Bariatric surgery changes many aspects of one’s lifestyle, and medications are no exception. All patients will be prescribed certain medications and supplements after their surgery for a specific period of time. There are issues with regards to concentration, digestion, absorption of the regular medications. Hence special interest has to be taken about the type of medications used in the immediate post-operative period. Importance has to be given to the continuation of existing medications that you were having before surgery due to the metabolic changes that happens in the body after surgery. Than BAROS will wine with you during the entire period to guide in in these regards.
REDUCED MEDICATION EFFECTIVENESS
The faster transit of food from stomach after sleeve or shorter intestinal length after any bypass can make regular mediation absorbed and the extended-release drug preparations even less effective. Because these formulations are intended to be absorbed over 1-12 hours, the pills may pass through the gastrointestinal tract before absorption is complete. This same principle also applies to delayed-release and enteric- or film-coated pills, which releases medicines only after the pill moves to the small intestine. Oral contraceptives may not be absorbed as effectively after surgery; thus, non-hormonal barrier contraception is recommended to prevent unwanted pregnancy for women who have had bariatric operations. Post surgery, you will be recommended medicines that are absorbed with in 20 minutes. For that matter, BAROS recommends chews and liquids to help with absorption from the moment it enters the digestive system. Tablets and capsules has to be easy dissolvable and if not the dosage has to be increased to balance the bio-availability after bariatric surgery.
After bariatric surgery, patients are prone to have an increased risk of anaemia due to inadequate amounts of iron, vitamin B12 and folate. Patients also may encounter deficiencies of the fat-soluble vitamins (A, D, E and K) and calcium. Deficiencies of protein leading to muscle loss are also restored. Because of these deficits, all patients should take a daily multivitamin, minerals, iron,
and calcium and protein supplements. Additional supplementation with iron, vitamin B12 and folate may be necessary in certain group of patients.
Though bariatric surgery has been successfully utilized to reverse or prevent further progression of fatty liver (Non-Alcoholic Fatty Liver Disease), liver dysfunction can occur is certain individuals. Incidence of gallstone formation ae also increased after bariatric surgery. Hence all surgical patients are advised to start on liver enzyme treatment for a short-term period using Ursodeoxycholic acid, a natural occurring bile acid to reduce liver incidences.
Non-steroidal, anti-inflammatory medications are used primarily to treat inflammation, fever and mild to moderate pain from headaches, arthritis and menstrual cramps. Taking NSAIDs after
Since bariatric patients consume less food, smaller amounts of stool are formed, which can lead to constipation. Some people find that taking two or three tablespoons of milk of magnesia every few days helps. Drinking plenty of water is very important, and nothing works well for constipation if water intake is poor. It is not uncommon for bariatric patients to have a bowel movement every two to three days once it is regulated. A fiber supplement is usually recommended.
RESUMING OLDER MEDICATIONS
Patients are usually instructed to resume most of their preoperative medications. Those who are on diabetic medications will need to monitor their blood sugar closely at home. Some patients’ blood sugar decreases very quickly after surgery (even before any weight loss), and they will need less of their diabetic medications. The same applies to insulin, which should be given when blood sugar is under strict vigilance through sliding scale and under the supervision of an Endocrinologist or primary care Physician.
Hypertensive patients have to be careful as well, as the possibility of drug reduction may happen in the immediate post operative period itself. Regular checking of BP and constant regulation of medicine through your physician is important to avoid chances of low BP scenarios. Cholesterol and other medicines needs to be monitored as well for the first 3 months as their need will come down, and even discontinued. BAROS team will coordinate with your physician to help you manage the post operative medications.