is a restrictive procedure that consists in reducing the size of the stomach by removing approximately 75% to 80% of it from the body, leaving only a small part that resembles a sleeve. By reducing the size of the stomach, the gastric sleeve only allows the ingestion of a certain amount of food, allowing the patient to reach or maintain a healthy weight. It also alleviates or improves conditions for people struggling with diabetes, sleep apnea, and hypertension. 

Aside from being one of the most effective and safest types of bariatric surgery, the gastric sleeve has shown to help with gastric emptying[1], as well as reducing nausea and vomiting. This means the quality of life and overall health of people who get the gastric sleeve improves significantly. 

The recovery from this surgery is faster than other bariatric procedures. Patients may expect a post-operative stay of 1 to 2 days in the hospital’s recovery room, and mandatory rest for four to six weeks. During the first weeks of recovery, the patient should follow a strict only-liquids diet, which will progressively move to purees and solids.

To achieve the best possible benefits from your surgery, it is important that you work with the bariatric nutrition experts at LIMARP®. If you overeat or consume a high-calorie diet, your stomach can stretch and your chances of successful weight loss could decrease.

Our treatment includes a long-term follow with which we monitor your progress and provide guidance for maintaining your optimal weight and health. We are committed to making you achieve your major goals with our treatment.

Playing Sports After the Gastric Sleeve

There are many physical activities that you can perform once you’ve recovered from your surgery, but one thing that you should keep in mind is that you must start small. We understand that you may be eager to dive in at full capacity, but it is imperative that you rest and limit your overall activity to avoid disrupting the recovery process. Heavy lifting and exercise could cause serious complications, such as a hernia in one of your wounds, so you are encouraged to wait the recommended time to engage in certain activities. Most patients can expect to return to work and normal activities in about four to six weeks.

So, where to begin?

If CrossFit is the first physical activity you want to try out, we recommend that you build your way up to it first; this means slowly increasing your strength and conditioning by trying light workouts that mainly consist of little movement, such as short walks and stretching. Make sure to avoid lifting heavy loads or trying out exercises that demand too much of your body.

In the first few months of your recovery, we recommend aerobic exercises, such as walking and biking to get the blood flowing and improve your heart rate; swimming is also recommended, as well as yoga and pilates. You should find what feels good for your body and state of mind and your doctor can also recommend exercise routines that push you to improve without hurting yourself.

For more intense workouts, such as weight lifting, running long distances, and CrossFit, we recommend that you wait at least six months to make sure that your body has fully recovered and that you don’t suffer any significant injuries. When it comes to these types of activities, especially CrossFit and resistance training, it’s important to be guided by a certified instructor so that they can help you master the correct forms for each exercise, as well as tell you how and when you should be progressing in the amount of weight you lift. This will allow you to not only keep a healthy body weight, but also to reach more advanced levels of these exercises.

A Deeper Look Into CrossFit

If you’re interested in trying CrossFit once you’ve recovered from your gastric sleeve surgery, it’s important that you learn more about this sport, as well as its upsides and downsides. Once again, you should wait until your doctor gives you the green light so that you can participate in high-intensity workouts. 

CrossFit was developed at the start of the new millennium and it’s described as “a branded fitness regimen that involves constantly varied functional movements performed at high intensity”[2], this means that it’s a multidisciplinary workout regime that includes practices such as high-intensity interval training (HIIT), Olympic weightlifting, plyometrics, powerlifting, gymnastics, kettlebell lifting, and calisthenics, among others. Each of these previous exercises are great on their own and the goal of the people who developed CrossFit was to “develop fitness in what the company deems to be the ten components of physical fitness: cardiovascular/respiratory endurance, stamina, strength, flexibility, power, speed, coordination, agility, balance, accuracy”[3]. 

The gyms that have become affiliated with CrossFit typically offer hour-long classes that are known as Workouts of the Day or WODs. What differentiates these WODs from other types of workouts is that they’re competition based, meaning that they encourage improvement by ranking the effectiveness of each participant. Aside from these workouts, a regular CrossFit session also includes warm-up and cool down sections to prevent injuries before and after your session.

Taking into account that CrossFit combines many types of exercises, we recommend that, as a bariatric patient who has fully recovered from the gastric sleeve, take things slow and to not push yourself to the point of injury. We also want to highlight the importance of your mental health and to view the competitive side of CrossFit as an invitation to improve your lifestyle and reach your personal goals, not as a way to compare yourself to others to the point of discouragement. 

CrossFit: Its Benefits and Risks

Any type of physical activity is necessary once you’ve recovered from bariatric procedures like the gastric sleeve, not only for maintaining your body at a healthy weight, but to improve other aspects of your life, such as your strength, coordination, flexibility, and mental health. CrossFit offers several of these benefits once you start practicing it and we’d like to discuss some of them.

• Improvement in Physical Strength

The high-intensity performed in CrossFit can help you gain muscle strength and stamina, especially if you add weight training and progressively increase your load once you’ve mastered certain exercises. The amount of repetitions that are done on each WOD can also help you increase your physical strength and muscle mass.

• Better Aerobic Fitness

CrossFit’s high-intensity power training allows you to increase the maximum amount of oxygen you can utilize during exercise[4]. However, compared to other aerobic exercises, such as swimming or biking, it’s hard to say which is better for this improvement in aerobic performance.

• Agility, Flexibility, and Balance

CrossFit mimics and favors functional movements that we tend to carry out in our daily life, such as squats and overhead presses. These exercises reduce the risk of getting hurt, not only when exercising, but when performing day-to-day activities that are strenuous. 

While the benefits of CrossFit are a good sign to try it out, there are also risks for which this type of workout has been highly criticized and it’s important to learn about them, especially if you’re a bariatric patient who has recently recovered from gastric sleeve surgery.

Although the use of functional movements within the workouts can be beneficial, CrossFit has been criticized for “using dangerous movements and inappropriate levels of intensity”[5]. Another reason why CrossFit may be dangerous is because of its link to exertional rhabdomyolysis, which is the breakdown of muscle from extreme physical exertion. Other risks include low back pain, rotator cuff tendonitis, tennis elbow, knee injuries, and Achilles tendonitis.

Injuries are part of any physical exercise, but their risk can be lowered if you practice them in a safe manner and by following guided instructions. Part of working out means listening to your body and to learn when to stop if you’re starting to feel pain that’s not associated with the exertion that usually comes with CrossFit or any other type of workout.

Contact Us to Learn More

If you’re interested in CrossFit following a bariatric surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] Bankole Samuel, Kofi Atiemo, Phillip Cohen, Donald Czerniach, John Kelly, and Richard Perugini.Bariatric Surgical Practice and Patient Care.Jun 2016.84-89.http://doi.org/10.1089/bari.2015.0052
• [2] “Understanding CrossFit”. http://journal.crossfit.com/2007/04/understanding-crossfit-by-greg.tpl. (Accessed September 15, 2022).
• [3] “CrossFit Guide for Beginners: What You Must Know Before You Start”. https://garagegympower.com/crossfit-beginners-guide/. (Accessed September 15, 2022). 
• [4] “What Are the Benefits of CrossFit and Is It Safe?”. https://www.healthline.com/health/exercise-fitness/crossfit-benefits. (Accessed September 15, 2022). 
• [5] “Is CrossFit Dangerous?”. https://www.bloomberg.com/news/articles/2014-09-04/crossfit-fights-injury-reputation-as-community-aspect-fuels-growth. (Accessed September 15, 2022).

If you’re struggling with obesity or any other weight related issues, bariatric surgery can be an option for you; whether it’s the gastric bypass, the abdominoplasty, or the gastric sleeve, your doctor will help you determine which procedure is right for you. Although each surgery has different techniques that can help patients achieve their weight loss goals, the preoperative and postoperative processes can present similarities, both in doctor recommendations and common struggles, such as overeating after you finish your recovery period.

We’ve already covered that overeating after a gastric bypass is possible and we explored what causes can lead to it, the consequences it can bring, and how to prevent it.  At LIMARP®, Dr. Liza María Pompa González and our team of multidisciplinary doctors want you to have all the information possible on what to expect before and after your surgical procedure. We’re also with you on every step of the way to ensure that your recovery process goes over smoothly and with no complications.

This article is directed toward bariatric patients that are eligible for the gastric sleeve. We’ll go over several topics, such as what makes you a candidate for this surgery and the preoperative recommendations, but our main focus is on the postoperative process and the struggles you may confront during it. One of them is the possibility of overeating after the gastric sleeve, which is entirely possible and also avoidable. 

Are You Eligible for the Gastric Sleeve?

The gastric sleeve is one of the most effective surgeries to help people lose weight and to help them maintain the extra pounds off. However, not everyone is a candidate for this type of surgery and bariatric patients must meet some criteria to become eligible for the gastric sleeve. This surgery is usually indicated for morbidly obese adults with a BMI of 40 or higher, and for patients who also suffer from other weight-related conditions, such as: diabetes, sleep apnea, joint pain, and hypertension.

The patient should also be able to handle physical stress because the invasive nature of the gastric sleeve can lead to complications and make the surgery very risky. Your doctor may recommend that you change your diet and take up a physical activity regime to prepare your body for surgery, and they may also refer you to a mental health professional to help you adapt to your new lifestyle.

At LIMARP®, you will meet our bariatric psychologist nutritionist so that they can prepare you for the changes you will experience after the gastric sleeve. They will give you a set of instructions that includes following a strict diet for ten days before your surgery; they will also indicate not to eat or drink anything on the night before your procedure, so that you have an empty stomach during the surgery. 

The Gastric Sleeve

The gastric sleeve is a restrictive procedure that consists in reducing the size of the stomach by removing approximately 75% to 80% of it from the body, leaving only a small part that resembles a sleeve. By reducing the size of the stomach, the gastric sleeve only allows the ingestion of a certain amount of food, allowing the patient to reach or maintain a healthy weight. This procedure does not interfere with the absorption of nutrients, though, because it does not involve any alteration to the digestive process, as it leaves the intestines intact.

The amount of weight loss to expect after a gastric sleeve procedure depends on many factors, such as the patient’s BMI before surgery, their commitment to maintain healthy habits, such as a well-balanced diet and physical activity, and the time that has passed after the surgery. The patient can expect major changes in weight loss as soon as six months and as long as three years. 

For more information on what to expect during and after the gastric sleeve procedure, we invite you to read this article that covers all the necessary information you need if you’re considering getting this surgery or contact us for a one-on-one consultation with one of our doctors. 

Common Postoperative Complications

As is the case with every surgery, the gastric sleeve can also come with complications in the postoperative recovery process. Some of them include: staple line leaks, bleeding, strictures, digestion issues, and sagging skin. These complications are considered rare and there are several ways to treat them in case they should appear. However, a complication that can lead to more uncomfortable symptoms is overeating after the gastric bypass. 

Eating a lot is not recommended after this surgery and doing so would mean breaking the diet your doctor recommended to maintain a healthy weight. Overeating can take form in irregular snacking behaviors or binging during meals despite being full. Because the surgery removes a large portion of your stomach, overeating can result in significant weight gain or plateaus, as well as abdominal pain, cramps, frequent indigestion, and heartburn. 

Overeating after gastric sleeve surgery can also result in the following symptoms:

• Vomiting and Diarrhea: When the stomach receives more food than it can hold, it’s natural for the body to release the contents through vomiting or diarrhea. Overeating can also affect the body’s digestion. 
• Dumping Syndrome: This can happen when the food you consume, usually undigested, passes too quickly through the intestine, and it’s usually a reaction that the stomach has when it comes to overeating. Some symptoms may include increased sweating, diarrhea, dizziness, and nausea. However, the most concerning side effect is the sudden drop in blood sugar; if you happen to experience this, seek urgent help immediately.
• Stretching of the Stomach: The stomach stretching to a larger size is the most serious consequence of overeating after gastric sleeve surgery. Repeatedly eating large meals will undo the progress surgery allowed you to make and you’ll regain the weight you lost due to your stomach stretching.

People can have a complicated relationship with food and overeating can become a type of coping mechanism to deal with stress or sadness, or it can simply be a force of habit. It’s important that bariatric surgery candidates seek professional counseling before and after getting the gastric sleeve in case they suffer from disordered eating habits. 

What Can Be Done To Prevent Overeating? 

Bariatric patients that become eligible for the gastric sleeve are given a detailed explanation of the process they will go through before and after the surgery, which includes a dietary plan that will evolve as your body recovers. Our medical team at LIMARP® works alongside you to create a personalized plan that’s right for you. While each patient’s relationship with food is different, here are some tips that can help you manage or prevent overeating:

• Eat Mindfully

When people eat quickly, it’s common that they don’t realize that they’re full until they’ve overeaten. If you chew slowly and really savor your meals, you’ll be able to tell when you’re really full and be conscious of the amount of food you’ve eaten. This is a good technique to follow, regardless if you’re recovering from the gastric sleeve or not.

• Identify When You’re Full

Everyone has grown accustomed to wanting to finish everything that’s on their plate, but you really don’t have to if you’re already full. Forcing yourself to finish every single thing on your plate can lead to overeating and it’s important to listen to your body when it’s already full. Get it boxed up or use a sealable container so you can save it for later. Learning how to identify your body’s cues when it’s full takes time, so it’s important to highlight that if you’re following a strict diet, this method may not be suitable for you. Contact your doctor or a trained professional if you’re having trouble maintaining a healthy diet or keeping yourself from overeating.

• Talk to A Mental Health Professional

Since our emotional and psychological relationship to food is complicated, it’s important that you speak with a therapist about these issues and prevent them from developing into more serious eating disorders. They can go over your thought process regarding food and help you develop better habits and behaviors when it comes to eating and your coping strategies. Our team at LIMARP® counts with licensed professionals that can help you in your journey of developing a healthier relationship with food and overall body image. 

• Keep a Close Eye on Your Portions

Portion control can make a major difference when it comes to how much you consume, but it must be done responsibly and by following a meal plan approved by a licensed dietitian. This technique can help prevent overeating, but it can also lead you to undereating; if you’re recovering from a gastric sleeve, it’s imperative that you follow a structured diet so that you can ingest the necessary nutrients. There are several tools that can help you eat the amount of  food you really need, such as measuring cups, scales, and small plates.

Contact Us to Learn More

For more information about the consequences of overeating after a gastric sleeve, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

Bariatric surgery is commonly associated as a weight loss solution for people struggling with obesity or any other condition that has to do with body image or “shedding a few pounds”. This isn’t a wrong assumption, most bariatric patients do struggle with obesity, but this type of surgery also benefits people who suffer from other diseases, such as diabetes, sleep apnea, high cholesterol, and gastroparesis.  

Some of the most popular weight loss procedures are the gastric bypass, the adjustable gastric band, and the gastric sleeve. These surgeries modify part of the patient’s gastrointestinal system by reducing the size of the stomach or bypassing a portion of the intestine, therefore altering the amount of food a person can ingest. This allows the patient to maintain a healthy weight and it can even improve their overall metabolism. 

The different types of bariatric surgeries are constantly being refined and studied to improve the procedures and ensure that all operations are swift and with almost no risks for the patients. This also means that the new research has shed light on new ways on how to help people who struggle with other types of gastrointestinal diseases. Over the last few years, new studies have been published about how to treat patients with gastroparesis and medical researchers have found that the gastric sleeve can be a viable and helpful option for them. 

Dr. Liza María Pompa González and our team at LIMARP®, located in Tijuana, MX, offer different treatment plans that meet the patient’s specific needs by going over your medical history to determine which weight loss surgery is best for you. The following article focuses on gastroparesis and how the gastric sleeve can help alleviate the symptoms this disease causes. We also invite you to contact us to book an appointment with one of our doctors if you wish to know more. 

What is Gastroparesis?

Gastroparesis is a disease in which the stomach of a person cannot empty itself in a normal way because there’s a partial paralysis in the stomach caused by damaged nerves that don’t allow the muscles in the area to function properly. This slows the movement in the digestive system and some of the symptoms include nausea, vomiting, bloating, heartburn, and chronic abdominal pain. 

So, what exactly causes gastroparesis? As it was mentioned before, this disease may be the result of nerve damage in the stomach, more specifically to the vagus nerve, but it can also be caused by a viral infection, complications from a gastric surgery, and the use of some medications like antidepressants. Hypothyroidism and other autoimmune diseases may also cause gastroparesis. 

It’s common for people with long-term diabetes to also have gastroparesis and while it may also present itself in other situations, it’s usually misdiagnosed for an ulcer, an allergic reaction, or acid reflux. Although these symptoms may be considered as mild, it’s important to schedule an appointment with your doctor if they persist or become unmanageable. If gastroparesis goes undiagnosed, it can cause dehydration, malnutrition, an increase in stomach bacteria, high sugar levels, and stomach blockages. 

To know if you have gastroparesis, your doctor may perform a physical examination and order blood tests. If you do have it, keep in mind that it’s not a curable disease, but there are treatments that can help you manage gastroparesis and reduce the problems that may come with it. Some patients benefit from medication that treats nausea or other drugs that help the stomach contract, while others may qualify for certain types of surgery such as the gastric electrical stimulation or the gastric bypass.

Now, what about the gastric sleeve? Is it a viable option for people struggling with gastroparesis?

The Gastric Sleeve: Is it Right to Treat Gastroparesis?

The gastric sleeve is a restrictive procedure that consists in reducing the size of the stomach by removing approximately 75% to 80% of it from the body, leaving only a small part that resembles a sleeve. By reducing the size of the stomach, the gastric sleeve only allows the ingestion of a certain amount of food, allowing the patient to reach or maintain a healthy weight. It also alleviates or improves conditions for people struggling with diabetes, sleep apnea, hypertension, and most recently, gastroparesis. 

Aside from being one of the most effective and safest types of bariatric surgery, the gastric sleeve has shown to help with gastric emptying, which is one of the main struggles for patients with gastroparesis. It has also shown to reduce nausea and vomiting, in addition to improving the eating habits of people who have not seen results from other types of treatments. This means the quality of life and overall health of people with gastroparesis.

Contact Us to Learn More

If you have gastroparesis and want to know if the gastric sleeve is right for you, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

The gastric sleeve, also known as sleeve gastrectomy, is one of the most effective and safe ways of losing weight if you are struggling from obesity. A gastric sleeve is a bariatric and laparoscopic procedure in which the stomach is divided with surgical staples, extracting roughly 80% of its size. The new stomach is in this way reduced to nearly 20% of its original size, allowing the patient to eat much less. Patients can experience less appetite and faster satiety when eating, thanks to a reduction in the production of the hunger hormone known as ghrelin, which is a convenient by-product of this procedure.

The laparoscopic techniques used in this procedure make the gastric sleeve a non-invasive surgery that lasts an average of 50 minutes. The patient is then held under observation for one day, and can then head home for a recovery period that lasts a couple of weeks. As for any type of surgery, proper recovery is very important for the treatments’ success and safety. The patient who underwent a gastric sleeve must rest for four to six weeks after the surgery. During these weeks, the patient should not lift heavy objects, walk through heavy sets of stairs nor engage in demanding exercises. This will allow the staple line in the stomach to heal properly. However, this doesn’t mean that the patient should be under bed rest for those four to six weeks nor that she or he should avoid any physical activity. 

Start by walking

Walking is one of the convenient and accessible forms of exercise. A patient who underwent gastric sleeve surgery should start recovering her or his mobility after the first week after surgery by doing short low-impact walks throughout the day. You can move around the house, go grocery shopping or give slow, short walks around your block. These walks can boost your circulation, energize your body, and strengthen your physical condition. 

Walking is also the perfect transitional activity for more demanding exercise routines later, after your recovery phase. During your second, third, and fourth weeks of recovery, you can gradually increase the pace, distance and duration of your walks for a more invigorating workout. 

And when can I start running?

This will depend on your recovery and on the advice of your surgeon. However, most patients can start running and exercising one month after their surgery. Running is considered a vigorous-intensity activity, because it requires a high level of energy expenditure, greater than 6 METs (Metabolic Equivalent of Task). Sitting quietly is equivalent to the expenditure of only 1 MET [1]. 

According to the World Health Organization, adults should engage in at least 75 to 150 minutes of vigorous-intensity aerobic physical activities per week as a healthy habit [2]. This means that exercising or running for 30 minutes a day, 5 days a week, accomplishes that goal. 

Common guidelines issued by the ASMBS, the Obesity Society, and the American Association of Clinical Endocrinologists recommend that postoperative patients should adhere to a healthful lifestyle including exercising for at least 30 minutes per day [3].

If you’re having trouble running for 30 minutes a day, don’t despair. Patients who underwent gastric sleeve surgery should increase their physical activity gradually. You can start by running only 10 minutes, making increases of 5 more minutes little by little. You can also start by running at a low speed, until you are feeling comfortable running at a steady pace for 30 minutes, and then increase your speed gradually in the following weeks. 

Exercise is key after gastric sleeve surgery

Exercising (either by walking, running, swimming, or any other exercise, for that matter), along with a balanced diet, are key measures that guarantee that the outcomes of the gastric sleeve surgery will be long lasting. The gastric sleeve surgery achieves great weight loss in a very short period of time, but this is not accomplished with the surgery by itself. To obtain long lasting results, and to avoid any weight regain, patients who underwent bariatric surgery should also adopt healthy lifestyle habits, such as having a balanced diet, and, of course, practicing moderate exercise frequently, at least thrice a week. 

Sustaining an exercise routine will guarantee the best possible results for your surgery; at the same time, it will improve your quality of life. Exercising improves your physical condition, it lowers the risk of developing heart conditions, diabetes and certain types of cancer, and it also boosts your mental health and self-esteem. 

Contact us

At LIMARP International Center of Excellence for obesity, located in Tijuana, Mexico we offer an integral bariatric program that treats obesity from a multidisciplinary approach. We provide either surgical or non-surgical interventions such as the gastric sleeve, gastric bypass, mini-gastric bypass, duodenal switch, intragastric balloon and gastric clip, along with nutritional guidance, psychological counselling and fitness coaching that includes a personalized fitness routine that adapts to your needs for every phase of your treatment. 

If you’re interested in knowing more about exercising after bariatric surgery or if you’re interested in getting to know more about our available treatments for obesity, please give us a call or send us a message through this webpage or any of our social media sites. You could schedule a free consultation today. 

References

[1] Physical Activity Guidelines Advisory Committee, “2018 Physical Activity Guidelines Advisory Committee Scientific Report,” U.S. Department of Health and Human Services, Washington, D. C., 2018. [Online]. Available: https://health.gov/sites/default/files/2019-09/PAG_Advisory_Committee_Report.pdf

[2] “Physical activity,” World Health Organization, Nov. 26, 2020. https://www.who.int/news-room/fact-sheets/detail/physical-activity (accessed Sep. 30, 2021).

[3] P. M. Coen, E. A. Carnero, and B. H. Goodpaster, “Exercise and Bariatric Surgery: An Effective Therapeutic Strategy,” Exerc. Sport Sci. Rev., vol. 46, no. 4, pp. 262–270, Oct. 2018, doi: 10.1249/JES.0000000000000168.

Gastric sleeve surgery, also known as sleeve gastrectomy, is by far the most popular bariatric surgery worldwide. More than half of the weight loss surgeries performed around the world are gastric sleeve surgeries [1]. It is recognized, as other bariatric surgeries, to be a safe and effective treatment for obesity and its associated comorbidities.

How is the gastric sleeve done?

The gastric sleeve is a restrictive operation which reduces the size of the stomach and helps people with obesity lose weight. With a smaller stomach the person feels full much faster than before, which helps him or her make important and necessary lifestyle changes.

During surgery more than half of the stomach is removed. The new stomach is closed with special surgical staples, and given the shape of a banana or vertical sleeve. This is a non-reversible process.

Thanks to the advanced laparoscopic techniques that are used today, the patient’s recovery process is quite fast and the risks are minimal.

This procedure mainly induces weight loss by restricting the amount of food that you can eat, resulting in an overall metabolic improvement. However, hormonal changes that result from the surgery are also a very important part of the patient’s weight loss process.

Who are candidates for this procedure?

Patients with a Body Mass Index (BMI) higher than 40 are eligible for gastric sleeve surgery. Patients with a BMI higher than 35 might be eligible if they have two or more life threatening conditions that are associated with obesity, such as hypertension, type II diabetes, dyslipidemia or others.

Candidates for gastric sleeve surgery should also be willing to change their habits towards a healthier lifestyle, that includes exercise and a balanced diet.

Benefits of the gastric sleeve:

The gastric sleeve surgery is a very effective way to lose weight, but not only that. The procedure has proved to be effective in ameliorating and even resolving many different health conditions. It is also a more convenient surgery when compared with others, such as the gastric bypass or the duodenal switch, considering different factors.

Please keep reading to find out more about all the different benefits of the gastric sleeve surgery.

• It is done with laparoscopic techniques. Nowadays, most bariatric surgeries are done with a laparoscopic camera and utensils, which means that the patient doesn’t need to be cut open for his surgical intervention.
• This surgery involves no prosthetic material nor surgical maintenance, like it happens with the gastric band and the intragastric balloon.
• The surgical intervention takes less than an hour to complete and the post-operative stay at the hospital or clinic is only one night for most patients.
• Most patients can expect a fast recovery. Patients that receive gastric sleeve surgery need to rest at least 3 weeks after their procedure. After this time, they can go back to their normal activities, with proper care and compliance to their post-operative diet.
• Weight loss is also accomplished very fast. Patients can lose a third of their body weight as soon as a year after their gastric sleeve surgery, but they can expect to witness major changes as soon as 6 months.
• It accomplishes major weight loss! Patients can expect to lose at least 80% of their excess body weight, meaning the weight that exceeded their ideal weight before their operation. The IFSO Global Registry Reports [1] shows that patients who received gastric sleeve surgery lost, on average, 30.5% or their total body weight after one year of surgery.
• With a gastric sleeve surgery, your sense of hunger and appetite diminishes. With this procedure, plasma ghrelin levels are significantly reduced in the early post-operative period and remain consistently low years after surgery. This peptide is secreted when the stomach is empty, and its function is to signal hunger for the production of secretions to digest food [2]. This isn’t accomplished with other restrictive methods.
• Patients diagnosed with type II diabetes can receive many benefits from a gastric sleeve surgery. On average, 39% of patients that were receiving medication for their type II diabetes stopped needing it after a year of their gastric sleeve surgery, according to the Global Registry Report of 2019 [1].
• Gastric sleeve surgery also benefits patients previously diagnosed with hypertension. On average, 57.2% of patients that were receiving medication for hypertension stopped needing it after a year of their procedure [1].
• Gastric sleeve surgery can lead to the improvement of different clinical markers. This procedure has considerable regulatory impacts on clinical markers, including biochemical, histological, hematological, and inflammatory markers [3].
• 85% of patients with non-alcoholic fatty liver disease (NAFLD) improve after weight loss induced by sleeve gastrectomy [3].
• Gastric sleeve surgery also reduces cardiovascular risks in patients.
• It eases respiration in patients with obstructive sleep apnea.
• It also reduces the risk of a stroke and heart attack.
• It eases joint pain.
• Sleeve gastrectomy improves hirsutism and polycystic ovary syndrome (PCOS) in female patients. It also increases fertility, although patients that are planning to get pregnant after their bariatric surgery should wait at least a year and a half to do so [3].
• This procedure can also reduce urinary incontinence symptoms.
• The gastric sleeve is also associated with a significant reduction in cancer incidence and mortality [3].

Bottom line:

It is a highly recommended, advanced and innovative technique to treat obesity in a permanent manner. A patient’s life changes dramatically after gastric sleeve surgery and the first thing he or she has to do is to strictly follow the post-operative program. This is of the highest importance.

Other things to consider:

The physician must provide the patient with specific instructions on what to eat after the surgery. During the first month, the stomach only tolerates small amounts of liquids and soft foods. Little by little, the patient can start to eat solid food, but it must be chewed thoroughly and eating must stop as soon as the patient feels satiated. Failure to follow these two simple steps can cause discomfort, nausea and even vomiting.

There is a risk that if the person starts to overeat (despite the discomfort that this will cause), the stomach might stretch and recover some of its former capacity, which significantly reduces the benefits of the surgery. Gastric sleeve surgery must be accompanied by a solid meal plan, with enough macronutrients (proteins, fats and carbohydrates), micronutrients (vitamins and minerals) and additional supplements for the rest of the patient’s life.

Bariatric surgery is not a magic wand, it is a life-long commitment; but for thousands of people throughout the world it has meant an amazing opportunity to reverse obesity and most of the related diseases that make it so dangerous.

It is worth noting that the gastric sleeve procedure can be the first step in a wider treatment plan that may include other types of bariatric surgery (like gastric bypass), or it can be used as a single procedure for weight loss. This is something that only a trained medical team can determine.

Bariatric surgery at LIMARP in Tijuana

LIMARP International Center of Excellence for Obesity, located in Tijuana, Mexico, offers an integral bariatric program for patients struggling with obesity. Our program includes either a surgical intervention like a gastric sleeve, a gastric bypass or a duodenal switch, or a non-surgical intervention like a gastric band or an intragastric balloon; it also includes psychological counselling, nutritional guidance and a personalized fitness program that adapts to every step or your treatment. This integral bariatric program considers a long-term follow-up where we monitor your progress and make sure you accomplish your weight-loss goals.

For patients travelling from abroad, we also offer an all-inclusive package that adds a two-night stay at our luxurious next-door hotel, the Grand Hotel Tijuana, and transportation to and fro the airport and the hotel.

Travelling to Tijuana to receive bariatric surgery is definitely the right choice. Tijuana is the number one medical tourism destination in Mexico. It offers quality medical service at just a fraction of the price compared with other countries.

Call today for a free consultation

If you want to know if gastric sleeve surgery is the right choice for you, call LIMARP International Center of Excellence for Obesity; our team is at your service and we can help. For a free evaluation call (619) 270-8823 or fill out a contact form at www.limarp.com

Bibliography

• [1] International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) (2019). 5th IFSO Global Registry Report 2019. https://www.ifso.com/pdf/5th-ifso-global-registry-report-september-2019.pdf
• [2] Zundel, N.; Hernandez, J. D.; Gagner, M. (2020). Laparoscopic Sleeve Gastrectomy: Technique and Outcomes. The ASMBS Textbook of Bariatric Surgery. Springer.
• [3] Kheirvari, M.; Dadkhah Nikroo, N.; Jaafarinejad, H.; Farsimadan, M.; Eshghjoo, S.; Hosseini, S. & Anbara T. (2020). The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review. Heliyon 6(e03496). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052082/