💊 Multivitamin
Daily — covers B vitamins and trace elements.
Golden rules — read every day for one month
- Sip, don't gulp. Ever.
- Protein first at every meal
- 30-minute gap between food & fluids
- Stop at the first sign of fullness
- Walk daily — every day
- Supplements & breathing exercises — non-negotiable
The diet phases
Timings are a guide — your surgeon confirms when to move on. All bariatric procedures (sleeve, mini/OAGB, SASJ) follow the same phases in the first month.
Day 1 only
Phase 1 — Clear liquids
The staple line is most vulnerable on Day 1 — nothing should stress it. Sip 30 ml of plain water every 30 minutes, two tablespoons at a time. No juices, soups or anything other than plain water yet. If nausea occurs: stop, wait 10–15 minutes, restart with even smaller 5–10 ml sips. If you cannot keep any sips down, inform the nursing team.
Day 2 – 15
Phase 2 — Full liquids
Everything must be smooth, strained liquid — no lumps, no chewing. No straws (they create gas), no carbonated drinks, alcohol or strong caffeine. Warm liquids only. Start sugar-free protein shakes after discharge as advised, and aim for 1.5–2 litres of fluid a day. An hourly schedule and the full allowed-liquids list are below.
Week 3 (as advised)
Phase 3 — Pureed foods
Once your team clears you, move to smooth, well-blended foods — smooth dal, mashed vegetables, blended khichdi, soft curd, paneer bhurji, mashed banana. Everything smooth, no lumps. Keep protein first and portions small.
Week 4 (as advised)
Phase 4 — Soft foods
Progress to soft, easily-chewed foods — soft-cooked vegetables, eggs, paneer, soft fish or minced chicken, soft idli, well-cooked dal. Chew thoroughly, eat slowly, and stop at the first sign of fullness.
Phase 2 — a sample daily schedule
A gentle full-liquid routine for Day 2–15. Keep each intake to small, slow sips.
| Time | What to take | Quantity | Notes |
|---|---|---|---|
| 6:00 am | Warm water | 50–100 ml | Sip slowly on waking |
| 8:00 am | Milk / thin veg soup | 100 ml | Skimmed milk or strained vegetable soup |
| 10:00 am | Hydration sips | 100 ml | Plain water or coconut water (no pulp) |
| 12:00 pm | Dal water / clear broth | 100 ml | Strained moong/masoor dal water or broth |
| 2:00 pm | Buttermilk / yogurt drink | 100 ml | Thin, unsweetened, well-strained |
| 4:00 pm | Decaf tea or skimmed milk | 100 ml | No sugar; avoid strong tea |
| 6:00 pm | Strained thick soup | 100 ml | Tomato, spinach or mixed veg — no chunks |
| 8:00 pm | Milk / dal water | 100 ml | Best-tolerated option from the day |
| 10:00 pm | Protein shake (post-discharge) | 100–150 ml | Sugar-free whey, diluted as advised |
Allowed liquids: plain warm water · skimmed milk / strained dal water · coconut water (no pulp) · strained clear veg soup or chicken broth · thin unsweetened buttermilk / yogurt drink · strained rice kanji / rice water · sugar-free protein shake (after discharge).
Medications after surgery
After bariatric surgery, many long-term medication needs change rapidly — blood pressure and blood sugar can normalise within days. Never stop, start or change any medication on your own — always consult Dr. Shashank or your treating physician first.
🩸 Diabetes
- Blood sugar often drops within days — insulin/oral doses may need urgent reduction
- Contact the team if sugars are consistently below 80 mg/dL
- Continue home monitoring (fasting + 2 hrs post-meal)
❤️ Blood pressure
- BP often falls with rapid weight loss — dizziness may mean over-medication
- Never stop BP medicines suddenly
- Home BP monitoring advised for the first 3 months
🦋 Thyroid & others
- Levothyroxine: continue unchanged; adjust based on blood tests at 1 & 3 months
- Take on an empty stomach, 30–60 min before the first meal
- Inform all physicians you have had bariatric surgery
Troubleshooting — common problems
🍽️ Food stuck / frothing
Why: food caught at the pouch outlet — eating too fast or not chewing enough.
Do now: stop eating, relax, sip warm water slowly, walk gently. Did you chew 20–30 times?
If not resolved in 15–20 min or very painful, contact the team.
🤢 Nausea & vomiting
Why: eating too fast, too much, or food too dense for the current phase.
Do now: stop at first fullness; step back to Phase 2 liquids temporarily.
If vomiting >24 hrs or you can't keep liquids down, contact the team.
⚡ Dumping syndrome
Why: sugary/fatty food moves rapidly into the intestine — bloating, dizziness, sweating, loose stools 15–30 min after eating.
Do now: stop eating, lie flat 20–30 min, sip water.
Prevent: no sweets or fried food, eat slowly, separate fluids from meals.
🚽 Constipation
Why: reduced intake means less bowel bulk. Passing stools every 2–3 days is normal.
Do: target 2 L fluid/day, walk daily, add fibre in Phase 3/4.
Lactulose stool softener is safe — ask the team. Avoid stimulant laxatives.
🔥 Heartburn / reflux
Do: eat slowly, never overeat by even one bite, avoid spicy and fried foods.
Take your prescribed PPI (omeprazole/pantoprazole) regularly without skipping. Elevate the head of the bed at night.
Report persistent symptoms to Dr. Shashank.
💧 Dehydration — act fast
Signs: dark urine, reduced urination, dry mouth, dizziness on standing, rapid heart rate.
Target: urine pale yellow or clear.
If unable to keep liquids down for >4–6 hrs, go to emergency immediately.
Call or come in immediately if you have: persistent vomiting >24 hours · severe abdominal pain · fever >38.5°C · breathlessness or chest pain · signs of dehydration · unable to keep fluids down. Front desk: 98886 91118.
Follow-up investigation schedule
Regular blood tests keep your recovery safe and catch any deficiency early. This is a lifelong requirement for all bariatric patients.
| Time after surgery | Investigations |
|---|---|
| 7 days (if diabetic) | Fasting & post-prandial blood sugars; insulin/medication adjustment as advised |
| 1 month | Fasting & PP sugars; HbA1c (if diabetic); Thyroid (T3, T4, TSH) if hypothyroid |
| 3 months | CBC, LFT, RFT, Electrolytes, Iron studies (Iron, Ferritin, TIBC), Folate, Vitamin B12, Vitamin D, Zinc, HbA1c |
| 6 months | CBC, LFT, RFT, Electrolytes, Iron studies, B12, Vitamin D, Calcium, Zinc, Lipid Profile, HbA1c |
| 12 months | As 6 months, plus Thyroid |
| Yearly (ongoing) | Same as 12 months — a non-negotiable lifelong requirement |
Supplement schedule — lifelong
🦴 Calcium + Vitamin D
Daily — calcium citrate preferred; Vitamin D3 1000–2000 IU.
🧬 Vitamin B12
Daily sublingual, or a monthly injection.
🔩 Iron
As advised — monitored with your blood tests.
🥚 Protein supplement
Sugar-free whey until your dietary protein target is met.
🔋 Zinc + Folate
As prescribed — supports wound healing and hair.
Weight & progress tracker
Note your weight at each milestone and bring it to your follow-ups.
| Milestone | Date | Weight (kg) | Notes |
|---|---|---|---|
| Surgery date | — | — | Starting weight |
| 10 days post-op | — | — | |
| 15 days post-op | — | — | |
| 1 month | — | — | |
| 3 months | — | — | |
| 6 months | — | — | |
| 12 months | — | — |
This guide reflects Dr. Shashank Bariatrics & Robotics' standard discharge protocol. Your personal plan from the team always takes priority — follow the advice given to you.