The "Gastric Bypass" is a restrictive and bad absorption surgery procedure that makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus calories consumed. Bypassing part of the intestine results in fewer calories being absorbed. This leads to weight loss.
The most common Gastric Bypass surgery is a Roux-en-Y Gastric Bypass.
In normal digestion, food passes through
the stomach and enters the small
intestine, where most of the nutrients
and calories are absorbed. It then
passes into the large intestine (colon),
and the remaining waste is eventually
excreted.
In a Roux-en-Y gastric bypass, the
stomach is made smaller by creating a
small pouch at the top of the stomach
with surgical staples or a plastic band.
The smaller stomach is connected
directly to the middle portion of the
small intestine (jejunum), bypassing the
rest of the stomach and the upper
portion of the small intestine
(duodenum).
This procedure can be done by making a
large incision in the abdomen (an open
procedure) or by making a small incision
and using small instruments and a camera
to guide the surgery (laparoscopic
approach).
See an illustration of a Roux-en-Y
gastric bypass.
What To Expect
After Surgery
This surgery usually involves a 4 to 6
day hospital stay (2 to 3 days for a
laparoscopic approach). Most people can
return to their normal activities within
3 to 5 weeks.
Gastric bypass surgeries may cause
dumping syndrome. This occurs when food
moves too quickly through the stomach
and intestines. It causes nausea,
weakness, sweating, faintness, and
possibly diarrhea soon after eating.
These symptoms are made worse by eating
highly refined, high-calorie foods (like
sweets). In some cases you may become so
weak that you have to lie down until the
symptoms pass.
Why It Is Done
Gastric
bypass surgery is rarely used to treat
obesity. Many health professionals will
consider it only for people who have not
been able to lose weight with other
treatments and who are at high risk for
developing other health problems because
of their weight.
Although guidelines vary, surgery is
generally considered when your body mass
index is 40 or higher or you have a life
threatening or disabling condition
related to your weight.
The following conditions may also be
required, or are at least considered:
- Have
been obese for at least 5 years
- Not
have a history of alcohol abuse
- Not
have depression or another major
psychiatric disorder
- Be
between 18 and 65 years of age
All
surgeries have risk, and it is important
for you and your health professional to
discuss your treatment options to decide
what is best for your situation.
How
Well It Works
Most people who have open gastric bypass
surgery quickly begin to lose weight and
continue to lose weight for up to 12
months. One study noted that people lost
about one-third of their excess weight
(the weight above what is considered
healthy) in 1 to 4 years.1 Some of the
lost weight may be regained.
The laparoscopic approach showed similar
results, with 69% to 82% of excess
weight lost over 12 to 54 months.2 At
this time, the laparoscopic approach for
gastric bypass has not been used long
enough to draw significant conclusions
about how well it works.
Risks
Risks common to all surgeries for weight
loss include an infection in the
incision, a leak from the stomach into
the abdominal cavity or where the
intestine is connected (resulting in
peritonitis), and a blockage of blood
flow within the lung (pulmonary
embolism) pneumonia bleeding ulcer.
About one-third of all people having
surgery for obesity develop gallstones
or a nutritional deficiency condition
such as anemia and osteoporosis.
Fewer than 3 in 200 (1.5%) people die
after surgery for weight loss.
After a Roux-en-Y gastric bypass:
- An
iron and vitamin B12 deficiency
occurs more than 30% of the time.
About 50% of those with an iron
deficiency develop anemia.
- The
connection between the stomach and
the intestines narrows (stoma
stenosis) 5% to 15% of the time,
leading to nausea and vomiting after
eating.
- Ulcers
develop 5% to 15% of the time.
- The
staples may pull loose.
- Hernia
may develop.
- The
bypassed stomach may enlarge,
resulting in hiccups and bloating.
What
To Think About
In a gastric bypass, the part of the
intestine where many minerals and
vitamins are most easily absorbed is
bypassed. Because of this, you may have
a deficiency in iron, calcium,
magnesium, or vitamins. This can lead to
long-term problems, such as
osteoporosis. To prevent vitamin and
mineral deficiencies, you may need to
work with a dietitian to plan meals and
may need to take nutrient supplements
and injections of vitamin B12.
Early studies of the laparoscopic
approach to surgery for obesity suggest
that it reduces recovery time and post
surgery complications. A laparoscopic
approach for this surgery has not been
used long enough to draw significant
conclusions.
Gastric
Bypass | Gastroplasty
| Adjustable
Gastric Band | Gastrectomy
|
