Roux-en Y is the most common gastric bypass. In this procedure, a small and upper section of the stomach is separated by staples or bands to create a small pouch. This would limit the amount of food the patient could consume. It could hold about an ounce of food but can expand to about 4 to 8 ounces of food after a few months. A Y-shaped section of the small intestines is attached to the stomach. This would allow the food to bypass the upper portion of the intestines.

There are many benefits brought by gastric bypass surgery. Individuals who have undergone the procedure are said to reduce their weight with an average of 50 to 60%. Some would lose about 80% of their body weight two years after the sugery. Diabetes, hypertension, high cholesterol levels and even cancer risks can be reduced by the procedure. However, there are also downsides with this surgery.

Gastric bypass surgery is an effective way of losing weight an obesity related health risks. However, there are studies showing concern about nephrolithiasis or the formation of kidney stones among those who have undergone gastric bypass surgery. According to paper presented in the 39th Annual Meeting and Scientific Exposition of American Society of Nephrology, gastric bypass surgery increased the possibility of kidney stones.

Actually, this was not the first time that this kind of risk is identified with almost similar operations. In 1979, the Food and Drug administration had the jejunal ileal bypass under moratorium. This was because patients who had the procedure developed kidney stones five years after surgery.

Currently, there are studies showing that those who have undergone gastric bypass surgery would experience changes in the chemical composition of their urine. These changes eventually can lead into formation of kidney stones. After the gastric bypass surgery, the level of oxalate increased. This chemical when bound with calcium can cause the increase of kidney stones.

Another cause could be the production of low levels of citrate. Citrate dissolves crystals which can cause kidney stones. Low citrate levels and high levels, a combination that leads to an increase of calcium oxalate supersaturation. This increases or a strong factor or risk for having kidney stones. Other chemicals which also contribute to kidney stone formation like uric acid and potassium remains unchanged before and after the surgery.

A study conducted by Mayo Clinic showed that those who have underwent the procedure for the last six months have not developed this kind of chemical change. This condition could be avoided or the risk be reduced by undergoing some dietary changes. Doctors would recommend an increase on the intake of fluids, low-protein and low-salt diet, and normal calcium diet.

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The results of the surgery are immediate—a patient may lose 50 to 60 percent of his weight within two years following the surgery. With healthy lifestyle (including proper diet and regular exercise), one can expect weight loss in the long run after the surgery. Those who are overweight will experience easier mobility and better quality of life after undergoing weight loss surgery.

But there’s more to this surgery than just weight loss. Aside from slashing off some figures from the weighing scale, the surgery also helps improve certain conditions that are often linked to obesity. These health problems include high blood pressure, type 2 diabetes, sleep apnea, high blood cholesterol, and gastroesophageal reflux disease. Thus, people who have gone through weight loss surgery are less likely to develop cardiovascular problems than those who have not tried the procedure. Also, the surgery can lessen a patient’s possibility of death due to heart ailment, diabetes, or cancer.

Now for the not-so good news. Weight loss surgery is not for the faint of hearts. As with other kinds of surgeries, weight loss surgery leads to several complications. If you will go through this procedure, you need to know the risks before you head over the clinic or hospital. Being aware of what to expect after the surgery helps a lot in your recovery process. The most common complications of the surgery include infection, bleeding, and swelling. Other complications are ulcer, low blood sugar, kidney stones, gallstones, iron deficiency anemia, and vitamin D and B-12 deficiency. After the operation, a patient may also experience vomiting, diarrhea, nausea, and dizziness especially when eating foods rich in sugar and fat. These are caused by a condition called dumping syndrome in which the contents of the stomach pass through the small intestine very fast.

There are certain postoperative risks that occur in rare cases but are severe and need immediate medical attention. The following are some of the complications and tips on how to deal with them.

1. Leak in the stomach

This is found at one of the staple lines in the stomach. The leak heals over time in most cases, though it can be treated using antibiotics. But severe cases require immediate surgery.

2. Thinning of the opening between the small intestine and stomach

This condition needs either a corrective surgery or a simple outpatient procedure wherein a tube is inserted through the mouth to make the opening wider.

3. Incision hernia or weakness in the incision

This complication happens if the surgery is an open procedure that involves a large incision on the abdomen. Incision hernia needs to be repaired through surgery depending on the severity of the condition.

4. Death

For every 200 to 300 weight loss surgeries, one case results in death. Although the risk of death has been linked to gastric bypass surgery, it still depends on many factors such as age and health and medical conditions.

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Actually, gastric bypass is just among the many similar operations to reduce obesity. To refer all of these procedures, bariatric surgery is the term. These operations intend to reduce accumulated fatty tissues by altering the physiological and psychological attitude of a patient towards food and eating.

How does it alter normal digestion?

What normally happens is that after eating, the food would go through the stomach and then proceed to the small intestine. The nutrients are absorbed in the small intestine before it goes to the large intestine where waste is eventually pushed out of the body. The most common gastric bypass procedure, the Roux-en Y gastric bypass, alters this process.

In the Roux-en gastric bypass, a small pouch is made on the top part of the stomach. The lower part of the stomach, which is much smaller now, is connected directly to the middle part of the small intestine. The stomach was made smaller and at the same time, the intestine was cut short, the upper portion of the small intestine was bypassed. Both the upper portion of the stomach and the small intestine no longer digest food.

Statistics showed that patients would lose 60%, on the average, of their weight after the gastric bypass surgery. There are even who would say that they have lost 80% of their weight. There are studies showing that about 90% of patient who have undergone gastric surgery were able to maintain their weight loss after ten years of having the surgery performed.

Having gastric surgery is not risk-free though. People who have undergone this procedure would report more cases of gallstones, in other studies, they would also report nutritional issues like anemia or osteoporosis.

Every year there are about 140,000 gastric procedure being performed in the United States alone. The results could really be successful, with people being able to get better weight-loss results, however, about 2% of patients would find it very fatal. In the 2%, one percent could be as a result of complications during surgery. The heart in unable to support the pumping it has to do to handle the excess weight or the complication brought by it.

The other one percent cause of fatality among people who gone through the procedure, would be about not following the dietary restrictions that should be followed after the surgery. After gastric surgery, the body could no longer handle too much intake of high-sugar and high-fat food. There is a special diet that those who have just undergone the surgery should follow. Bypass diet would usually include foods that are high in protein but low in fat, fiber, calories, and sugar. There are vitamins and mineral supplements that are required to be taken to avoid health and nutritional deficiencies.

With more and more people turning to gastric bypass surgery as a weight-loss option, it is important to understand not only the procedure and the benefits. It is also important to weigh the risks and if our lifestyle and our body would be able to handle the dramatic loss of weight.

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1. Avoid foods that are not nutritious. The culprits for weight gain are foods and liquids that are rich in calories, fat, and sugar. These include soda, milk shakes, alcohol, and sugar-rich desserts. These foods do not provide nutrients; instead, they cause hunger pangs and vomiting. Avoid them so that you do not out your weight loss effort to waste. Make sure that your diet is rich in protein, and include lots of fruits and vegetables.

2. Avoid foods that cause discomfort. Sticky, dry, and fibrous foods such as pasta, rice, bread, and meat are usually a no-no for bypass surgery patients. Soda is also not allowed because it causes bloating, gas pain, and even pressure in the stomach.

3. Avoid snacking between meals. This will only hurt your chances of keeping a healthy weight.

4. Avoid drinking liquids immediately before, during, or after meals. Filling your stomach with liquids instead of foods will deprive you of your much-needed nutrients for healing and recovery. Be sure to drink fluids at least 30 minutes before and after your meals. And of course, avoid drinking fluids while eating meals.

5. Refrain from drinking alcoholic and caffeinated drinks. Alcohol does more harm than good for people who have gone through weight loss surgery. Devoid of calories, alcohol can cause stomach ulcers. Caffeine have the same effect, aside from working against hydration in the body.

6. Contact your surgeon if problems arise. If you experience one or more of the following problems, call your surgeon immediately: extreme pain in the legs, shortness or difficulty of breathing, fever, bleeding of the incisions, and dark stools.

7. Maintain your follow-up visits after the surgery. This will make it easier for you and your surgeon to monitor and assess your progress. Also, this will result in early detection of problems such as surgical complications and nutritional deficiencies.

8. Keep yourself from getting pregnant for two years following surgery. Because your body is undergoing weight months after the surgery, it may not be able to support a baby. This will be unhealthy for both of you and the fetus. Ask your surgeon for advice in case you plan on getting pregnant.

9. Join a support group. Coping with the aftermath of the surgery may be much easier if you do it with the help of other people. There are many support groups formed to provide emotional support and advice for people who have undergone weight loss surgery. Search for these groups on the Internet; for sure, you can find one within or near your locality.

10. Find ways to cope with stress. Stress usually leads to comfort eating, which is not good for people who have had weight loss surgery. Listen to your favorite music, read books, meet up with friends, and do whatever you can to effectively deal with stress.

You will get the best results from gastric bypass surgery if you follow the guidelines mentioned above.

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First of all, let’s talk about what exactly is a gastric bypass. Have you ever heard of a heart bypass? This is when surgeons stitch up you arteries to avoid the clogged vessels of the circulatory system around your heart. This is also what happens in a gastric bypass, although the operation involves your digestive system rather than your blood vessels. What the surgeons do is make your stomach smaller by making a pouch at the top of the stomach. This neatly halves your stomach capacity. Then, the surgeons would connect your small intestine to this pouch, skipping a part of it. These two changes contribute to increased weight loss by lower food capacity and lesser calorie absorption over all. Weight loss would accelerate over a three to six-month period, until your body manages to adapt to the lower energy intake.

The question that most doctors ask before they have someone undergo all of this is very simple: do you really need it? Most doctors advise patients seeking a gastric bypass to exhaust all other forms of weight-loss options before doing this operation. It may be the safest option but it is still major surgery on a sensitive part of your body. These is still a chance for complications to set in both during and after the operation. Doctors also screen any patient wanting to have a gastric bypass – you may not have a gastric bypass if you have not been obese for more than five years, are alcoholic, experiencing a psychiatric disorder and you have to be between 18 to 65 years of age.

If the patient has exhausted all other options and is eligible for a bypass then the doctor outlines exactly what happens after the bypass is done. After the surgery, the patient will stay in observation for the next three days to check for complications. He won’t be eating anything solid for awhile to let the pouch in his stomach heal. After discharge, he will also be under a rigid, progressive diet that would take him from liquid foods to solid foods in twelve weeks. The patient will also be experiencing the effects of lower energy intake: headaches and bodyaches, along with lower energy levels.

He will also have to take vitamin supplements since the part of the small intestine that is being skipped by the bypass is predominantly in charge of getting the appropriate vitamins and minerals from the food – not all, of course, but a significant portion of the recommended daily allowance. The long-term effects are also there. A lower stomach capacity means you may vomit or feel abdominal pains if you eat too much or too fast.

It sounds extreme, but still, a lot of gastric bypasses are done each year – it’s up to you to decide whether it is worth the risk.

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Gastric bypass surgery is not the popular among the young population though. About 1% of those who undergo the procedure are teens according to the survey reported in Archives of Pediatric and Adolescent Medicine in March 2007. There is a relative increase on the number of teens undergoing the procedure, but still remains unpopular or uncommon.

Sadly, obese children think that they are living a kind of life like those who have cancer and undergoing chemotherapy, according to the survey done by the Journal of the American Medical Association. Teens suffering from obesity would deal with being teased, socially not accepted, and unable to participate in social activities.

Not all obese teens are recommended to undergo gastric bypass surgery. According to the American Academy of Pediatrics in 2004, there are guidelines that should be considered before a teen or an adolescent is recommended for gastric bypass or any weight-loss surgery:

• Failed to lose weight by any organized attempt of weight management for the last six or more months, with an assistance of a doctor.

• Have reached a physiological and skeletal maturity. Adolescents that have reached an age (or older) of 13 years old for girls and 15 years old for boys have reached this level of maturity.

• Has a body mass index (BMI) of more than 40 associated with severe obesity-related problems. Has body mass index of more than 50 even though there are no serious obesity-related problems.

• There are medical and physiological examinations and evaluations performed before the surgery, the teen undergoing that should be prepared to handle these evaluations.

• In general, those who have undergone gastric bypass surgery are advised to avoid pregnancy at least two years after the surgery. This is to avoid any complications and increasing risk to the fetus because of drastic weight loss. Anybody, not only teens, should be aware and agree on this.

• Prepared to follow strict dietary regulations after the surgery. There is a strict diet that patients should follow like low sugar, low fat, low-carbohydrates, and low-calories meal plans.

• Have a supportive environment. Because of the dramatic change in their lifestyle, teens should have supportive family environment that will be able to guide them to the different changes. Often times, there are patients of weight loss surgeries who would suffer from different physiological and psychological side-effects, like depression. Families should be prepared in helping their children through these stages.

There are doctors who would say that conducting gastric bypass or other bariatric surgery on teen-agers are safer than conducting the procedure with adults. Teens have not developed any case of obesity-related problems like high blood pressure and heart disease which are common among adults and also increases the risks of surgeries. Teens also heal faster and required less time spent in the hospital.

There are many benefits by undergoing gastric bypass and weight-loss surgeries. Some patients would even report losing 5% of their weight within the first month and about 50 to 60% within a year. Associated obesity related problems are also reduced by having the surgery. However, not everybody is recommended to undergo the procedure.

Even a teen is required to have be able to make sound decisions, before undergoing surgery. Afterall, maturity does not come with age.

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Also called the Roux-en-Y surgery, the procedure primarily entails making a walnut-sized pouch at the upper stomach and putting a bypass around a portion of the small intestine and the stomach. Consequently, the food you eat bypasses most of the stomach and restricts the ability of your digestive system to take in calories. Hence, the term “bypass” surgery. Surgeons perform this operation using a small tube called a laparoscope that creates small incisions in the abdomen.

A small video camera is attached on the instrument, and this device enables the surgeon to see the inside of the abdomen. The laparoscopic technique is generally preferred over the traditional open bypass surgery that makes large incisions in the abdomen. Compared to the open bypass surgery, the laparoscopic technique is less risky and less painful because of the small incisions. Also, it results in shorter recovery period.

The procedure starts with the stapling of the patient’s stomach at the top to seal this area off from the rest of the stomach. As a result, the sealed portion or the pouch will be able to contain only an ounce of food. Separated from the entire stomach, the pouch is then connected to a small part of the small intestine. To be able to achieve that, the surgeon cuts a small part of the small intestine and sews it onto the pouch.

The surgery is not for everyone, though. There are certain risks involved; and a prospective patient must understand them before undergoing the surgery. If you plan to undergo the weight loss surgery, consult a surgeon and ask all your concerns regarding the procedure. Usually, the surgeon explains the things you should expect during and after the surgery.

Before the surgery, you will be given anesthetics to keep you asleep during the operation. The anesthesia is usually in the form of an intravenous (IV) line or analgesics. During the procedure, the surgeon inserts a tube into your nose down to the top of the stomach. To heal the staple line on the stomach, the tube is joined to a suction machine that empties the stomach pouch after the surgery. The surgery lasts for about two to four hours, but you will need to stay in the hospital for around three to five days for recovery.

Expect some diet and lifestyle changes after the weight loss surgery. One to three days after the procedure, you will not eat anything to allow your stomach to heal. Then, for about three months, you will follow a diet that starts with liquids, progresses to soft and pureed foods, and lastly to regular foods. You will have to be cautious with your food intake because eating huge meals can cause extreme pain under the breastbone and vomiting.

Also, you will notice some changes in your body and behavior three to six months after the gastric bypass surgery. These include dry skin, hair thinning, fatigue, body pains, and mood swings. These will be your body’s reactions to the quick weight loss resulting from the surgery.

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But unfortunately, regaining weight is possible several years after the weight loss surgery. Most patients keep on losing weight until achieving their ideal weight within one to three years after the procedure. Have you undergone weight loss surgery? It is likely that you lose much weight in one year, only to have the excess weight back. That usually happens to patients who do not follow the recommended food intake and the necessary lifestyle changes following the surgery. Good thing, there are several steps you can do to avoid gaining weight ever again. Read on the following tips to get the most out of your weight loss surgery.

* Stop eating when you are full. Eating more food than your stomach can hold will result in not only weight gain, but also pain in the abdomen, vomiting, nausea, and dizziness. Also, avoid eating when you are not really hungry.

* Avoid going back to your old, unhealthy habits. Binging or comfort eating are just some of the causes of weight gain and obesity. Sure, old habits die hard. But if you cannot resist the urge to overeat, then your weight loss surgery is as good as useless.

* Find some ways to deal with stress, anxiety, loneliness, and other emotions that lead to binge eating. Seek help from a professional such as a psychotherapist to be able to curb negative emotions that trigger incessant food cravings.

* Make sure to follow the diet plan designed for you. The diet recommended for people who have undergone weight loss surgery includes foods that are low in fat and sugar. Now, if you eat sugar- or fat-rich foods, then expect your weight to increase again.

* Follow an exercise program. Regular exercise can help you maintain a healthy weight. You can do yoga, Pilates, aerobics, walking, jogging, and other physical activities to keep your body and mood in great shape.

* See your doctor. If you notice that you are gaining weight at any point after your surgery, it is best to consult your doctor to determine the reasons for your weight gain. Your weight gain may be due to medical causes such as a disease, and the doctor can help you find solutions to stop the problem. On the other hand, some instances of weight gain after surgery are caused by a patient’s diet or fitness routine. Your doctor can also help you determine those problems and suggest changes or adjustments to your eating habits and regular workouts to stop your weight gain.

Remember, nothing beats a healthy diet and consistent exercise regime to make sure that you maintain an ideal healthy weight years after your gastric bypass surgery. Do not forget to always consult your doctor whenever you encounter health problems. Doing so gives you the peace of mind that you will not have to deal with obesity problems ever again.

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Those who have undergone weight loss surgeries, lose about 50 to 60% of their body weight, a year after the surgery. Along with the weight loss, they would also be losing ailments associated with obesity like high blood pressure, diabetes, stroke, heart diseases and even cancer.

The Procedure

The most common gastric bypass performed is called the Roux-en Y gastric bypass. In this procedure, a small pouch is created on the top of the stomach. It is stapled, to seal it off from the rest of the stomach. This small pouch will no longer digest any food. The upper part of the small intestine, the duodenum, is attached to this small pouch.

When eating, the food would bypass the small pouch in the stomach and the upper portion of the small intestine. The food would go directly to the middle section of the intestine called the jejunum. Since it is the small intestine that does the absorption of minerals, vitamins and calories, the body will absorb limited calories only. A Y formation is formed just below the stomach.

Incisions are made in the abdomen to perform the procedure. Surgeons will be using the laparoscope or a small, tubular instrument with a camera. This will enable the surgeon to see the abdomen and perform the surgery. The laparoscopic gastric bypass actually makes the stay in the hospital and the recovery period shorter and quicker.

There are still “open” gastric bypass performed, however, there could be wound-related problems with this kind of procedure. The laparoscopic gastric bypass surgery is performed under general anaesthesia. The procedure lasts for about four hours. Patients who have undergone the procedure stay in the hospital for about two to six days to be monitored for any complications.

After the Surgery

Having a smaller stomach has effects on how much food the patient can eat. There are special diets that a patient recovering from gastric bypass surgery follows. Every food that the patient would eat will be important for his nutrition. There are times that they are also recommended nutritional supplements to avoid deficiencies like anemia or vitamin deficiency.

There are patients reporting weight loss of as much as 50 to 60 percent a year after the surgery. There are even some who would report an astounding 80% weight loss. However, it is still possible for patients to stretch their stomachs and have that large size again. There is still a possibility of getting back those lost pounds. That is why doctors would recommend dietary restrictions and exercise plant that would keep the pounds away.

There are also tendencies that gastric bypass patients would develop gallstones, stomach ulcers, hernia or nutritional deficiencies. The part of the stomach which was bypassed can get enlarged, it could cause bloating and hiccups. There is also the Dumping syndrome which happens when the food moves quickly to the small intestine. This can happen after eating foods high in sugar or fat.

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It is because this type of bariatric surgery is much safer and less risky than other weight-loss procedures. Compared with the other type of bariatric surgery (gastric banding surgery), this procedure does not easily lead to weight gain. And with consistent changes in a patient’s lifestyle and behavior, the surgery can result in a long-term and immediate weight loss, as well as other health benefits such as treatment of sleep apnea and type II diabetes.

How safe it is?

The technology used in the weight loss surgery makes the operation much safer than before. Majority of bariatric procedures take advantage of the new laparoscopic technology, which uses a tiny video camera and other instruments to make very small incisions on the abdomen. Whereas before, surgeries of the stomach involved creating large incisions that usually caused intense pain and inflammation to patients. Smaller incisions using the laparoscopic technique leads to less pain, less swelling, fewer scars, and faster recovery rate.

How does it work?

Usually performed within two hours, the surgery involves making the stomach smaller by creating a line of staples that is joined to an end of the small bowel.

Is this surgery right for you?

It depends on your body mass index (BMI). You are a candidate for the surgery if your BMI is not less than 40. But if you have any serious disease such as pneumonia, bronchitis, or diabetes, your BMI must be at least 35 in order to undergo a weight-loss surgery. Otherwise, the surgeon may not allow you to go through the procedure because of the complications. Aside from the right physical condition, you must be emotionally and mentally prepared for the surgery. For the operation to be successful, you should be properly motivated and aware of the risks or complications that may arise. Also, surgery should always be the last resort—meaning you use it only after you have tried dieting and exercise but to no avail.

What are the risks?

Of course, any kind of surgery entails some risks due to the incisions involved in the operation. Deaths resulting from the surgery are very rare (about 0.1 to 2 percent). The complications of the surgery are bleeding, respiratory dysfunction, stenosis or the obstruction of stomach, and leaking due to the staples.

How to find the right surgeon?

Choosing the best surgeon is one of the most important decisions to make when it comes to weight-loss surgery. The surgeon is the only person to entrust your life and limb with, so to speak. So he or she must not only be competent, but also a person whom you’re comfortable dealing with. Also, look for a surgeon with a vast experience in gastric bypass surgery, preferably someone who has performed hundreds of operations. That way, you can be sure that your surgery is safe and effective.

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