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Lactose Woes Pregnancy after Gastric Reduction

Posted On : May 04, 2009

Lactose intolerance is a set of symptoms resulting from the body’s inability to digest the milk sugar called lactose. Lactose is commonly found in dairy-based foods and is digested in the intestines by the enzyme lactase. The production of gas and the presence of fluid create the cramping and digestive distress that are the symptoms of lactose intolerance. Yogurt, although made from milk, is often well tolerated by people who have lactose intolerance because yogurt bacteria produce their own lactose-digesting enzyme of actase. If you have a strong reaction to lactose, you will have to become an avid labelreader. Look for words, such as whey, lactose, nonfat milk solids, buttermilk, malted milk, margarine, and sweet or sour cream. Some breads, dry cereals, cookies instant soups, breakfast drinks, and milk chocolate contain small amounts of lactose. The good news is if you are lactose intolerant after surgery it is because the area in your small bowel where lactase is secreted has probably been diverted over to the bile-containing channel. In time, your intestine may adapt by producing lactase enzymes again—if not you can always take Lactaid, a lactase supplement with your food. Hard cheeses like cheddar, low fat cottage cheese and yogurt may be tolerated better. Milk and ice cream may be tolerated the least. Remember that lactose is a milk sugar and we ask you to stay away from sugar during your weight loss period.
Leslie Patterson MS. RD. LD. CNSD.

We can all make small changes that increase our daily physical activity. By adopting a more active lifestyle, we reduce the risk of chronic disease and have an enhanced quality of life: walking 3 to 4 mph, carrying baby up stairs, swimming moderate effort, using stairs instead of elevator, general house cleaning, walk to lunch, golfing while carrying the clubs, go shopping (walking, not buying) play on playground with your kids, dance to the radio, ride a bike to friends house, crawl around with your kids, walk your dog, baby-sit your grandchildren, play sports (don’t watch), mow the lawn, walk at the beach (don’t lay) wash your car (instead of the car wash), gardening, surf the water not the web, bag your own groceries and carry them out to the car, at work, take a walking break instead of a coffee break, volunteer at a local daycare community center.
Erin Nelson RN, BA, MS, Exercise Scientist

As patient who are getting past or close to their 18 month to 2 years post-op
anniversary they may start thinking of getting pregnant. What every potential
mother to be should consider is: Has my weight loss stabilized? Have I had my vitamin levels checked and have I followed up with my weight loss surgeon before attempting to conceive? Is my OB/GYN aware of my weight loss urgery procedure and do they have experience with patient who has had weight loss surgery? Have I informed my surgeon of who my OB/GYN is? These are all important questions to consider and resolve before getting pregnancy as a post weight loss surgical patient.

Due to the nutritional imbalances that may follow all weight loss surgical procedures it is imperative to make certain that your weight loss has stabilized and you have made it past your 18-month to 2 years postop anniversary. During the weight loss period a patient is in a negative nutritional balance not getting enough calories are absorbed to support the patient’s own weight and therefore would not be able to support the addition of a growing healthy fetus. There is a possibility of birth defects if you become pregnant prior to weight stabilization and your 18-month to 2-year anniversary. The decision absolutely needs to be discussed with your weight loss surgeon prior to any attempts to conceive.

After all the above questions have been dealt with and resolved and you have been cleared by your surgeon to attempt to conceive there are extra steps needed for a post weight loss surgery pregnancy. We will inform you of these steps during the decision process with your surgeon. You always have to keep in mind that you anatomy has been changed and how your body works also has been changed. You should also start your preparation to become pregnant several months prior to attempting to conceive. You will need to be more diligent with follow-up with your OB/GYN and your weight loss surgeon during your pregnancy. Our office will work closely with your OB/GYN in your monitoring your lab work and the progression of your pregnancy

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