Gastric bypass

Gastric bypass

Definition

Gastric bypass surgery is one type of procedure that can be used to cause significant weight loss if you are very obese. The surgery reduces your body's intake of calories. Calorie reduction is accomplished in two ways:

1. After the surgery, your stomach is smaller. You feel full faster and learn to reduce the amount that you eat at any given time.
2. Part of your stomach and small intestines are literally bypassed (skipped over) so that fewer calories are absorbed. Unfortunately, sometimes nutrients are lost as well.

The surgery is only right for you if you meet certain strict criteria described later in this article.

Alternative Names

Bariatric surgery - gastric bypass; Roux-en-Y gastric bypass

Indications

Gastric bypass surgery may be an option if you are significantly obese and have tried unsuccessfully to lose weight on diet and exercise programs and are unlikely to lose weight successfully with non-surgical methods.

Gastric bypass surgery is not a "quick fix" for obesity. The surgery can take several hours and has risks and possible complications. For example, vomiting following the surgery is not uncommon because of eating more than the new, small stomach can accommodate.

Your commitment to diet and exercise must be very strong because even after the surgery, you must adhere to these lifestyle changes. Otherwise, complications from the surgery are likely to develop.

The procedure may be considered for obese individuals who have:

• A Body Mass Index (BMI) of 40 or more. BMI is a calculation based on height and weight that is used to determine whether you are of normal weight or are overweight. Someone with a BMI of 40 or more is at least 100 pounds over their recommended weight. A normal BMI is between 18.5 and 25.
• A BMI of 35 or more along with a life-threatening illness that can be made better with weight loss, such as sleep apnea, type 2 diabetes, and heart disease.

LAPAROSCOPY

Not everyone is a candidate for the laparoscopic (minimally invasive) approach. You are probably NOT a good candidate for laparoscopy if you weigh more than 350 pounds. Others who have had past abdominal surgery may also not be candidates, due to scar tissue. Your surgeon will determine the best and safest approach for you.

Expectations after surgery

The weight loss results of gastric bypass surgery are generally good. Most patients lose an average of 10 pounds per month and reach a stable weight between 18 and 24 months after surgery. Often, the greatest rate of weight loss occurs in the very beginning (that is, just following the surgery when you are still on a liquid diet).

After the surgery, you will need to follow up with your doctor fairly often during the first year. During those visits, your physician will be evaluating your physical and mental health status, including any change in weight and your nutritional needs. You will likely see a dietitian during those visits as well.

The surgery is not a solution in and of itself. While it can train you to eat smaller quantities and feel full more quickly, you still have to do much of the work. To achieve weight loss and avoid complications from the procedure, you must exercise and eat properly -- according to important, healthy guidelines that your doctor and nutritionist will teach you.

Risks

The risks of gastric bypass surgery include:

• Bleeding
• Infections
• Follow-up surgeries to correct complications, or to remove excess skin
• Gallstones due to significant weight loss in a short amount of time
• Gastritis (inflammation of the lining of the stomach)
• Vomiting from eating more than the stomach pouch can hold
• Iron or vitamin B12 deficiencies (if they occur) can lead to anemia
• Calcium deficiency (if it occurs) can contribute to the development of early osteoporosis or other bone disorders

Follow up surgeries may be less likely if gastric bypass is performed with a laparoscope.

Another common complication from gastric bypass is "dumping syndrome." The symptoms often include:

• Nausea and vomiting
• Diarrhea
• Bloated feeling
• Dizziness
• Sweating

You can lessen these symptoms by following your dietitian's guidelines very carefully, especially during the first two months after surgery.

Roux-en-Y stomach surgery for weight loss

Adjustable gastric banding

Vertical banded gastroplasty

Biliopancreatic diversion (BPD)

Biliopancreatic diversion with duodenal switch

Dumping syndrome

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.