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The Delayed Side Effects After Bariatric Surgery

Bariatric surgery can be associated with a number of side effects. These side effects can be immediate, early or delayed. In this article, we will discuss the delayed side effects which typically manifest a few months to years after the procedure.

The most important of these side effects are:-

Nutritional deficiencies can include protein deficiency, deficiency of B complex vitamins, iron and calcium deficiency. Since all bariatric surgeries are associated with restriction of diet and in some cases malabsorption, there are chances of deficiency these essential elements of diet which are required by our body on a daily basis. These deficiencies can be avoided by intake of proper supplements on a regular basis.

Ulcer can occur in the part of stomach or intestine which was cut during the initial surgery. This ulcer can occur as a result of acid/bile juice, smoking, alcohol intake, infection or some foreign body such as suture(thread) which was placed at the time of surgery. This ulcer can cause bleeding, abdominal pain, anaemia or black stools. The diagnosis is confirmed by endoscopy and the treatment is mostly by medicines and lifestyle modification. In case of very deep/large ulcers not treated by medicines, surgery may be required.

Stricture or narrowing of the food passage can occur a few months after bariatric surgery and can cause difficulty in intake of solid food and repeated vomiting. Some cases of stricture may require endoscopic treatment and very rarely, a repeat surgery may be required for its correction.

Hernia formation can occur after any abdominal surgery and can occur at the sites of incisions or cuts placed in bariatric surgery. The area of the cut may develop weakness due to improper healing which can lead to protrusion of abdominal contents through the muscle layer which is known as hernia. This hernia requires surgical repair mostly in the form of mesh placement to strengthen the area of weakness.

Skin sagging occurs after bariatric surgery due to extreme weight loss. It is seen again a few months after the procedure and is more common in women, older age group, those with initial very high BMI or those who have undergone a rapid weight loss. It can be minimized by doing regular exercises, taking a high protein diet and proper skin care. If this problem becomes cumbersome, it may require a corrective surgery.

Hair fall is common side effect of bariatric surgery which occurs as a result of micronutrient and protein deficiency. This hair fall is due to accelerated telogen phase of hair growth which means that the hair starts aging prematurely and falls off. This side effect is temporary and self limited and usually stops when the weight has stabilised. It can be avoided by taking proper supplements and a high protein diet after bariatric surgery.

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