Roux-en-Y (Gastric Bypass)
Gastric bypass surgery is when the surgeon makes a small pouch out of the stomach and reconnects it to the small intestine. The stomach remains intact (ie. it is not removed from the body), however there is a small pouch (30-40mls) – the size of an egg, that prevents too much food or fluid being consumed. The new stomach is attached to the middle of the small intestine. This allows some mis-match absorption of foods and restricts the food allowed into the stomach. This leads to greater suppression of hunger and appetite and subsequent weight loss. With less food being absorbed, there is a greater need of vitamin and mineral supplements.
Figure 1: Roux-en-Y Bypass (Gastric Bypass)
Benefits of Gastric Bypass Surgery:
- Diabetes remission – diabetes is never reversed, the symptoms dissipate, meaning that diabetes is in remission.
- Reflux or heartburn remission – There is less acid producing cells in the stomach, which reduces how much acid is left in the stomach. Additionally, there is less
- Greatest speed of weight loss– weight loss of up to 50% excess weight in six months. The weight tends to be maintained in 60-70% of patients up to ten years post-op.
- Remission ofhypertension or high blood pressure. Weight loss decreases blood pressure.
- Remission of sleep apnoea. Weight loss will improve your sleep and reverse sleep apnoea.
- Improved quality of life.
Negatives of Gastric Bypass Surgery:
- Requires a permanent change in dietand lifestyle.
- Gallstones – caused by rapid weight loss. Bile, released when you eat fat, builds up in the gallbladder when on a consistent low-fat diet. When bile is not released, stones form in the gallbladder, which then need to be removed.
- Dumping Syndrome: An outcome after eating foods too high in fat/sugar. There is a hormonal change, which causes the gut to move too quickly, causing diarrhoea, nausea, pain, cramps or reflux.
- Risks of not absorbing nutrients. Multivitamin supplementation is very important.
- Post-surgical complicationsare low but not to be discarded.