Your gastric bypass patient guide
Understand what happens during Roux-en-Y gastric bypass, what to expect around surgery, and how to protect your health afterward. Dr. James Augusta performs all of JourneyLite’s gastric bypass procedures.
Understanding the operation
How gastric bypass works
Roux-en-Y gastric bypass changes the path food takes through your digestive system. The surgeon creates a small pouch from the upper stomach and connects it to a section of the small intestine. Food travels from the pouch into this intestine, bypassing most of the stomach and the first part of the small intestine. The bypassed stomach remains in your body; digestive juices meet food farther along the intestine.
The smaller pouch limits how much you can comfortably eat at once. The operation also changes nutrient absorption and signals involved in hunger, fullness, and blood-sugar control. It requires lifelong nutrition care and follow-up.
Learn more: ASMBS: Roux-en-Y gastric bypass.
You receive general anesthesia so you are asleep during surgery. Gastric bypass is usually performed through small incisions using laparoscopic or robotic instruments. Dr. Augusta will explain the approach planned for you and any circumstances that could require a larger incision.
Planning for surgery day
Procedure length & facility stay
Christ Hospital
Jewish Hospital
Dr. Augusta performs gastric bypass at JourneyLite Surgery Center, Christ Hospital, and Jewish Hospital. Your surgical team will confirm where your procedure is scheduled.
Your time at the facility includes check-in, preparation, anesthesia, the operation, and monitored recovery. The surgery time alone does not describe the full visit. Your individual health, previous surgery, and recovery may affect timing and the care you need. An overnight stay is typical; some patients may need a longer stay.
Preparing to go home
Follow your written discharge instructions for drinking, eating, medications, wound care, and activity. Arrange transportation and help at home. Confirm your follow-up visit and the number to use for postoperative concerns before you leave.
Recovery continues after discharge. Start with short walks as instructed, progress activity gradually, and follow the team’s restrictions on lifting and driving. Do not drive while taking sedating pain medicine. Your team will advise when you can return to work based on your recovery and job duties.
Recovery guidance: MedlinePlus: gastric bypass discharge instructions.
Making an informed decision
Risks of gastric bypass
Gastric bypass is major surgery. Complications can occur soon after surgery or years later, and some require endoscopy, another operation, or hospital care. Your surgeon will explain how your health history changes your personal risk.
Risks around the operation
- Bleeding or infection. Treatment may require medicines, transfusion, or another procedure.
- Leak. A leak at a staple line or intestinal connection can cause serious abdominal infection.
- Blood clots. Clots in the legs can travel to the lungs and become life-threatening.
- Anesthesia, heart, or breathing complications. Rarely, complications can result in death.
Risks during long-term recovery
- Stricture. A narrowed connection can make swallowing or eating difficult.
- Internal hernia or bowel obstruction. Intestine can become trapped or blocked and may need urgent surgery.
- Vitamin and mineral deficiencies. These can lead to anemia, bone problems, or other illness.
- Gallstones. Rapid weight loss increases the risk.
Sources: NIDDK: weight-loss surgery side effects; Mayo Clinic: gastric bypass risks.
Other possible problems include dumping syndrome (food moving rapidly into the intestine, with symptoms such as nausea, cramping, or diarrhea), low blood sugar after meals, vomiting, and kidney stones. Weight loss varies, and weight regain can occur. Continuing follow-up helps the team identify problems and adjust your care.
Source: Mayo Clinic: longer-term risks and results.
A lifelong safety priority
Marginal ulcers: avoid smoking, NSAIDs & steroids
A marginal ulcer is a sore at or near the connection between the stomach pouch and small intestine. It can cause pain, nausea, bleeding, or a perforation—a hole that may require emergency surgery.
Smoking, NSAIDs, and steroids greatly increase the risk of marginal ulcers and need to be avoided by all gastric bypass patients. This precaution continues for life, including after you have healed from surgery.
- Do not smoke. Tell the team about tobacco and nicotine use, including vaping, nicotine pouches, gum, and patches, so they can guide you on stopping safely.
- Avoid NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve), as well as prescription anti-inflammatory medicines unless specifically cleared by your bariatric team.
- Avoid systemic corticosteroids such as prednisone or methylprednisolone unless your bariatric team and prescribing clinician determine they are medically necessary and coordinate your care.
Before starting any steroid, NSAID, or aspirin, contact your bariatric team. If you already take a prescribed medicine, do not stop it on your own—especially long-term steroids or aspirin prescribed for heart or stroke protection. Ask your clinicians to arrange a safe plan.
Take any prescribed ulcer-prevention medicine exactly as directed. It does not make smoking or unapproved NSAID or steroid use safe.
Evidence: ASMBS marginal-ulcer prevention review; 2024 review of smoking and steroid risk; marginal-ulcer complications and management.
Nicotine testing before surgery
JourneyLite will perform bloodwork before surgery to check that you are not using nicotine. Tell the team about every nicotine-containing product you use, including smoking-cessation products. Follow JourneyLite’s instructions for stopping nicotine and completing this testing.
Protecting your long-term health
Your follow-up plan matters
Follow JourneyLite’s postoperative diet stages, hydration and protein instructions, and prescribed vitamin and mineral plan. Keep your follow-up appointments and lifelong laboratory monitoring. Do not wait for symptoms before checking your nutrition status.
Symptoms that need prompt attention
Call 911 for chest pain, severe trouble breathing, fainting, or signs of a life-threatening emergency. Seek urgent medical evaluation for severe or worsening abdominal pain, vomiting blood, or black, tarry stools.
Contact your surgical team promptly for persistent vomiting, inability to keep fluids down, fever, increasing incision redness or drainage, or new leg swelling. Tell any emergency clinician that you have had gastric bypass, even if your surgery was years ago.
Sources: MedlinePlus: follow-up and warning symptoms; marginal-ulcer complications.
Your JourneyLite bypass surgeon
Dr. James Augusta, DO, FACOS
Dr. Augusta performs all of JourneyLite’s gastric bypass procedures. He is a board-certified general surgeon specializing in advanced laparoscopic and bariatric surgery, including gastric bypass and revisional procedures.
He earned his medical degree at Pikeville College of Osteopathic Medicine and completed his general surgery residency at Grandview Medical Center. He is certified by the American Osteopathic Board of Surgery and serves as an affiliate professor at Ohio University Heritage College of Osteopathic Medicine.
Common questions
Before and after gastric bypass
Will I need nicotine bloodwork before surgery?
Yes. JourneyLite will perform bloodwork before surgery to check for nicotine use. Tell the team about cigarettes, vaping, pouches, nicotine gum, patches, and other nicotine products.
Can I take ibuprofen or naproxen after bypass?
These medicines are NSAIDs and need to be avoided because of marginal-ulcer risk. Check with your bariatric team before taking any anti-inflammatory pain medicine, including a prescription product.
What if another doctor prescribes steroids?
Tell the prescribing clinician that you have had gastric bypass and contact JourneyLite. Systemic steroids increase marginal-ulcer risk. Your clinicians should coordinate an alternative or a medically necessary treatment plan. Do not abruptly stop a prescribed steroid.
Questions about your bypass plan?
Bring your medication list and questions to your consultation with Dr. Augusta. Your individual preoperative and discharge instructions guide your care.
Use your postoperative contact instructions for urgent surgical concerns. Appointment forms are not for emergencies.