Risks:
The duodenum being bypassed, poor absorption of iron and calcium can result
in the lowering of total body iron and a predisposition to iron deficiency
anemia.
A chronic anemia due to Vitamin B12 deficiency may occur. The problem can
usually be managed with Vitamin B12 pills or injections.
A condition known as "dumping syndrome" can occur as the
result of rapid emptying of stomach contents into the small intestine. This
is sometimes triggered when too much sugar or large amounts of food are consumed.
While generally not considered to be a serious risk to your health, the results
can be extremely unpleasant and can include nausea, weakness, sweating, faintness
and, on occasion, diarrhea after eating. Some patients are unable to eat any
form of sweets after surgery.
Metabolic bone disease in some patients, resulting in bone pain, loss of height,
humped back and fractures of the ribs and hip bones.
All the above listed deficiencies can be easily managed through a proper diet
and vitamin and calcium supplements. It is mandatory for patients undergoing
gastric bypass to consume a multivitamin and calcium supplement daily.
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Malabsorptive procedures: Roux -En- Y Gastric
Bypass
Procedures that alter digestion are known as malabsorptive procedures. Malabsorptive
techniques reduce the length of intestine that comes in contact with food
so that the body absorbs fewer calories. According to the American Society
for Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric
bypass is the current gold standard procedure for weight loss surgery. In
this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder
of the stomach is completely stapled shut and divided from the stomach pouch.
It is not completely removed. The outlet from this newly formed pouch empties
directly into the lower portion of the jejunum, called the Roux limb, thus
eliminating the duodenum and a small portion of the jejunum from the absorptive
circuit. The omitted segment is connected into the side of the Roux limb of
the intestine creating the "Y" shape that gives the technique its
name. The length of either segment of the intestine can be adjusted to produce
lower or higher levels of malabsorption.
The hour
glass configuration only constricts the upper stomach thus acting as a pure
restrictive operation. Since the outlet is small, food stays in the pouch
longer and one also feels satiated for a longer time.
In a cooperative and compliant patient, the reduced stomach capacity, along
with behavioral changes, can result in consistently lower caloric intake and
consistent weight loss. Patients who see the best results from a restrictive
procedure are those who learn to eat slowly, eat less, and avoid drinking
too many caloric fluids, particularly carbonated beverages. If the patient
fails to follow these guidelines, they can stretch the stomach pouch and/or
the stoma outlet and defeat the purpose of the surgery. The effectiveness
of a restrictive procedure is reduced by constant snacking or by drinking
high-calorie, high-fat liquids.
Possible Complications:
Band Infection
and migration
Leakage
Slippage and
dilatation
Punctures
Restrictive weight loss surgery works by reducing the amount of food consumed at one time. The theory is simple; due to the restriction created, you feel satiated with small amounts of food and because of a smaller outlet, food stays in the stomach for a longer time. The net result is - a reduction in daily caloric intake without a feeling of deprivation.