Recovery after sleeve gastrectomy: stage by stage

The figures here come from the NHS and from leaflets by North Tees and Hartlepool and Leeds teaching hospitals. They do not agree in every detail. For example, North Tees describes multivitamin and calcium for six months after the operation while Leeds describes lifelong supplements, so your unit's own written schedule is the one to follow.

A sleeve changes the stomach rather than the route the food takes, so reflux becomes a bigger theme than it is after some other operations; the Leeds sheet says so directly.

North Tees describes five to six small cuts, bruising and scarring, and lists shoulder and abdominal pain from the air used during surgery among the effects. It says to avoid soaking in the first week and to shower when able. Fever with a hot, red or sticky wound, new pain or nausea should be reported.

A staple line leak is the complication the leaflets emphasise most. The NHS describes it as a small chance in the days or weeks after a sleeve or bypass, causing a serious infection inside the abdomen that needs antibiotics. Increasing abdominal pain, fever or a racing pulse after you go home should therefore be treated as urgent.

The NHS plan says water and thin fluids first, then soft and runny foods, then soft foods, with balanced eating coming back gradually from about week eight. It tells people to eat slowly, chew carefully and take small amounts.

Leeds describes lasting habits: small portions, around 20 minutes per meal, three regular meals, a 30-minute gap between eating and drinking, and avoiding fizzy drinks, including sugar-free ones. For reflux, Leeds lists persistent heartburn as a reason to see your GP and suggests an endoscopy at the five-year point after a sleeve.

North Tees says you can drive as soon as you feel comfortable, work when you feel comfortable, and resume sex when you feel comfortable. Walking is encouraged with gradually increasing distances. GOV.UK says you must inform the DVLA if you have had an operation and cannot drive three months later, and advises asking your doctor if you are unsure. Your insurer may also have its own conditions.

Avoid heavy lifting and abdominal exercises for six weeks, then increase exercise gradually, according to the leaflet. The NHS says to expect to resume normal activities after four to six weeks and describes gradual activity plans to avoid muscle loss.

On pregnancy, the NHS advises waiting 12 to 18 months and North Tees says to avoid pregnancy for two years after surgery, so ask your team which they advise.

Leeds describes a lifelong multivitamin, calcium with vitamin D, iron, and B12 injections every three months after sleeve or bypass, together with annual blood tests, including zinc, copper and selenium for sleeve patients. North Tees gives a telephone call in the week after discharge, an outpatient visit at six to eight weeks and regular visits for up to two years.

The NHS says you will attend follow-up for the rest of your life, with at least two years in a weight loss surgery clinic and then yearly GP reviews.

• Severe abdominal pain, chest pain with leg swelling, breathlessness, continuous bleeding or vomiting blood: call 999.

• High temperature, fast heartbeat, a swollen red calf, repeated vomiting or trouble swallowing: NHS 111 or your GP the same day.

• Persistent heartburn, abdominal pain or weight regain later on: GP review, as the Leeds sheet advises.