Diving after Bariatric surgery FAQ

Diving after Bariatric surgery

DAN medical information specialists and researchers answer your questions about dive medicine.

I’m an instructor, and I have a student who completed his pool sessions, but he had gastric bypass surgery before he could do his open-water dives. Before I allow him to continue with his training, I’m asking him to get an updated medical form signed by his doctor and to contact DAN for advice. What does DAN think about diving after this kind of surgery? 
Risk assessment for recreational scuba diving is a personal- and individual matter. DAN offers insight into the medical principles applied when making these risk assessments; DAN also has the benefit of experience with Hotline calls and – occasionally -- the outcome of diving with specific medical conditions. Nevertheless, DAN cannot approve or disapprove diving fitness merely on the basis of having undergone a given medical procedure. Instead, DAN offers medical information and resources to allow the individual, and their medical doctor or surgeon,to make the most informed decision about diving-safety.
There are a few factors to consider with regard to bariatric surgery. The first is the recovery time from the surgery. It is important that surgical wounds have closed and healed before the patient dives to ensure there’s not an elevated risk of infection. Depending on the type of surgery that was performed, air is sometimes introduced into the abdominal cavity. The body requires time to reabsorb this air. Air pockets are of concern given their ability to compress and expand as ambient pressure changes. Similarly, there is air within the gastrointestinal tract that may contract and expand as the depth changes. Therefore it is essential to allow the surgical sites inside the abdomen to heal to avoid creating a leak.
Another consideration is the delayed complications and/or known side effects of the surgery. These factors depend on the particular surgery that was performed. Some bariatric surgeries put an individual at increased risk for intestinal blockage, gastroesophageal reflux disease (GERD) or malabsorption.
Next, consider the physical demands of scuba diving. Weight-loss surgery and the resulting drastic change in body mass that may occur afterwards can involve loss of muscle mass and general deconditioning. As scuba diving is physically demanding, it is important that an individual can perform vigorous physical activity.
Finally, many patients who undergo bariatric surgery have other medical problems that are associated with obesity (such as diabetes, heart disease and high blood pressure). These issues should be addressed and stabilisedbefore returning to diving. A typical expected recovery time is 6-12 months.
As you suggested, it would be worthwhile for a physician trained in dive medicine to evaluate your student and clear him for diving. He will require clearance for full, unrestricted activity — including lifting heavy weights such as dive gear, unrestricted mobility and tolerance for vigorous exercise such as extended swimming. We can search the DAN referral database for a doctor trained in dive medicine close to the student’s location.
— Mala Trivedi, M.D.

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