7 Common ESG Surgery Side Effects and How to Manage Them

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Yes, you will probably have some side effects after your ESG surgery, but it's hard to predict how they will look for each patient. What we can do is present the 7 most common ones, so you can prepare for what you might be dealing with in the first days or weeks.

1. Nausea and vomiting

Nausea and vomiting are among the most frequently reported ESG surgery side effects. They are a completely normal, temporary response of your body, as the digestive system adjusts to its new, smaller size. Nausea, especially when triggered by eating, actually functions as a direct physiological signal. It is a way for a body to tell you that the newly reduced stomach is being overtaxed, either by too much food, consumed too quickly, or by food types that the stomach can not yet tolerate.

These symptoms typically go away within one to three days, or a few days, as your body heals.  

Tips for Relief:

• Eat Slowly
• Take Small, Frequent Portions  
• Choose  foods at room temperature or cooler
• Stop eating before a feeling of fullness
• Wait 30 minutes between taking liquids and solids
• Avoid lying flat for at least two hours after a meal
• Strictly follow the prescribed liquid diet  

2. Abdominal cramps or discomfort

Abdominal cramps and general stomach discomfort are also common experiences after ESG. The stomach itself cannot hurt because it does not have pain nerves, but the discomfort is often described as an indirect sensation originating from the stomach. As with nausea, cramping is frequently a direct consequence of stomach overload. The newly sutured stomach has a significantly smaller capacity, and when an excessive amount of food or liquid is consumed too fast, it can lead to spasms and cramping.

These symptoms are typically most pronounced during the first three to four days post-procedure and generally resolve completely within five days.  

Tips for Relief:

• A healthcare provider will probably prescribe pain medications
• Take care of the portion control
• Eat and drink slowly
• Engage in light movement and walking around, as tolerated

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3. Bloating and gas

Trapped gas, bloating, and a feeling of abdominal fullness are common ESG surgery side effects. They can happen because of swallowed air, certain gas-producing foods, or the consumption of large meals. Swallowed air, for instance, creates disproportionately higher pressure in the "new",  smaller stomach, which leads to discomfort.

These symptoms can occasionally persist for a few weeks or even months.

Tips for Reduction:

• The most effective way to relieve gas is often through movement.
• Lying down and placing a heating pad on the stomach can help alleviate pressure and discomfort.  
• A healthcare provider may suggest over-the-counter medications for gas and bloating.
• Consuming ample fluids (at least 64 ounces daily) is crucial.
• Avoid carbonated drinks,  chewing gum, and straws.
• Eat small meals - chew them slowly and thoroughly.
• Common food triggers are high-fiber foods, dairy products, cruciferous vegetables and legumes.  
• Foods that may help include kiwi, peppermint tea, chamomile tea, banana, cilantro, ginger, papaya, and fennel seeds.

4. Low energy and fatigue

You should prepare to have low energy and some fatigue. This often happens because of the low caloric intake as the body adjusts to the new dietary and eating habits. Additionally, your body will also spend lots of energy on healing, especially during the first eight weeks.  

Tips for Recharging:

• Prioritize Nutrition (take bariatric vitamins, focus on healthy calories, meet your protein goals).
• Stay Hydrated.  
• Balance Activity and Rest
• Review medications that can induce fatigue.
• Optimize sleep.

5. Mild reflux or heartburn

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Heartburn feels like a burning sensation in the chest, and it happens when stomach acid travels up into the esophagus. This is a common symptom after ESG, but some might experience it for the first time.  

Why does it happen? Because the stomach is significantly smaller after the procedure, it can lead to higher pressure within. This increased pressure can then force gastric contents and acid back up into the esophagus, causing reflux and heartburn.

Tips for Management:

• Take small, frequent meals
• Avoid overeating and late-night eating.  
• Take medications when lifestyle changes are not enough.

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6. Difficulties with eating solids

Because the stomach is smaller, it also empties more slowly, which contributes to prolonged feelings of fullness. Consequently, you might experience a temporary period of difficulty eating solid foods. The stomach requires time to adjust to its new size, and the newly formed sutures need to stabilize and heal properly.

Key Dietary Guidelines:

• Chew thoroughly and eat slowly
• Always consume protein first at meals, followed by vegetables, and then starch only if still hungry.
• Meals should be no larger than the size of a 'side plate' or 'tea plate'.
• Do not drink during mealtime.  
• Avoid carbonation and processed sugars
• In the first week, you may need to crush tablets and open capsules for easier swallowing.

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7. Emotional side effects (mood swings, anxiety)

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Choosing ESG means making a lifelong commitment that influences both physical and mental health. While many individuals report a much better quality of life after they have had the procedure, the emotional and psychological adjustments can still present challenges.  

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The procedure fundamentally changes your body image, your relationship with food, social interactions, and even neurochemical balance due to changes in nutrient absorption and gut bacteria. These changes, while often leading to positive outcomes, necessitate considerable psychological adaptation. Emotional side effects are not just "moods" but a complex response to your new identity, new challenges, and changed physiological processes. If you want a successful recovery, you must address these topics.

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Tips for Supporting Mental Well-being:

• Seek professional counseling or therapy
• Engage with the healthcare team
• Prioritize physical activity
• Consistently follow the treatment plan
• Take Vitamins and Supplements
• Build a Strong Support System
• Give Your Body time to Heal

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As we could see, ESG surgery side effects are common, but in most cases, they are temporary signs that your body is healing and adapting to a healthier way of functioning. By recognizing symptoms early, applying the right strategies, and maintaining open discussions with your healthcare team, you can confidently navigate the recovery period.

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FAQ

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How long do ESG surgery side effects normally  last?

Most ESG surgery side effects,  such as nausea, bloating, or abdominal discomfort, are temporary and typically improve within a few days to a few weeks.

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Can ESG surgery cause long-term side effects?

Long-term complications are rare with ESG when it is performed by an experienced specialist and there is proper aftercare. Most side effects, including digestive discomfort or fatigue, are short-lived. Maintaining follow-up appointments and sticking to your medical team's guidance reduces the risk of persistent issues.

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How soon can I return to normal activities after I had the ESG?

You can resume light activities within a few days, but it's best to avoid strenuous exercise or heavy lifting for at least 2 to 4 weeks. Remember to always follow your surgeon's advice for a safe and steady recovery.

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