Post Op - Laparoscopic Gastric Band
Binge eating and excessive vomiting should be avoided to prevent possible stretching of the esophagus and the stomach pouch. Anti-inflammatory medication such as aspirin, Motrin, Advil, and other non-steroidal inflammatory drugs should be used with great caution, as they may irritate the stomach and increase the risk of bleeding. Some individuals may need to take vitamin supplements to maintain normal vitamin B12 and folate levels. In addition, the first six months after rapid weight loss you are at an increased risk to develop gallstones. You will undergo gallbladder testing before surgery if you have not had it removed previously. If the testing is normal then you will be placed on medication to prevent gallstone formation for the duration of six (6) months.
Following surgery your diet will be altered for several weeks. This is necessary to allow for your pouch to heal and adjust to the position of the band. It may take 4-6 weeks for this to occur. Immediately after surgery when you awaken in recovery room you will be allowed a few sips of water or ice chips. Then a UGI (a x-ray test to check passage of liquid into the stomach) will be done before you go home.
The next day after surgery you may start to increase your liquid intake only by a small amount at a time. To help prevent nausea and vomiting do not drink too much. In addition to water choose liquids that have an adequate amount of calories. You will be on a clear liquid diet for 1-2 weeks. The goal behind is to protect your new pouch. It is important to keep yourself hydrated so drink plenty of water. Thin liquids are allowed during this period. Such liquids include:
- clear broth or soups (avoid any vegetables or meat)
- skim milk
- sugar-free Popsicle's
- Fruit juices.
The general rule of thumb is if you can blend or pureed it thin enough to go through a straw then you may drink it. Weeks three and four (3-4) after surgery you may introduce slightly textured foods. The goal should be the consistency of baby food. Remember that when you loose weight it is important to maintain muscle mass, so eat protein rich food first. Examples of such foods are:
- pureed chicken and fish
- protein shakes
- mashed potatoes
- Low fat pudding or yogurt.
Week five (5) you may begin introducing cooked foods such as baked fish or ground turkey. Make a habit of cutting your food in to small pieces and chewing your food very well before swallowing. This will help accommodate passage of food through the band into the lower part of the stomach. If you try to eat too fast and take too big of bites you may experience nausea/vomiting, stomach irritation and possible blockage of the stomach. If you have nausea and vomiting with the solid foods back off, return to clear liquids and then progress your diet back to solids. Each stage of the diet progression may vary. You may find that one day you might be able to eat something and the next day you can not. Try to avoid vomiting as this may put pressure on the stomach above and below the band increasing the risk of band slippage.
Initially the band will be left empty and adjustment will be determined based upon your individual needs. Only your surgeon or a clinically trained healthcare provider should adjust the band. Never try to adjust the band yourself. In order to adjust the band saline is injected into the port that lies just under the skin. A special needle is used for this procedure. More than one adjustment may be required to allow for gradual weight loss. The band is usually adjusted four to six (4-6) weeks after surgery but may vary depending on the following factors:
- your weight loss
- the amount of food you can eat comfortably
- your routine exercise
- the amount of fluid all ready in the band
Once you have graduated to solid foods you will need to become aware of your food intake. Remember that the band was made to limit solid food not liquids, thus allowing for unrestricted passage of liquids and decreased sensation of fullness. Drinking large quantities of liquids immediately after eating will not only flush the food through your pouch but also decrease the prolonged feeling of fullness. Eat three balanced small meals a day. Your stomach should only hold about a fourth (1/4) cup or 2 oz. of food at a time. Stop eating when you are no longer hungry or feel comfortable. Set goals to eat healthy meals high in protein, low fat and limited sugar content. Below are ten simple steps that can help you achieve an optimal outcome and help you eat your way into success.
- Eat only three (3) small meals a day
- Eat slowly and thoroughly chew your food
- Stop eating as soon as you feel full
- Do not drink while you are eating (Avoid drinking anything 1-2 hrs after eating)
- Do not eat between meals (Avoid snacking)
- Eat only good healthy foods
- Avoid fibrous food
- Drink enough liquids during the day (6-8 glasses/day)
- Drink only low caloric liquids
- Exercise for at least thirty minutes (30) a day
Examples of healthy food choices include the following:
Fruits and Vegetables
- 1-2 serving of fresh fruit daily
- 2-3 serving of fresh vegetables daily breads and cereals
- 1 small serving of low sugar cold or hot cereal
- ½ to 1 slice of toasted whole wheat or whole grain bread
(Breads may cause a problem for some individuals)
Meat, Fish, Poultry and Eggs
- 1-2 oz of meat, fish, poultry or egg daily
- Remove all visible fat
- Remove all skin from poultry
- Grilling Steaming, Boiling and Microwave are excellent ways to prepare food
- Avoid fried foods
- Skim milk (Maximum of two (2) cups/day
- Low fat yogurts
- 1 oz cheese daily
- 3-4 teaspoons of margarine, butter, or oil daily
- Use mayonnaise in moderation
- Low fat salad dressings
- Tea or coffee (black) with low calorie sweetener
- Non-carbonated low to no calorie beverages
- Carbonated beverages should be avoided due to the possibility that they can cause the pouch to become enlarged
- Alcohol should be taken in moderation (1 glass of wine/day)
Foods that may slowly be introduced to diet are as follows:
- Dry meat
- Un-toasted or doughy bread
- Pasta or rice
- Peanut butter
- Dried fruit
- Fibrous vegetables such as corn, celery or asparagus
- Nuts and popcorn
- Fried foods
- Seeds or skins of fruits or vegetables
These foods may not pass through the stomach easily and may increase the risk of stomach blockage. As you introduce this food group to your diet remember to always chew thoroughly and take small bites.
Follow up from surgery will include the following schedule.
- two weeks post-surgery
- every six (6) weeks for the first six (6) months after surgery
- One year with blood work
- Other follow up will be scheduled as necessary
In addition, pregnancy should be avoided for the next 1-1 ½ years after the procedure.