What are the routine tests before bariatric surgery?

Certain basic tests are done before surgery: a Complete Blood Count (CBC), urinalysis and chemistry screen. Often, a blood glucose test is done for diabetes, which is very common in people suffering from obesity. Many surgeons will conduct a gallbladder ultrasound to look for gallstones. Other tests include pulmonary function testing, echocardiogram, sleep studies, GI evaluation, cardiology evaluation and psychiatric evaluation.

Why do I need to have a GI evaluation?

Patients who have gastrointestinal symptoms, such as upper-abdominal pain, heartburn, belching sour fluid, etc., may have problems such as a hiatal hernia, gastroesophageal reflux or a peptic ulcer. Many patients have symptoms of reflux, and up to 15 percent may show early changes in the lining of the esophagus, which could be an early sign of esophageal cancer. It’s important to identify these changes so that a treatment program can be planned.

Why do I need to have a sleep study?

A sleep study looks for abnormal stopping of breathing caused by your airway being blocked when the muscles in the back of the throat relax during sleep, which is linked to a high mortality rate. After surgery, you will be given pain-killing drugs, which affect normal breathing and reflexes. Airway blockage becomes more dangerous at this time, and it is important to have a clear picture of what to expect and how to handle it.

Why do I need to have a psychiatric evaluation?

Bariatric surgery is a process that will affect you for the rest of your life, and the decision requires a lot of serious thought. For many people, the results are positive, but successful treatment takes dedication and a commitment to lifelong changes in your current lifestyle. Most psychiatrists will look at your understanding of the risks and complications of bariatric surgery and your desire to follow the basic recovery plan to see if bariatric surgery is right for you.

What impact do my medical conditions have, and how can they affect my risk?

Medical conditions, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, these conditions also increase the need for surgery. Your surgeon may not recommend gastric bypass surgery because of your medical conditions, but those conditions will make your health risks higher than average.

What is the purpose of all of these tests?

A clear picture of your health is needed before surgery. It is important to test your thyroid function because hypothyroidism can lead to sudden death after surgery. If you are diabetic, special steps must be taken to control your blood sugar after surgery. Because surgery increases cardiac stress, your heart will also be tested. These tests will show if you have liver malfunction, breathing difficulties, excess fluid in the tissue, abnormalities of the salts or minerals in body fluids, or abnormal blood fat levels.

If I want to have gastric bypass surgery, how long do I have to wait?

Although the amount of time between the first consultation and the date of surgery depends on several factors, some patients wait a few months (verify with department). These factors depend on your completion of certain steps, which include insurance approval, any preoperative education (including attending a informational seminar free), a medical evaluation and a preoperative workup.

What can I do before my appointment to speed up the process?
  • Choose a primary care physician if you don't have one already, and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing is current. For example, women may have a Pap smear and, if older than 40 years of age, a mammogram. For men, this may include a Prostate Specific Antigen test (PSA). Results of diagnostic and routine screening for co-morbid conditions such as type 2 diabetes and high cholesterol can be necessary for documentation of medical necessity 
  • Make a list of all the diets you have tried (a diet history) and take it to your doctor
  • Take any relevant medical data to your appointment with your bariatric surgeon, including reports of special tests (echocardiogram, sleep study, etc.), or a hospital discharge summary if you have been in the hospital for weight-related health problems
  • Make a list of your medications, including dosage and schedule
  • Quit smoking—patients who use tobacco products are at a greater risk during surgery. Talk to a doctor for help with this
  • Make sure your primary care physician is documenting your weight loss efforts and your weight in your medical records at every visit

If you are interested in bariatric (weight loss) surgery, call 585.922.5465 to register for one of our free informational seminars