Gastric Bypass

dorelle · Silver Member Joined: 23 Dec 2000 Posts: 263

Hello,
I need advice. I am seriously overweight. I tried many things and nothing helped. I exercise some and trying not to eat too much, but it does NOT help!!! I am still overweight… What is gastric bypass and how much does it cost?
Thanks for advice!

kaila · Silver Member Joined: 21 Oct 2000 Posts: 269

Hi there!
Gastric Bypass is the last thing I would recommend you. This is a real operation with pain and everything that goes along. And risk, there are big risks!!! Have you talked to your doctor? You must advise your doc before taking any action. Did you have any obesity treatments in a hospital before. The
This is not inexpensive operation- it costs more than 20.000 $ !!! Gastric Bypass is for extremely obese people with body mass index more than 40. It means they are around 100 lbs overweight. Besides that Gastric Bypass is used when other more conventional weight loss programmes have been tried and failed. Plus candidates for Gastric Bypass must generally have severe obesity-related health problems. Are you a part of this group? This is a major operation that will change your life- you shall probably have to use all kinds of supplements to provide basic nutrition, which cannot be ingested during normal food consumption. This is a big step and consumption of food you will be able to eat shall decrease dramatically. But besides that long-term consequences for the body are still not known since this procedure is relatively new.

Guest · Guest

At 2 yrs/2 mos post Gastric Bypass, I am a success story. While the procedure is not for everyone, for me me it was a new lease on life. I entered the program where I attended sessions with experienced medical professionals and most importantly, a licensed Nutritionalist. I was educated on the pros/cons/do and dont's. I followed every guideline I was given and have done very well thus far. When approached, I never tell anyone to have the surgery because I did and I am a success story but what I DO encourage is that each individual at least think seriously about his or her personal issues and how obesity is impacting life (health-wise, foremost). As any experienced Nutrionalist or surgeon who performs the Gastric Bypass procedure will tell you, it is a "TOOL" only and after you have lost the initial bulk of weight, you will need to follow the guideline for the remainder of your life which means eating foods to supply protein and leaving off sweets and the foods that contain high startches, hidden sugars, etc. I still am forced to think about what I'm eating when I am putting each bite into my mouth. Otherwise, I will gain the weight back.

I would sugest anyone thinking of having the procedure, each day as you encounter people, try to find others who have had the proedure. Discuss in detail with each person who has already been down that road. Gather as much experience, kno Cool

wledge as you can and then make an "informed" decision. Good luck with whatever you decide to do but I would encourage you to find a way that works for you to decrease your body weight for many reasons.

ayeshaa · Newbie Joined: 06 May 2008 Posts: 13

Gastric bypass procedures (GBP) are any of a group of similar operations used to treat morbid obesity—the severe accumulation of excess weight as fatty tissue—and the health problems (comorbidities) it causes. Bariatric surgery is the term encompassing all of the surgical treatments for morbid obesity, not just gastric bypasses, which make up only one class of such operations.

A Gastric Bypass first divides the stomach into a small upper pouch and a much larger, lower "remnant" pouch and then re-arranges the small intestine to allow both pouches to stay connected to it. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different GBP names. Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and psychological response to food. The resulting weight loss, typically dramatic, markedly reduces comorbidities. The long-term mortality rate of Gastric Bypass patients has been shown to be reduced by up to 40%[1][2]; however, complications are common and surgery-related death occurs within one month in 2% of patients

Any major surgery involves the potential for complications — adverse events which increase risk, hospital stay, and mortality. Some complications are common to all abdominal operations, while some are specific to bariatric surgery. A person who chooses to undergo bariatric surgery should know about these risks.

Complications of gastric bypass

Anastomotic leakage
An anastomosis is a surgical connection between the stomach and bowel, or between two parts of the bowel. The surgeon attempts to create a water-tight connection by connecting the two organs with either staples or sutures, either of which actually makes a hole in the bowel wall. The surgeon will rely on the healing power of the body, and its ability to create a seal like a self-sealing tire, to succeed with the surgery. If that seal fails to form, for any reason, fluid from within the gastrointestinal tract can leak into the sterile abdominal cavity and give rise to infection and abscess formation. Leakage of an anastomosis can occur in about 2% of gastric bypass procedures, usually at the stomach-bowel connection. Sometimes leakage can be treated with antibiotics, and sometimes it will require immediate re-operation. It is usually safer to re-operate if an infection cannot be definitely controlled immediately.

Anastomotic stricture
As the anastomosis heals, it forms scar tissue, which naturally tends to shrink ("contract") over time, making the opening smaller. This is called a "stricture". Usually, the passage of food through an anastomosis will keep it stretched open, but if the inflammation and healing process outpaces the stretching process, scarring may make the opening so small that even liquids can no longer pass through it. The solution is a procedure called gastroendoscopy, and stretching of the connection by inflating a balloon inside it. Sometimes this manipulation may have to be performed more than once to achieve lasting correction.

Dumping syndrome
Normally, the pyloric valve at the lower end of the stomach regulates the release of food into the bowel. When the Gastric Bypass patient eats a sugary food, the sugar passes rapidly into the bowel, where it gives rise to a physiological reaction called dumping syndrome. An affected person feels his heart beating rapidly and forcefully, breaks into a cold sweat, gets a feeling of butterflies in the stomach, and has a "sky is falling" type of anxiety. He usually has to lie down, and is very uncomfortable for about 30 to 45 minutes. Diarrhea may then follow. The dumping syndrome is a response to a behavior which the patient should not be doing anyway: eating sugary foods. It is not life-threatening, and may assist one in making healthier food choices.

Nutritional deficiencies
Hyperparathyroidism, due to inadequate absorption of calcium, may occur in over 30%[citation needed] of GBP patients. Calcium is primarily absorbed in the duodenum, which is bypassed by the surgery. Most patients can achieve adequate calcium absorption by supplementation with Vitamin D and Calcium Citrate (carbonate may not be absorbed - it requires an acidic stomach, which is bypassed).
Iron frequently is seriously deficient, particularly in menstruating females, and must be supplemented. Again, it is normally absorbed in the duodenum. Ferrous sulfate can cause considerable GI distress in normal doses; alternatives include Ferrous fumarate, or a chelated form of iron. Occasionally, a female patient develops severe anemia, even with supplements, and must be treated with parenteral iron.
Vitamin B-12 requires intrinsic factor from the gastric mucosa to be absorbed. In patients with a small gastric pouch, it may not be absorbed, even if supplemented orally, and deficiencies can result in pernicious anemia and neuropathies. Sub-lingual B-12 appears to be adequately absorbed.

Thiamine deficiency (also known as beriberi) will, rarely, occur as the result of its absorption site in the jejunum being bypassed. This deficiency can also result from inadequate nutritional supplements being taken post operatively.

Protein malnutrition is a real risk. Some patients suffer troublesome vomiting after surgery, until their GI tract adjusts to the changes, and cannot eat adequate amounts even with 6 meals a day. Many patients require protein supplementation during the early phases of rapid weight loss, to prevent excessive loss of muscle mass.

Nutritional effects
After surgery, patients feel fullness after ingesting only a small volume of food, followed soon thereafter by a sense of satiety and loss of appetite. Total food intake is markedly reduced. Due to the reduced size of the newly created stomach pouch, and reduced food intake, adequate nutrition demands that the patient follow the surgeon's instructions for food consumption, including the number of meals to be taken daily, adequate protein intake, and the use of vitamin and mineral supplements.

Results and health benefits of gastric bypass
Weight loss of 65 to 80% of excess body weight (the amount by which actual body weight exceeds actuarial ideal body weight) is typical of most large series of Gastric Bypass operations reported. The medically more significant effects are a dramatic reduction in co-morbid conditions:

Hyperlipidemia is corrected in over 70% of patients.
Essential hypertension is relieved in over 70% of patients, and medication requirements are usually reduced in the remainder.
Obstructive sleep apnea is markedly improved with weight loss, so that most patients are asymptomatic, and often do not even snore, within one year.

Diabetes mellitus type 2 is reversed in up to 90% of patients, usually leading to a normal blood sugar without medication, sometimes within days of surgery.

Gastroesophageal reflux disease is relieved from the time of surgery in almost all patients.

Venous thromboembolic disease signs such as leg swelling are typically much improved.

Low back pain and joint pain are typically relieved or improved in nearly all patients.

A recent study in a large comparative series of patients showed a 89% reduction in mortality over the 5 years following surgery, compared to a non-surgically treated group of patients. There were accompanying decreases in the incidence of cardiovascular disease, infections, and cancer.

Concurrently, most patients are able to alter their lifestyle, to consume "healthier" foods, exercise more regularly, and to enjoy greater participation in family and social activities. Bariatric surgery is the most effective treatment for morbid obesity, and can markedly improve health and lifestyle.

Living with gastric bypass
Gastric bypass surgery has an emotional, as well as a physiological, impact on the individual. Many who have undergone the surgery suffer from depression in the following months.[3] This is a result of a change in the role food plays in their emotional well-being. Many morbidly obese people use food as an emotional crutch, and the strict limitations on the diet can place great emotional strain on the patient. Energy levels in the period following the surgery will be low. This is due again to the restriction of food intake, but the negative change in emotional state will also have an impact here.[4] It may take as long as three months for emotional levels to rebound. Muscular weakness in the months following surgery is common. This is caused by a number of factors, including a restriction on protein intake, a resulting loss in muscle mass and decline in energy levels. The weakness may result in balance problems, difficulty climbing stairs or lifting heavy objects, and increased fatigue following simple physical tasks. Many of these issues will pass over time as food intake gradually increases. However, the first months following the surgery can be very difficult, an issue not often mentioned by physicians suggesting the surgery. The benefits and risks of this surgery are well established; however, the psychological effects are not well understood, and potential patients should ensure a strong support system before agreeing to the procedure.

Source: Wikipedia

Gastric Bypass

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