Gastric Bypass and Hysterectomy

If you’ve had gastric bypass surgery and are now having a hysterectomy, you may face some unique challenges and concerns. You may also need to take some extra precautions both before and after your hysterectomy.

To help you prepare, it’s a good idea to talk to your entire medical team. All of your doctors will need to be aware of both procedures so they can help you make the best plan for you.

Before Hysterectomy

Bowel Prep: One of the issues that may arise before your hysterectomy is the bowel prep. It can be very dehydrating which may already be a side effect of your gastric bypass surgery. Depending on your situation, if a bowel prep is required it may need to be adjusted to accommodate your prior gastric bypass surgery.

Fasting: There may also be a concern with fasting prior to surgery. If you already have a limited diet, you may find it extra difficult to be without food for that span of time. If you believe this could be an issue for you, discuss it with your doctor. Possible solutions could include being the first surgery of the day and starting your IV immediately upon reaching the hospital.

Supplements: If are taking supplements or infusions because your body does not absorb enough minerals and vitamins, you need to discuss them with your surgeon prior to surgery. Many of them are typically stopped 7-14 days before surgery due to possible issues with bleeding or anesthesia. Your surgeon and anesthesiologist may need to make changes to accommodate your specific health situation.


During Hysterectomy

Scar Tissue: You may have some scar tissue and adhesions as a result of your prior gastric bypass surgery. This could make your hysterectomy a bit more difficult and potentially have an impact on the type of hysterectomy that is best for you.

Anesthesia: If your surgeon has allowed you to continue using certain medications or supplements in the days immediately before surgery because of issues you have with absorbing vitamins and nutrients, there may need to be adjustments made to your anesthesia. Be sure to let your anesthesiologist and pre-op team know about the medications, supplements, ands vitamins so safe decisions can be made for you during surgery.

After Hysterectomy

Diet: While healing from surgery, it’s important to eat a healthy diet with adequate protein and nutrients. Dietary limitation and absorption issues that follow a gastric bypass surgery may restrict your diet enough that it affects the healing process after your hysterectomy. Discuss with your surgeon what you can and cannot eat and in what amounts to be sure it will be adequate for recovery. It might be necessary to work with a dietician to develop a food plan that is both safe and effective for healing after having had a gastric bypass procedure.

Bowel Movements: In addition, it’s not uncommon to have issues with bowel movements following a hysterectomy because of anesthesia, medications, diet changes, hormones, and more. If you already experience difficulty with digestion because of your gastric bypass surgery, this could become a bigger issue for you. Be sure to discuss with your surgeon any current bowel and digestive problems so together you can decide how you might prevent or treat any that will occur following your hysterectomy.

Skin Care: If you now have an apron of skin because of significant weight loss following your gastric bypass surgery, you may find it a bit more difficult to keep the area area dry and clean while recovering from your hysterectomy. It may be extra difficult if your hysterectomy incision is also in that area. Be prepared to ask someone to help if you are too tender and sore during recovery to comfortably care for this area.

Medications and Supplements

Iron: Typically, women who have had a hysterectomy are instructed to avoid vitamins with iron or iron supplements. You, however, may need the iron if have an issue absorbing it from food as one of the side effects of gastric bypass surgery is difficulty absorbing vitamins and minerals, including calcium and iron.

Calcium: If you have both ovaries removed along with your hysterectomy, the resulting surgical menopause puts you at greater risk for osteoporosis. Thus, it may be critical for you to use calcium supplements.

Pain Medications: You may already have issues with various medications since your gastric bypass surgery and may have been advised to avoid NSAIDs (aspirin, ibuprofen). They may worsen some of your resulting digestive issues, you may not be able to tolerate others, and there can be issues absorbing some, especially if taken orally. If you are needing pain medications before or after your hysterectomy, be sure to talk to your doctor about the gastric bypass surgery and any known issues you have with medications.

Oral Medications: Don’t forget to discuss how your gastric bypass surgery could impact any oral pain medications. You may not able to take the medications your doctor typically prescribes and may need alternative options or delivery forms.

HRT: If you will be having your ovaries removed, you also need to discuss hormone replacement therapy (HRT) options. Because of absorption issues from the gastric bypass surgery, you may need to try alternative delivery methods and doses.

This content was written by staff of by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.  Reprinted with permission: Gastric Bypass and Hysterectomy

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