Biliopancreatic Diversion With Duodenal Switch: What to Expect at Home
A biliopancreatic diversion with duodenal switch is surgery to make your stomach smaller. This surgery also allows food to bypass part of the small intestine so that you absorb fewer calories and lose weight.
The cut (incision) the doctor made in your belly will probably be sore for several weeks after the surgery. If you have stitches, the doctor will take these out at your follow-up visit.
You probably will lose weight very quickly in the first few months after surgery. As time goes on, your weight loss will slow down. You can expect most of your weight loss to happen in the first 12 months after your surgery. You will have regular doctor's appointments during this time to check how you are doing.
It is important to think of this surgery as a tool to help you lose weight. It's not an instant fix. You will still need to eat a healthy diet and get regular exercise. This will help you reach your weight goal and avoid regaining the weight you lose.
It is common to have many different emotions after this surgery. You may feel happy or excited as you begin to lose weight. But you may also feel overwhelmed or frustrated by the changes that you have to make in your diet, activity, and lifestyle. Talk with your doctor if you have concerns or questions.
This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
How can you care for yourself at home?
- Rest when you feel tired. Getting enough sleep will help you recover.
- Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
- Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
- Until your doctor says it is okay, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
- Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
- Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
- Ask your doctor when you can drive again.
- You will probably need to take about 2 to 4 weeks off from work. It depends on the type of work you do and how you feel. You will probably return to normal activities within 3 to 5 weeks.
- You may shower, if your doctor okays it. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
- Ask your doctor when it is okay for you to have sex.
- Your doctor will give you specific instructions about what to eat after the surgery. For the first 2 to 6 weeks, you will need to follow a liquid or soft diet. Bit by bit, you will be able to add solid foods back into your diet.
- Your doctor may recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements for the rest of your life.
- At first you may feel full after just a few sips of water or other liquid. It is important to try to sip water throughout the day to avoid becoming dehydrated.
- You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Your doctor may suggest fibre, a stool softener, or a mild laxative.
- Sometimes the stomach empties food into the small intestine too quickly. This is called dumping syndrome. It can cause diarrhea and make you feel faint, shaky, and nauseated. It also can make it hard for your body to get enough nutrition.
- Avoid high-sugar foods—such as desserts, soda pop, and fruit juices—which are most likely to cause dumping syndrome.
- Do not drink liquids within a half hour before eating and up to an hour after eating. Liquids move food even more quickly into the small intestine. Quick emptying of the stomach increases the chance of diarrhea.
- Eat slowly. Try to chew each bite about 20 times. Allow 20 to 30 minutes for each meal.
- Eat 5 or 6 small meals or snacks a day. This may keep you from feeling too full after eating and may reduce problems with diarrhea and dumping syndrome.
- Check with your doctor before drinking alcohol. Your body may absorb alcohol more quickly after surgery.
- Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
- If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.
- Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
- If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
- If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
- If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
- Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
- Keep the area clean and dry.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
When should you call for help?
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You are short of breath.
Call your doctor now or seek immediate medical care if:
- You have pain that does not get better after you take pain medicine.
- You cannot pass stool or gas.
- You are sick to your stomach and cannot drink fluids.
- You have loose stitches, or your incision comes open.
- You have signs of a blood clot, such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.
Where can you learn more?
Go to https://www.healthwise.net/patientEd
Enter N833 in the search box to learn more about "Biliopancreatic Diversion With Duodenal Switch: What to Expect at Home".
Current as of: December 27, 2021
Author: Healthwise Staff
Medical Review:Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Martin J. Gabica MD - Family Medicine & C. Dale Mercer MD, FRCSC, FACS - General Surgery