Gastric Bypass Surgery
Gastric Bypass Surgery via the
Roux-en-Y procedure is generally considered to be the
best surgical procedure for the treatment of morbid
obesity. Weight loss is achieved when the functional
portion of your stomach reduced to a pouch that is about
one ounce is size, and by creating a small opening
between the stomach and the intestine.
The size of your new stomach will cause you to feel full
after eating only a small amount of food. Since it will
also take longer for your stomach to empty, you will
also feel full for a longer amount of time.
The limb of intestine coming down from the small pouch
is called the Roux limb. The limb of intestine coming
down from the bypassed portion of the stomach can be
called the Bypassed limb. The remaining portion of the
intestine is called the Common Channel. Both of these
result in less absorption of nutrients and contribute to
weight loss, and are called the malabsorptive components
of the procedure.
Exactly how the procedure is done varies from patient to
patient and depends on your individual anatomy, general
health status, whatever changes you may have from prior
surgeries, and what you hope to be achieve from the
operation. The stomach compartments can be completely
divided from each other or simply partitioned, the small
stomach pouch and the intestinal limbs may be connected
to each other with either staples or sutures, a small
band may be placed around the stomach pouch, and the two
intestinal limbs may be made longer or shorter.
You will be on a clear liquid diet for the first few
days immediately following gastric bypass surgery, and
then advance to a pureed diet. These foods must be very
soft so they can pass easily through your new and
smaller stomach. One of the main issues during this
period will be adequate fluid intake, and dehydration
can be a problem while you are recovering from the
surgery. You will need to take in at least 32 ounces of
liquid a day before leaving the hospital. Approximately
one month after surgery you can expect to advance to a
transitional diet. You will begin to eat more regular
table foods, but may still go back to eating pureed
foods if they are more easily tolerated.
It will take some time for you to learn
how to eat differently. This includes chewing carefully,
learning to drink most liquids between meals rather than
with meals, and learning that eating the wrong foods
such as junk food or fatty foods can make you sick.
The first few months after surgery are
an exciting time, as this when you will experience the
most rapid weight loss. Although you may lose close to
20 pounds a month, you also may experience a significant
decrease in energy, as the amount of calories you are
consuming is considerable less that what you're used to.
You will need to be careful not to eat too much too
quickly and side-effects such as diarrhea can be
controlled by avoiding certain foods or taking specific
medications. Hair loss is also a symptom of rapid weight
loss but usually begins to grow back within a few
months.
Six months after the surgery you will
probably be on a long-term maintenance diet, which is
more or less what and how you will eat for the rest of
your life. The maintenance diet for the most part
consists of regular table foods, but in smaller
portions. Most patients describe their meals as child
sized, and often do not finish what they are served. You
will grow accustomed to eating these smaller meals and
most likely will be compensated by the ability to
successfully control your weight.
You can expect to lose approximately 70% of your excess
body weight during the first 2 years following surgery.
Some patients will regain about 10% between the 2nd and
5th year after surgery, mostly because the stomach has
slowly increased in size or because patients eventually
learn to consume more calories without feeling sick.
Staying involved in a support group and
being consistent with your follow-up visits will help to
reinforce what you learned after the surgery and avoid
regaining any weight. Long term success with gastric
bypass surgery requires a team effort by both you and
your doctor.
Since gastric bypass patients take in
less food and absorb less of what they take in, this
makes them at risk for developing nutritional
deficiencies. You must also make a life long commitment
to taking vitamin, mineral, and possibly protein
supplements. These supplements will cost about $30.00 a
month and can be purchased almost anywhere.
