Can you NOT do the pre-op diet?

[Photo925 100]

I'm scheduled for my 3rd surgery in one week due to extreme bile reflux. Im supposed to be on a pre-op diet that includes 2 shakes a day and one sensible meal. Since dealing with this the last couple of years, the only thing that helps to keep pain and vomiting down is scheduled eating that included carbs in order to absorb some of the acid and bile, so I suspected that the pre-op diet would be tough. I saw my surgeon on Monday and she told me just to do the best I can, but not to do anything that was going to make me sicker leading up to surgery. Im trying my best to follow the protocol, but the last two days, I'm vomiting twice a day. Does anyone have any suggestions? Has anyone not done a pre-op diet and everything went fine? I feel obligated to follow the pre-op diet to get the best results, and the surgeon basically said I didn't need to follow it 100%.

[Jaelzion 1,127]

This is a 2nd hand experience but my cousin and I had surgery just days apart. While I was struggling through the 10 day liquid diet, his surgeon did not require ANY pre-op diet at all! I asked him how he was doing with the pre-op and he looked at me like "what's that?" 😀. My surgeon said the pre-op diet helps to shrink the liver and makes things easier to work with in there. But my cousin did fine and had no complications. So I know of one person who didn't do it and had a successful surgery.

Edited October 21, 2020 by Jaelzion

[NovaLuna 710]

I'm sure it'll be fine as long as you don't go crazy and have a ton of processed food or greasy food, which I doubt you'd do anyway since your stomach seems to be sensitive. Just do what you can and if what you can is not do the pre-op diet because it makes you sick then the doctor will just have to understand. Your health and nutrition is more important!

[ChubRub 1,702]

I think the important thing is to be honest with your surgeon, which you have been! I've heard tales of people having too fatty of a liver for surgery, and also tales of those who needed an extra incision so the surgeon could lift the liver. I don't know anyone first hand who this has happened to, so can't say how often it happens. It's like the urban legends they us when we are in pre-op!

Best of luck to you!!!

[RickM 1,747]

We didn't have any pre-op diet, and many surgeons don't need to impose them on their patients. The big question here is what your surgery for? Talking about bile reflux problems, implies that it is to resolve that complication as opposed to weight loss, If you haven't regained substantial weight, there is probably little need to go through with any extensive pre-op diet.

A few years ago I was looking at the prospect of a surgery with a bariatric center, though it was for reasons other than weight loss, The RD went through the usual nutritional spiel and outlined their pre-op diet. When I asked her if I really needed to do that as I didn't need to lose weight and didn't have fatty liver, she simply said, "let me ask the doctor..." since she didn't have the authority to make that decision. (The answer was no, I didn't need to do it.)

So, if your weight is normal-ish and you don't have any liver issues, there is little value to the diet (other than the usual day before thing to ensure a clear GI tract.

Curiosity here - what are they doing to resolve the bile issue? The DS will knock it out for sure, but few surgeons can do that. Moving the roux limb further down? Just curious.

[Photo925 100]

I originally had a sleeve that I was told was done incorrectly. That info has still been upheld with current scans. The original surgeon did not cut enough of my stomach away to have enough effective weight loss. A couple of years later, I approached a surgeon in MX for a revision and they talked me into a MGB as opposed to the full bypass. So now I have two problems, one, my stomach is still too large and the bile duct is "basically dumping bile into my stomach" (dr's words, not mine). Only 2 months after the MGB, I started having reflux issues, but was just told to take medicine and it would pass. I saw Dr's while living in CA for almost 2 years before deciding to move to WA to be closer to family because I was in such bad shape over this and the CA surgeons were shady as hell and trying to just immediately push me into a revision without insurance approval. It still took almost a year for diagnosis and surgery scheduling in WA, but I have a huge amount of faith in the dr's I have here. It's been a long road and I definitely didn't want another weight loss surgery after the first two, but I've been assured that this will fix the issue and even help me shed some of the weight gain that I experienced. I did gain over the last couple of years because consistently eating food was the only thing that kept the acid at bay.

[RickM 1,747]

Boy, you have been through the wringer (and a run of not-so-great surgeons)!

That makes some sense, as bile reflux is reputedly one of the problems of the MGB -(sadly, I guess you have helped confirm that...). I haven't seen much reference to it being a big problem with WLS oriented RNY procedures (it seems to crop up more with non-WLS RNY where the surgeons seem to keep the limbs short to minimize weight loss.

I hope this one corrects everything and all works as it should once you're done; and you can be done with surgery for this lifetime.

Good luck on it