The first few weeks after gastric sleeve surgery is often called, the “make or break” period. It is most crucial for overall outcome of the surgery success but also the riskiest for complications. A majority of all complications occur within the first 30 days post-surgery.
Avoiding certain medications is one way to improve your odds after gastric sleeve surgery. Please review the entire list of prescription drugs and medication to avoid. This list is NOT meant to be comprehensive. Your physician will inform you of specific medications and drugs you should discontinue before and after gastric sleeve surgery.
If you have any questions regarding this list of medications to avoid after gastric sleeve surgery, please consult with your patient coordinator.
First Week After Gastric Sleeve Surgery
Avoid All NSAIDs
NSAIDs (nonsteroidal anti-inflammatory drugs) can cause gastric ulcers. Bariatric patients are susceptible to marginal ulcers (ulcers at the gastrointestinal suture line/staple line).
Marginal ulcers are a frequent complication of surgical treatment; they are difficult to control medically and often require further surgery. Bleeding ulcers can be fatal.
Tylenol, and non-NSAID pain relievers prescribed by physicians.
Note: Many anti-arthritic medications like Celebrex and Meloxicam are NSAIDs.
Can I Take NSAIDS After the First Weeks
Occasional use of NSAIDs for pain (less than 3x per month) is fine. Chronic use increases a Bariatric patient’s risk of developing a gastric ulcer. NSAIDs are an ulcer risk in all people.
In bariatric patients, the risk is higher because of the smaller stomach. The ratio of NSAID going into the stomach to the surface area of the stomach is higher. Aspirin for cardio health and chronic use of medications for arthritis is best to discontinue permanently.
First Two Weeks After Gastric Sleeve Surgery
Discontinue Estrogen-Containing Medications
These medications are often prescribed for birth control or hormone replacement therapy (HRT). Avoid hormone medications that contain Estrogen or Estrogen analogs. These medications are known to increase a person’s risk of a DVT (Deep Vein Thrombosis-blood clot in the leg).
Surgery in general also increases a person’s danger of developing a DVT. Patients who have surgery and take these hormones are doubling their risk of developing a DVT. If a DVT dislodges from the leg, it can travel through the body and become lodged in the brain (STROKE) or lung (DEATH).
After Two Weeks
The risk will return to the same risk of taking the medication previously without the increased risk caused by post-op surgery status.
Avoid All Nicotine Products
Nicotine increases a patient’s risk of developing a DVT after surgery. Avoid all nicotine products (gum, patches, cigarettes, etc.).
What about after two weeks? Toxins from smoking can adhere to saliva and mucous membranes where it can travel to the stomach and promote gastric ulcer formation. Smoking is best to discontinue permanently. After two weeks, the risk of DVT from nicotine products returns to the same as before having a surgical procedure.
Avoid All Steroids
These can lead to gastric ulcers, bleeding, or perforation. Oral steroids delay healing in the stomach and impair the stomach lining’s ability to form the protective layer between the muscle wall and acid. If steroid use is unavoidable, it should be accompanied by a proton pump inhibitor (PPI) like Prilosec or Prevacid. Some antacids that do not provide adequate protection include Pepcid and Zantac.
After Two Weeks
Occasional steroid use is acceptable. Chronic steroid use is to be avoided permanently.
All steroids are to be discontinued for two weeks after surgery. After two weeks, steroid injections are acceptable.
Bariatric Surgery and Ulcers
Rapid weight loss after bariatric surgery increases the risk of developing symptomatic gallstone disease. Studies show that approximately 25 to 30% of patients undergoing weight loss procedures may develop symptomatic gallstones within the first year postoperatively.
A regression analysis shows that gastric sleeve surgery has a higher chance of developing gallstones in some patients . Gastric bypass may result in a chance of gallstone formation due to a slightly higher weight loss within the first 12 months.
Some surgeons routinely remove the gallbladder for every patient going through weight loss surgery to prevent gallstone complications. Mexico Bariatric Center surgeons do not recommend the removal of the gallbladder at the time of the surgery unless the patient already has cholelithiasis. Our bariatric surgeons recommend administering ursodiol as prophylaxis therapy for 6 months after surgery.
As bariatric surgeries alter the structure and function of the GI tract in various ways, it is crucial to evaluate patients’ comorbidities, other health issues, lifestyle, and level of commitment when considering which surgery fits best for them. We hope that this overview of gastric sleeve vs gastric bypass proves helpful to you.
Written by Surgeon Liaison at Mexico Bariatric Center
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