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Gastric Bypass Surgery (Stomach Bypass)

WHAT GASTRIC BYPASS SURGERY (STOMACH BYPASS)?

Gastric bypass (also known as Roux-en-Y (roo-en-wy) gastric bypass), is a type of weight loss surgery that involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine. After gastric bypass, swallowed food goes into the small pouch of stomach and then directly into the small intestine, thereby bypassing most of the stomach and the first section of the small intestine.

WHY GASTRIC BYPASS SURGERY IS PERFORMED?

Gastric bypass is one of the most common types of bariatric surgery to reduce the weight. Gastric bypass is recommended when diet and exercise haven't worked or when serious health problems arise because of excess weight such as Gastroesophageal reflux disease, Heart disease, High blood pressure, High cholesterol, Obstructive sleep apnea, Type 2 diabetes, Stroke, Infertility. 

Gastric bypass is advised in following conditions:

  • Body mass index (BMI) is 40 or higher (extreme obesity).

  • BMI is 35 to 39.9 (obesity), and the person is having serious weight-related health problems, such as type 2 diabetes, high blood pressure or severe sleep apnea.

  • In some cases, a person may qualify for certain types of weight-loss surgery if BMI is 30 to 34 and there is serious weight-related health problems. 

Gastric bypass isn't not recommended for everyone who is overweight. Screening tests are done to qualify for the surgery.

HOW IS GASTRIC BYPASS SURGERY IS PERFORMED?

Before the surgery

The preparations for surgery include various lab tests and medical examinations. Inform the doctor about the ongoing medicines such as blood-thinning medications as these medications affect clotting and bleeding, in case of diabetic patients, consult  a doctor who manages insulin or other diabetes medications.

During the procedure:

The procedure happens in general anesthesia. Some surgeries are done with large open incisions in the abdomen. However, most are performed laparoscopically, which involves inserting instruments through multiple small incisions in the abdomen. After making the incisions with the open or laparoscopic technique, the surgeon cuts across the top of the stomach, sealing it off from the rest of the stomach. The resulting pouch is much smaller and can hold much smaller  quantity of food. Then, the surgeon cuts the small intestine and sews part of it directly onto the pouch. Food then goes into this small pouch of stomach and then directly into the small intestine sewn to it. Food bypasses most of the stomach and the first section of small intestine, and instead enters directly into the middle part of the small intestine. Surgery usually takes a few hours. After surgery, patient is taken to a recovery room, where medical staff monitors for any complications.

After the procedure:

Immediately after gastric bypass surgery, patient may have liquids but no solid food as stomach and intestines begin to heal. A special diet plan is followed that changes slowly from liquids to pureed foods. After that, gradually patient can eat soft foods, then move on to firmer foods as the body is able to tolerate them.  Patient might have many restrictions or limits on how much and what patient can eat and drink. The doctor will recommend to take vitamin and mineral supplements after surgery, including a multivitamin with iron, calcium and vitamin B-12.

Patient will go through frequent medical checkups to monitor the health in the first several months after weight-loss surgery. 

Following changes are experienced by the patient due to rapid weight loss in the first three to six months after gastric bypass: these may include body aches, feeling tired, feeling cold, dry skin, hair thinning and hair loss, mood changes etc

WHAT ARE THE RISKS INVOLVED?

There are few health risks are involved in gastric bypass surgery:

  • Excessive bleeding

  • Infection

  • Adverse reactions to anesthesia

  • Blood clots

  • Lung or breathing problems

  • Leaks in gastrointestinal system

Longer term risks and complications of gastric bypass can include:

  • Bowel obstruction

  • Dumping syndrome, causing diarrhea, nausea or vomiting

  • Gallstones

  • Hernias

  • Low blood sugar (hypoglycemia)

  • Malnutrition

  • Stomach perforation

  • Ulcers

  • Vomiting

In rare cases gastric bypass can be fatal.

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