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Department of Surgery Referrals Patient Clinician Researcher

Columbia University Center for Metabolic and Weight Loss Surgery
Patient Experience  Post-Operative Care

Gastric Bypass Discharge Instructions

Now that you are ready to go home here is some information to help you manage your care.

What medicines must I take and how do I take them?

So that the medicines can be absorbed and used by your body, you must:

  • Crush all non-chewable tablets and open all capsules. Mix powder with food.
  • Chew any chewable tablets completely then wash them down with liquid.
  • You may take liquid forms of your medicines, when available. Shake the bottle well before you pour the medicine dose.
1 Prilosec® Take 20mg once a day for four weeks Open one 20mg prescription capsule OR two over-the-counter 10mg capsules into pureed food.
2 Lortab® Elixir (Hydrocodone/Acetaminophen) Take ½ - 2 teaspoons of the 7.5mg/500mg (in 15ml) elixir every 4-6 hours as needed. Once your discomfort lessens, change to Extra-Strength Tylenol® every six hours as needed. Take 2 tablespoons of liquid (equal to 1000mg) or two tablets (crushed).
3 Actigall® Take one 300mg tablet twice a day for six months. If you still have your gallbladder and do not have gallstones, we will start you on Actigall® at your first follow-up appointment.
4 Multivitamin with minerals Take 2 children's chewables every day.You can choose another form/type. Check your diet booklet.
5 Calcium   Check your diet booklet to choose a form/brand and to find the amount that you need to take every day.
6 Vitamin B12, Iron and
Vitamin D
  At your first follow-up appointment, your Dietitian will tell you how much vitamin B12, iron and vitamin D you must take.

Medicines to avoid!

Do not take aspirin or aspirin-containing products. Do not take non-steroidal anti-inflammatories such as ibuprofen (Advil®, Motrin®, etc.) and naproxen (Naprosyn, Aleve®, etc.). They may cause ulcers in your pouch. Check with us if you are not sure which medicines you can take.
If you need to take any of these kinds of medicines, even once, call the the Weight Loss Surgery Center. You may need a medication to protect your stomach, or a different prescription.

How do I care for my incision?

Remove the bandage 3 days after surgery if it is still on. Leave the Steri-strips® [strips of tape over the incision (cut)] in place; they will curl and fall off. If they are still in place 2 weeks after your surgery, gently peel them off. You can do this in the shower. The incision (cut) may itch during healing; this is normal. Do not scratch the area.

Can I shower or bathe?

It is OK to shower with soap. Pat the incision dry after showering. Do not take a bath or soak in water for one month.

What kind of activity is allowed?

Do not drive until your pain is resolved and does not require medication. Pain can make it hard to move quickly. Stop any strenuous activity if it is uncomfortable during the first month. Walk as much as is comfortable for you. Your goal for the first 4 weeks after surgery is to walk 30 minutes per day, 7 days per week.

How do I manage constipation?

If you do not have a bowel movement within 5 days of surgery, try Milk of Magnesia® (2 Tablespoons, twice a day). If this does not work after one day, try a Dulcolax® suppository or Fleets® enema. If none of these measures help, call the Weight Loss Surgery Center.

What do I do if I vomit?

If you vomit, you have probably eaten or drunk too quickly and/or too much or the food may have been too solid. Wait four hours and then try one ounce of liquid that doesn't have sugar. If this liquid does not make you nauseous or vomit, then take only liquids until the next day. Then you can try pureed foods again. If vomiting continues, call the Weight Loss Surgery Center.

Diet Notes

If you had trouble tolerating liquids in the hospital OR you did not tolerate pureed food on the day of discharge OR you are released within 23 hours of your surgery, follow the dietary instruction of your surgeon/surgeon representative when you are being discharged. Most likely, you will be instructed to follow a liquid diet for one week before trying pureed food. If you did tolerate pureed food on the day of discharge, follow the dietary instructions below.

Diet Notes
For three weeks after discharge All food must be pureed no thicker than applesauce.
Starting the day of discharge and for one day afterwards Consume one ounce of pureed food OR one to two ounces of liquid no more frequently than every twenty minutes while you are awake.

Drink one high protein drink per day, one to two ounces at a time.
For the next 19 days Eat 6 to 8 tiny meals of pureed foods a day. Make sure that you eat/drink 1 to 2 servings from the milk group per day and 4 to 6 servings from the protein group per day.

Drink one high protein drink per day.

Eat slowly! Stop eating when you are comfortably satisfied. Do not spend more than 20 minutes eating at one meal.

Do not eat foods or drink liquids that have any type of sugar listed as one of the first three ingredients.
More about liquids Try to drink 48 ounces of liquid without caffeine starting day 4 after surgery. Stop drinking 30 minutes before eating and wait at least 30 minutes after eating before you start drinking again.

Drink slowly. Do not use a straw.

Do not drink carbonated after surgery.
Do not drink alcoholic beverages for one month after surgery.

May I become pregnant?

You MUST avoid getting pregnant for 18 months after surgery. There may be a higher risk of birth defects while you are losing weight. Rapid weight loss increases fertility. Birth control must be used correctly and all the times to avoid pregnancy, even if you were not able to get pregnant in the past.

When do I follow-up after surgery?

You will meet with your Surgeon/Nurse Practitioner and Dietitian 2 to 3 weeks after surgery and with your Surgeon/Nurse Practitioner at 5-6 weeks after surgery. You will then follow-up with your Surgeon/Nurse Practitioner/Dietitian at 3 months and 6 months after surgery, every 6 months for 1 years and then every year.

You should have received dates and times for your first two follow-up visits with your pre-operative instructions. If not, please call the Center to schedule them.

When should I call the Obesity Center?

Call us if you notice:

  • Increasing redness, swelling, heat or pain at an incision
  • Drainage from an incision
  • A fever greater than 101ºF
  • Abdominal pain
  • Frequent vomiting
  • Shortness of breath
  • Generally not feeling or doing well


Call 212.305.4000 with any problems.
After 5PM, call your surgeon:

Dr. Marc Bessleron212.305.9506
Dr. Beth Schropeon212.305.9441
Dr. Melissa Baglooon212.305.9506

This information is brief and general. It should not be the only source of your information on this health care topic. It is not to be used or relied on for diagnosis or treatment. It does not take the place of instructions from your health care providers. For answers to your health related questions, talk to your health care providers for guidance before making a health care decision.

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