Tuesday 20 March 2012

Gastric bypass surgery

Gastric bypass surgery is a type of operation done in morbidly obese people. In fact, it is one of the most common weight loss surgery performed in many parts of the world.

Gastric bypass is done when diet and exercise have not worked. Serious health problems related to obesity is other indication for this procedure.

Gastric bypass operation is not for everyone who is severely obese. You may need to fulfill certain criteria to qualify for this surgical procedure.

You may be selected for this surgery if you have tried to lose weight by diet and exercise, and if

  • Your Body Mass Index (BMI) is 40 or more.
  • You have serious obesity related problems and your BMI is more than 35.
  • Your body weight is more than 45 kg above the ideal body weight for your hight and sex.
  • And your age is between 18 and 65.

Facts about the procedure.

Normally food passes through the stomach and enters the first part of the small intestine called duodenum. The stomach acts as a reservoir. That means, when we eat all the food are stored in the stomach. This food is mixed with gastric juice and slowly released into the small intestine where most of the foods are digested and absorbed.

Gastric bypass surgery makes the stomach small in size. In addition, it makes food to bypass part of the small intestine. As a result, you feel full more quickly than when your stomach was its normal size. This significantly reduces the amount of food that you can eat each time.

Bypassing a part of the small intestine effectively reduces the absorption of food. This leads to loss of body weight.

Commonly performed procedure is called Roux-en-Y operation. In this, a small part of the stomach is used to create a pouch. This pouch is connected to the middle part of the small intestine called jejunum. So food will bypass rest of the stomach and upper part of the small intestine. See the diagram illustrating the path of food before and after the operation.
gastric bypass surgery
Passage of food before and after bypass.

Open versus Laparoscopic approach.

In open surgery, a large surgical incision is made on the upper part of the abdomen. The surgical team can directly visualize and work on your stomach and small intestine. This procedure is done under general anesthesia.

Laparoscopic operation is done with the assistance of a small video camera and several other thin instruments. The camera and instruments are inserted through small holes made on the anterior abdominal wall. The surgeon looks at a video screen and performs the operation.

Laparoscopic surgery has some advantages over open procedure, such as minimal scar, less chances of wound infection, fewer days of hospital stay, and low incidence of incisional  hernia.

However, not all people are suitable for laparoscopic operation. Patients who have had previous abdominal surgery, and patients who are extremely obese may require open surgical procedure.

What is expected after the bypass?

The surgery will make your stomach smaller, so you will get full more quickly when you eat. The food will go into the jejunum (part of the small intestine) more quickly. This may cause abdominal discomfort or diarrhea.

After gastric bypass it is difficult to regulate the movements of food through the digestive tract. Food dumps too quickly into the small intestine. This condition is called dumping syndrome. Just after eating,you may feel  abdominal cramps, nausea, vomiting, flushing, and palpitations.

These symptoms usually follow ingestion of foods that contain large amounts of sugar such as candy, soft drinks, cakes, and cookies. So it is not advisable to eat sweets after the operation.

Side effects.

The operative procedure is fairly safe. However, you should know some facts about the adverse effects that can follow the procedure. Here are some common long term adverse effects.

  • Dumping syndrome
  • Incisional  hernia
  • Vomiting
  • Gallstones
  • Kidney stones
  • Iron deficiency
  • Osteoporosis

What and how to eat after gastric bypass?

  • Eat six small meals a day.
  • Avoid large meals.
  • Avoid raw sugar and sweet foods.
  • Cut food into tiny pieces and chew completely before swallowing.
  • Drink more water to prevent dehydration.
  • Eat fruits and vegetables that have plenty of vitamins and minerals.
  • Eat protein rich food like fish, lean meat, and nuts.
  • Your doctor may prescribe nutrition supplements. 

Weight loss after surgery.

Most people lose about 3 to 4 pounds a week in the first year. Rate of weight reduction will decrease over time. Significant drop in body weight leads to improvements of medical conditions that are related to obesity.

Gastric bypass surgery alone is not a solution for obesity. You need to keep in mind the facts that you still need to follow proper diet and exercise programs.

You may like to read prevent childhood obesity.