Obesity Treatment Gastric Sleeve Surgery Complications and Risks Physical and mental health concerns can occur even years after the procedure By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FN LinkedIn Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine. Learn about our editorial process Updated on October 14, 2022 Medically reviewed by David Hampton, MD Medically reviewed by David Hampton, MD David Hampton, MD, is a board-certified surgeon and assistant professor at the University of Chicago. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Surgery Risks Complications After Surgery Long-Term Complications Rare Complications Mental Health and Social Concerns Prevention When to See a Healthcare Provider Pros and Cons Frequently Asked Questions About 20% of individuals will experience complications following gastric sleeve surgery, also known as a sleeve gastrectomy. These may range from surgical complications to a lack of weight loss and even relationship problems, and they can occur during the procedure, shortly after, or even years later. This article covers potential gastric sleeve surgery risks. It also discusses ways to prevent complications, as well as when to reach out to your healthcare provider. This surgery involves removal of about 80% of the stomach. Many complications occur because the stomach can only hold about 4 ounces of food post-surgery. Verywell / Laura Porter Gastric Sleeve Risks During Surgery Gastric sleeve risks that can occur during or right after surgery include: Bleeding Pain Infection Blood clots Staple line leak leaks that happen in the connections made during the surgery) Bad reaction to anesthesia, the medications given to make you unconscious during a procedure Potential Risks of Any Surgery Gastric Sleeve Complications and Side Effects After Surgery Some individuals may experience gastric sleeve complications and side effects following surgery. These may occur within days to months following surgery. These may improve as you recover, but some can last long-term. Indigestion Some gastric sleeve patients may notice an increase in indigestion or upset stomach. This might be because of the smaller stomach size. It could also be because of changes in the way food moves through the digestive tract. Natural Remedies to Soothe Indigestion Nausea Nausea is a common gastric sleeve complication. Most people notice that nausea improves as they recover, but some people have it for months or longer. It's not clear why some individuals have nausea after this surgery. It might be partly because food stays in your stomach longer. Nausea medications may be helpful. Diarrhea Some individuals may have diarrhea after surgery. This may happen because the balance of bacteria in your gut may change after surgery. Undigested nutrients in your small intestine may also cause diarrhea. Diarrhea can cause dehydration or malnutrition. If diarrhea doesn't go away on its own, your gastroenterologist, or doctor who specializes in digestive disorders, may be able to help. How Diarrhea Is Treated Sagging Skin When you gain excess weight, your skin stretches. This is why sagging skin is so common after any weight loss surgery and can show up within months after the procedure. A panniculectomy is a surgery to remove excess skin. Your surgeon may want to wait until your weight has been stable for one to two years before recommending this. Stomach Obstruction Stenosis is a narrowing of the stomach outlet that makes it hard to digest food. It can sometimes block your stomach. This tends to occur within six weeks after surgery. A surgeon can fix this problem by "stretching" the narrow spot. Long-Term Gastric Sleeve Complications Gastric sleeve surgery can cause mild to severe long-term complications. These can show up within months or years post-surgery. Talk to your healthcare provider if you're worried about gastric sleeve complications that may occur after a year or longer. Weight Regain Weight gain usually starts in the third year after surgery. Individuals who don't change their habits may gain back some or all of the weight they previously lost. Food Intolerance After gastric sleeve surgery, individuals can't eat as much food at one time compared to before. This can cause trouble digesting certain foods, like red meat, rice, pasta, and bread following surgery. 10 Types of Food Intolerance and Their Symptoms Failure to Lose Weight The stomach pouch can only hold half a cup of food in the first days after surgery. Over time, the pouch stretches. If you eat larger meals, weight loss may stop. This can happen if the stomach pouch is too large or you don't follow post-surgery instructions. Research indicates that around 20% to 35% of individuals experience a long-term failure rate. Failure rate is defined as a body mass index of greater than 35 within 18 to 24 months post-surgery. Malnutrition Malnutrition, or failure to get adequate nutrition, is serious and can show up years after the surgery. Some patients have trouble getting enough nutrients when they eat fewer calories, especially if they have diarrhea or nausea. Your healthcare provider may suggest vitamins and minerals, medication, or other things to help you stay healthy. Malnutrition After Gastric Bypass Surgery Gastroesophageal Reflux Disease (Acid Reflux) Heartburn and other symptoms of gastroesophageal reflux disease (GERD) are common complications of gastric sleeve surgery and can show up even a year after the procedure. Symptoms include: Bloating Feelings of fullness Upset stomach Acid-reducing medication can help improve GERD symptoms. Stomach Ulcers Stomach ulcers, also known as peptic ulcers, are more common after this surgery and can show up months to years later. Stomach ulcers can cause: Dark, tarry stools Blood in vomit Pain in the stomach area Stomach ulcers are usually found during an upper endoscopy, or a procedure that uses a flexible tube with a camera to look at the upper digestive tract. Gallstones Gallstones, or hard substances that form in the gallbladder, are more common after any weight-loss surgery. These tend to appear within 18 months following the procedure. Because of this, individuals sometimes need a cholecystectomy, or a surgery that removes the gallbladder. Abdominal Adhesions (Scarring) The tissues of the abdomen are slippery. This helps them slide past each other when you move. Within days to years after surgery, you may have scarring that makes tissues "sticky," causing a pulling feeling. It may be annoying or even painful. Sometimes, this scarring can block your small bowel. Incisional Hernia A hernia forms when an organ pushes through a weak spot in tissue or muscle. A hernia can occur after any surgery. With laparoscopic, or minimally invasive, surgeries, which are typically performed for gastric sleeve, it is less common. Still, a hernia may develop months or years later. A hernia looks like a bulge at the site of your incision. Gastric Sleeve vs. Gastric Bypass: Which Is Right for You? Rare Gastric Sleeve Complications Rare gastric sleeve complications can occur within weeks to years after the procedure. Abscess An abscess is a pocket-like collection of pus that forms in your body. When this happens just after surgery, it is usually because some of the contents of your intestines spilled or leaked. An abscess in the spleen, the organ that filters your blood, is a very rare complication of this surgery. Delayed Leak A suture line leak, also called a suture line disruption, is when stomach contents leak through the spot that was sewn together. When this happens, it is usually just after surgery. Sometimes, though, the suture area will start leaking months or even years later. Delayed leaks are rare, but still dangerous. They may require medications, hospitalization, or additional surgery. The symptoms of gastric sleeve leakage include: Fever Abdominal pain Peritonitis, or when the tissue that lines the abdomen becomes irritated Hypotension, or low blood pressure Leukocytosis, or high white blood cell count Tachycardia, or increased heart rate Contact your healthcare provider if you have an increased heart rate and/or other concerning symptoms. Mental Health and Social Concerns This surgery can affect your mental health and your relationships in various ways. Addiction Transfer For some people, food is an addiction. They may self-medicate by eating too much. Because this surgery makes it impossible to overeat, individuals may form new addictions. Examples of other addictions include: Alcohol useDrug useSex and love addiction Is Alcoholism a Disease? Relationship Issues The divorce rate in the United States is 50%. A 2018 study found that people who have had weight loss surgery have even higher divorce rates. Weight loss can be hard on couples and the surgery may change the dynamics of the relationship. This can put stress on each individual, as well as the couple collectively. Healthcare providers recommend talking about these issues with your partner. Couples counseling can help, too. How to Know If You Need Marriage Counseling Preventing Gastric Sleeve Complications Before and after gastric sleeve surgery, there are considerations to keep in mind that can help prevent complications. Before Surgery Prior to surgery, some measures are often recommended to reduce gastric sleeve risks. These include: Attending a bariatric surgery education program Receiving nutritional counseling Getting psychological counseling Having a physical exam, blood tests, and possibly stomach imaging done Quitting smoking several months prior to surgery Stopping blood thinning medication like aspirin Losing some weight After Surgery After surgery, it's important to: Exercise, as this can reduce how long it takes to recover and help prevent blood clots Continue any breathing and/or coughing exercises that your healthcare team taught you, as these can help prevent a lung infection and increase circulation Stay hydrated to help with nausea Consider having someone help with personal hygiene, physical tasks, and emotional support Consider joining a support group with others who have been through a similar process When to See a Healthcare Provider After surgery, your healthcare provider will schedule some follow-up appointments with you to check on your progress and recovery. However, you should reach out to your healthcare provider immediately if: You have a fever You are having difficulty breathing You have chest pain Your legs are swollen or red You are having difficulty urinating Pain medication is not working effectively You have been throwing up for 12 hours If in doubt, it's always best to reach out to your healthcare provider. Gastric Sleeve Pros and Cons Pros of gastric sleeve surgery include: You will likely lose weight, because you will only be able to eat about half a cup of food at a time.It is a permanent surgery.It can improve the health of individuals who have had trouble losing weight and keeping it off.It may help improve long-term health concerns like diabetes and high blood pressure.Death due to gastric sleeve surgery is rare. However, there are cons to be aware of. It's still possible to eat too much after gastric sleeve surgery. If you do, you may not lose much weight. This procedure may not help with long-term health conditions and you may experience complications. Your surgeon will give you a post-surgical plan. Following the plan can help reduce the risk of complications. Summary Gastric sleeve surgery may cause complications. Individuals can have physical symptoms that last a long time after surgery. Medical and mental health concerns may also happen. While there are ways to reduce the risks associated with gastric sleeve surgery, it is important to discuss all possible complications with your healthcare provider before deciding to move forward. A Word From Verywell You should feel good about your choice to have surgery. Your healthcare provider can explain the risks and complications. Your healthcare provider may also suggest other treatments. This will help you make an appropriate decision. Frequently Asked Questions What percentage of gastric sleeve procedures result in complications? About 20% of gastric sleeve surgeries result in complications. What is the risk of death from gastric sleeve surgery? The death (mortality) rate for gastric sleeve surgery is about 0.3%. This is considered low and is similar to other common surgeries. Does gastric sleeve surgery shorten lifespan? Not on average. One study compared the life expectancy of people with obesity who did and didn't have bariatric surgery. The life expectancy for the bariatric surgery patients was three years longer than the other group, but five and a half years shorter than the general population. Learn More: Bariatric Surgery and Heart Attack Prevention How many years does a gastric sleeve last? Gastric sleeve is a permanent procedure. It lasts for the rest of your life and can't be reversed. Is there anything I should avoid after gastric sleeve surgery? 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A nationwide registry study. Obes Surg. 2017;27:2444–2451. doi:10.1007/s11695-017-2664-z Carlsson LMS, Sjöholm K, Jacobson P, et al. Life expectancy after bariatric surgery in the Swedish obese subjects study. N Engl J Med. 2020;383(16):1535-1543. doi:10.1056/NEJMoa2002449 American Society for Metabolic and Bariatric Surgery. Life after bariatric surgery. By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit