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Gastric Bypass Surgery Tips

Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

Dr. Tulip Chamany 90% (80 ratings)
MBBS, Fellowship In Minimally Invasive Bariatric Surgery, Fellowship In Minimally invasive(Keyhole) Surgery
Bariatrician, Bangalore
Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

The “Roux en Y Gastric Bypass” surgery was first performed by Professor Mason in 1966. Being done in the conventional way (i.e by open surgery) earlier and later laparoscopically, the Gastric Bypass has stood the test of time over the last 52 years.

Over 50 years the Gastric bypass surgery is being performed across the globe. It has given excellent results in terms of significant and long-standing weight loss in the morbidly obese, as well as remission of Type 2 diabetes in properly selected patients. Selection of the patient to undergo this procedure is paramount. 50 years of successful results are enough to term this procedure as the GOLD Standard.

Obesity and Diabetes have been a menace over the last 2 decades world over. In India obesity is growing in such a rampant way that we can equate it to an epidemic.

As we all know, India is considered to be the Diabetic Capital of the world. Type 2 diabetes contributes to the major chunk of diabetes affected population. We Indians get affected by diabetes at very early ages and hence complications are seen at very early ages among us. Strikingly important to notice is that Diabetes is seen not only in the obese category of people but also in the normal weight people.

Diabetes is feared of only because of the complications it is capable of causing affecting the vital organs like the brain, heart, eyes, kidneys.

Intermittent or elevated surges in the blood sugars levels during the course of the day are responsible for causing microangiopathies ( damage to the small vessels supplying blood to the vital organs).

We have seen that diabetes is accompanied by high blood pressure and dyslipidemia in most of the cases. So, when a person has diabetes, high blood pressure and dyslipidemia, we label them as having the metabolic syndrome.

Oral hypoglycemic agents (OHA) and insulin form the mainstay of treatment in getting sugars under control. But these are not able to avoid these surges in high sugar levels. This does not mean that OHA’s and Insulin are not the right way to treat diabetes- they indeed are.

We are going a step higher, in an attempt to get control of diabetes without OHA and insulin. Not only this, we are trying to tackle not just diabetes, but the metabolic syndrome on the whole i.e one procedure that will take care of diabetes, dyslipidemia and hypertension. This procedure is popularly known and referred to as the “Gastric Bypass” or the “Roux en Y Gastric Bypass”. Thus, In short, the gastric bypass surgery offers ICE BURG treatment.

Now, the first question is that “Is this possible”. The answer is YES. The second question is that is this procedure applicable for all diabetics. The answer is NO. Only Type 2 diabetics are the beneficiaries of this procedure where insulin resistance has a major role to play. (This procedure does not benefit Type 1 diabetics) Reasons for this will be explained later. The third and important question is that, “Is the Gastric bypass going to give remission of diabetes in all type 2 diabetics?” The answer is NO.

There is strict selection criterion or eligibility criteria to select a patient for The Roux en Y Gastric Bypass surgery. Best results of the Gastric Bypass surgery are seen when it is confirmed that the person is suffering from Type 2 diabetes, duration of diabetes is less than 5 years, the pancreatic reserve is good and showing good levels of C -peptide in the blood, the person has a family history of diabetes, Insulin was not required to control sugar levels within the first 5 years of onset of diabetes and person should not be underweight( BMI > 27.5 preferred).

Losing weight is not easy and even if we lose weight, weight regain is very common. Most of us would have already experienced it. When we are tackling just the weight issue, we are talking into consideration only the morbidly obese people who have a BMI > 37.5. In the morbidly obese, at first, it is very difficult to lose significant weight by the normal method of diet and exercise. Even if weight loss does occur, weight regains or bouncing back is sure.

Here we bring in the trump card – The “Roux en Y Gastric Bypass” that helps the :

  1. “Morbidly Obese” (BMI >37.5) to lose significant weight and reach their ideal weight.
  2. “Obese” (BMI >32.5) who also have comorbidities (like diabetes, hypertension, dyslipidemia, sleep apnea, obesity-induced infertility) not only to lose significant weight and reach their ideal weight but also to get control of the associated comorbidities.
  3. “Type 2 Diabetics” (BMI > 27.5) to get Remission from type 2 Diabetes.
  4. “Metabolic Syndrome” (BMI > 27.5) to get remission from type 2 diabetes, dyslipidemia and Most cases hypertension.

Type 2 diabetics can be offered this procedure even if they are not morbidly obese, is what I would like to bring it to notice.

Exposure to Type 2 diabetes for long years can lead to potential complications like coronary heart disease, chronic kidney failure, brain stroke, gangrene of the lower limbs.

In some, in spite of talking OHA’s, Insulin, sugars are not under control. In these cases, the gastric bypass can be offered to those who fulfil the eligibility criteria.

Remission of diabetes after the gastric bypass procedure is very quick, ranging from a week to a month in most of the cases. However, in some, The sugar levels come to normal the very next day after the surgery in some without the OHA and /or insulin.

Gastric bypass is done through laparoscopy i.e through tiny holes over the tummy, requiring 3 days hospital stay. Supplements need to be taken following the procedure on a daily basis. Following the procedure, intake is reduced to a great extent which increases over few months as the gastric pouch stretches.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2923 people found this helpful

Bariatric Surgery - A Boon For Patients Suffering From Diabetes!

Dr. Ashok Gupta 92% (5463 ratings)
MS - General Surgery, MBBS
General Surgeon, Delhi
Bariatric Surgery - A Boon For Patients Suffering From Diabetes!

Diabetes is a gnawing problem that affects millions throughout the world. It is a disorder that if overlooked can lead to serious diseases; cardiovascular ailments, problems related to vision, kidney problems and many more. While medication tries to regulate your blood sugar levels, it is not always unfailing. Medication along with changes in your diet and lifestyle can still not improve your condition in certain cases. At times it is hard to increase the insulin production in a person's body even after administering medicines solely known for their efficacy. Such kind of diabetic patients can therefore benefit from a Bariatric surgery.

What is a Bariatric surgery?

Bariatric surgery doesn't refer to a single operative method. It involves a host of surgical procedures conducted on a person to rid him or her of obesity. Obesity in combination with diabetes can make a person's life miserable. The treatment of one can come in the way of curing the other. A diabetic patient who also suffers from obesity usually finds it hard to lose weight in spite of exercising or being on diet. Surgery comes to their rescue. This kind of surgery should be fallen back upon as the lender of last resort that is to say when other solutions have not helped. Bariatric surgery is always performed under skilled supervision. It might include reduction of the size of your stomach, removal of a portion of the stomach, or even gastric bypass surgery.

How does Bariatric surgery help reduce Diabetes?

Diabetes can be of three basic kinds;

Type 1 diabetes in which the body produces no amount of insulin.

Type 2 diabetes in which the body produces an insufficient amount of insulin or Gestational diabetes that pregnant women tend to contract.

Bariatric surgery proves to be very advantageous for patients of Type 2 diabetes:

1. Surgery lowers blood sugar levels considerably. Research shows people with acute diabetes made huge improvements after having undergone a Bariatric surgery. Their blood sugar levels dropped by a noticeable percentage and they felt healthier. Reduced blood sugar is an almost immediate effect in some while for others it does take some time.

2. Bariatric surgery exercises a control over cholesterol, blood pressure and triglyceride levels.

3. The impressive benefits of this operation for a Type 2 diabetes patient are not superficial or temporary. If the patient adheres to the lifestyle prescribed by a doctor, takes medication regularly and follows the basics of post- operative care he or she is likely to remain beyond the ambit of this metabolic disorder.

4. It successfully takes care of ailments resulting from diabetes.

5. Bariatric surgery can eliminate the need for medication or it can reduce the dosage of medicines you take.   

In case you have a concern or query you can always consult an expert & get answers to your questions!

              

Type diabetes

2684 people found this helpful

Gastric Bypass Procedure - Precautions and Associated Risks!

Dr. Premkumar Balachandran 84% (25 ratings)
MBBS, MS - General Surgery, M.Mas, Diploma In Minimal Access Surgery, Fellowship In Minimal Access Surgery, Fellowship In Robotic Surgery, FICS, F.I.A.G.E.S, FAMASI
Surgical Gastroenterologist, Chennai
Gastric Bypass Procedure - Precautions and Associated Risks!

The risk of developing heart problems has increased to a great extent and this is mainly due to obesity, which leads to other diseases. A gastric bypass surgery is a medical procedure, which is commonly known as Roux en-Y surgery. It aids in reducing the size of the stomach. The reduction in the size of the stomach makes an individual feel full even when they have eaten very little.

Gastric Bypass Procedure
The stomach bypass surgery is generally known as a bariatric surgery and it guarantees weight loss of about 30-40% within a year. For this procedure, the patient has to be in the hospital for 4-5 days and it takes about 2-3 hours for the medical procedure. It is through this procedure that the size of the stomach is reduced permanently and is performed laparoscopically.

Five small holes are made in the stomach under general anaesthesia. The procedure is conducted only after tests like ECG, blood and urine tests, chest X-Ray chest, abdominal scan and echocardiogram are carried out.

The patient can be discharged from the medical centre on the fourth day. However, it is necessary that calcium, vitamins and supplements are included in the diet plan, mainly to prevent malnourishment and tiredness. In the medical procedure, the surgeon divides the stomach into two sections using surgical staples. The sections are divided into a small upper pouch and a large remnant. The medical procedure makes use of surgical staples, which is why the procedure is sometimes referred to as stomach stapling.

The small intestine is re-arranged in a manner that the stomach pouches are connected to the intestine. The intake of food is reduced by the reduction in the functional capacity of the stomach and by the re-arrangement of the small intestine that causes food to go through the first portion of the small intestine. The procedure is mainly targeted for people with body mass index of 50 and above. It is important that the individual should not drink water for next 24 hours of surgery.

Benefits of Gastric Bypass Procedure
Results in reduced calorie absorption and helps in weight loss. It is generally advised for people who are unable to accomplish weight loss through diet and exercise.

Risks involved in gastric bypass procedure

  1. Inflammation of the stomach lining
  2. Nausea and vomiting
  3. Bleeding
  4. Nutritional deficiency
  5. Development of gallstones. This occurs mainly due to loss of significant weight within a short span of time.

The procedure is a little expensive, but it is a reliable medical procedure for weight loss. It is always better to know about the risks involved in this surgery before opting for a weight loss program. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

3394 people found this helpful

Alcohol & Gastric Bypass - Can They Be Mixed?

Dr. B N Shukla 85% (31 ratings)
Fellowship in Minimal Access Surgery, Fellowship in Bariatric Surgery, M.S.
Bariatrician, Lucknow
Alcohol & Gastric Bypass - Can They Be Mixed?

Gastric bypass, one of the weight loss surgeries bring about many changes and alterations (physiological, metabolic, hormonal) in your body. The gastric bypass surgery rearranges the stomach into an upper pouch (the smaller part) and a relatively larger lower part. It is the small pouch that is connected to the small intestine, where the absorption of nutrients and minerals from the ingested food takes place. The surgery plays a significant role in limiting the intake of food. Thus, post-surgery, a person's body reacts differently than it used to before the surgery. Many, if not all, people experience difficulties in coping up with the changes.

Patients are often advised to refrain from alcohol consumption after the gastric bypass surgery. Surprisingly, and quite alarming, cases of alcohol abuse increases post the surgery. According to a survey by the American Society for Metabolic and Bariatric Surgery, few people, who had no prior history of alcohol abuse developed one after the weight loss surgery. What triggers the alcohol abuse in some patients is still a debatable issue.

Many patients experience an emotional breakdown, stress, anxiety, and depression after the surgery. People who needed no reason to binge on food are suddenly expected and made to consume a limited quantity of food. Unable to do what they loved doing the most, people look for an alternate solution. As expected, in most cases, alcohol becomes the much-needed solution. What started as a means of distraction gradually becomes an integral part of life. Hormonal changes associated with the surgery can also result in panic attacks, stress, and anxiety.

Incidences of alcohol abuse may also be high in patients who had a history of drinking (regular or occasional) and smoking before the gastric bypass. Under normal circumstances (before the weight loss surgery), there is a partial enzymatic breakdown of the consumed alcohol in the stomach before it passes into the small intestine. However, post-surgery, the small size of the stomach does not facilitate such enzymatic breakdowns. Thus, the alcohol passes into the intestine, where it gets rapidly absorbed. As a result, a person gets into an inebriated state at a faster rate.

It is because of this reason that doctors advise the patients to keep away from alcohol as much as possible after the surgery. To keep away from or reduce the instances of alcohol abuse after the gastric bypass surgery,

  • Look for healthier and low-calorie food options when you get an urge to eat.
  • Meditate, go for morning and evening walks. These physical activities act as great stress busters.
  • If you are feeling low or going through an emotionally low phase, share it with your loved ones. Do not suppress your emotions.

Consult an expert & get answers to your questions!

1872 people found this helpful

Bariatric Surgery - A Boon For Diabetic Patients!

Pelvinic Clinic 90% (410 ratings)
MON-SAT 10 AM - 07 PM
General Surgeon, Delhi
Bariatric Surgery - A Boon For Diabetic Patients!

Diabetes is a gnawing problem that affects millions throughout the world. It is a disorder that if overlooked can lead to serious diseases; cardiovascular ailments, problems related to vision, kidney problems and many more. While medication tries to regulate your blood sugar levels, it is not always unfailing. Medication along with changes in your diet and lifestyle can still not improve your condition in certain cases. At times it is hard to increase the insulin production in a person's body even after administering medicines solely known for their efficacy. Such kind of diabetic patients can therefore benefit from a Bariatric surgery.

What is a Bariatric surgery?

Bariatric surgery doesn't refer to a single operative method. It involves a host of surgical procedures conducted on a person to rid him or her of obesity. Obesity in combination with diabetes can make a person's life miserable. The treatment of one can come in the way of curing the other. A diabetic patient who also suffers from obesity usually finds it hard to lose weight in spite of exercising or being on diet. Surgery comes to their rescue. This kind of surgery should be fallen back upon as the lender of last resort that is to say when other solutions have not helped. Bariatric surgery is always performed under skilled supervision. It might include reduction of the size of your stomach, removal of a portion of the stomach, or even gastric bypass surgery.

How does Bariatric surgery help reduce Diabetes?

Diabetes can be of three basic kinds;

Type 1 diabetes in which the body produces no amount of insulin.

Type 2 diabetes in which the body produces an insufficient amount of insulin or Gestational diabetes that pregnant women tend to contract.

Bariatric surgery proves to be very advantageous for patients of Type 2 diabetes:

1. Surgery lowers blood sugar levels considerably. Research shows people with acute diabetes made huge improvements after having undergone a Bariatric surgery. Their blood sugar levels dropped by a noticeable percentage and they felt healthier. Reduced blood sugar is an almost immediate effect in some while for others it does take some time.

2. Bariatric surgery exercises a control over cholesterol, blood pressure and triglyceride levels.

3. The impressive benefits of this operation for a Type 2 diabetes patient are not superficial or temporary. If the patient adheres to the lifestyle prescribed by a doctor, takes medication regularly and follows the basics of post- operative care he or she is likely to remain beyond the ambit of this metabolic disorder.

4. It successfully takes care of ailments resulting from diabetes.

5. Bariatric surgery can eliminate the need for medication or it can reduce the dosage of medicines you take. If you wish to discuss about any specific problem, you can consult a general surgeon.

3036 people found this helpful

Bariatric Surgery - Types And Complications

Dr. B N Shukla 85% (31 ratings)
Fellowship in Minimal Access Surgery, Fellowship in Bariatric Surgery, M.S.
Bariatrician, Lucknow
Bariatric Surgery - Types And Complications

Bariatric surgery is a procedure that involves modifications to the digestive system so that the food intake can be restricted or the nutrients absorbed by the body is reduced. This surgery is recommended when exercise and diet may not cause the desired results with weight loss. Bariatric surgery is a group of surgeries that are the procedure to reduce weight in the body. The various types of surgeries that come under this category are: 

  1. Gastric bypass: The most common bariatric surgery, gastric bypass is a procedure used to reduce the size of the stomach pouch in the body. Once the size is reduced, it leads to reduced consumption of calories. This procedure also causes alterations in the behavior of the gut hormones resulting in appetite reduction. 
  2. Adjustable gastric band: This procedure involves placing an inflatable band around the upper stomach to make a small stomach area above the band. This causes one to feel full just after eating a small amount of food. 
  3. Sleeve gastrectomy: In this procedure, almost 80% of the stomach area is removed surgically, resulting in a small stomach pouch being left. It reduces the stomach size, which cause an overall reduction in the number of calories. Modifications also occur in the behavior of the gut bacteria linked with reduced appetite. 
  4. Biliopancreatic diversion with duodenal switch: This procedure involves surgical removal of a large area of the stomach along with bypassing a major portion of the smaller intestine. This procedure may reduce fat absorption of up to 70%. The behavior of the gut hormones change resulting in a decrease in appetite and improved satiety. Other procedures like Mini gastric bypass and Intragastric ballooning 

Complications 

Various complications may result from this surgery such as - May cause 

  1. Postoperative bleeding
  2. Postoperative anastomosis leak
  3. Postoperative infections
  4. Deep vein thrombosis (Clots may form in the blood vessel)
  5. It can result in bowel stricture
  6. Ulcers can form in the stomach
  7. Internal intestinal herniation
  8. Malnutrition

    If you wish to discuss about any specific problem, you can consult a bariatrician.

1933 people found this helpful
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