Staying hydrated after a gastric sleeve

Before surgery, you may never have thought about how much you drink. After a gastric sleeve, it becomes a daily task. Dehydration is a common reason for extra care after weight-loss surgery, and a simple plan helps you stay ahead of it.

Why it takes planning

• Your new stomach holds much less, so you can only take small sips at a time, especially in the first weeks.
• You no longer drink with meals. Canadian guidelines advise leaving about 30 minutes between drinking and eating solid food.
• You eat much less food, and food normally gives you part of your water.
• On a busy day it is easy to fall behind, so sipping on a schedule works better than waiting until you feel thirsty.

How much to drink

The 2019 nutrition guidelines for bariatric surgery from several North American medical societies advise keeping up good hydration after a sleeve, usually more than 1.5 litres a day. At 360 Sleeve, most people aim for about 8 cups (2 litres) a day. Your care team may set a different amount for you, based on your health.

Water is the main drink. Milk, broth and protein shakes count too.

How to sip all day

• Keep a water bottle with you, and take small sips often, all day long.
• Set reminders on your phone, or mark your bottle with times of day.
• Stop drinking about 30 minutes before a meal, and wait about 30 minutes after.
• Sip slowly instead of gulping. Guidelines advise drinking fluids slowly.
• Keep a simple log in the first weeks. Your nurse may ask about it.
• Drink more when you lose more fluid, for example when you sweat a lot on a hot day or during exercise, or when you have a fever, vomiting or diarrhea.

What to drink, and what to skip

Good choices include water, low-sodium broth, decaf coffee, herbal tea, milk and sugar-free drinks without bubbles.

Guidelines suggest drinks that are low in calories and sugar, without caffeine, bubbles or alcohol. Canadian guidelines explain that carbonated and caffeinated drinks can raise the risk of ulcers after bariatric surgery. Ask your team before you add caffeine or alcohol back.

Signs of dehydration

Dehydration means your body has lost too much fluid. Watch for:

• Feeling very thirsty, or a dry mouth.
• Passing less urine than usual, or dark urine.
• Dry skin.
• Feeling tired or dizzy.

In a large US registry study of more than 250,000 people who had a sleeve or a gastric bypass, about 4 in 100 needed treatment for dehydration within a month of surgery. Those who did were much more likely to visit an emergency department or go back to hospital. Steady sipping is one of the simplest ways to protect your recovery.

When to call your team

Call your care team if you cannot keep fluids down, if you keep vomiting, or if you pass very little urine.

Get medical help right away, or call 911, if you feel confused or faint, have a racing heartbeat or fast breathing, or have not passed any urine. What applies to you is decided with your care team.