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Gastric Bypass (Bariatric Surgery)
What is a gastric bypass
A gastric bypass is a surgical procedure that literally shrinks the stomach.
It is a major medical procedure that makes over-consumption of food impossible, by drastically lowering the amount of food you can eat.
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.
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