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Glossary

 

Gastric Bypass Surgery


Gastric Bypass Surgery in DubaiThe most common type of gastric bypass surgery is called a ‘Roux-en-Y’ gastric bypass. Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which will reduce the amount of food you eat and thus reduce the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This will lead to weight loss.

In normal digestion, food passes through the stomach and enters the small intestine where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon) and the remaining waste is eventually excreted.

In a Roux-en-Y procedure, a small stomach pouch is created which reduces the amount of food you can eat. The smaller stomach is connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine.

Who can have this procedure?
Although guidelines can vary, surgery is generally considered when body mass index is 40 or greater. Also, if you have a life-threatening or disabling condition related to your weight. Your doctor may only consider doing gastric bypass surgery if you have not been able to lose weight with other treatments. The following conditions may also be required or at least considered:
• You have been obese for at least 5 years
• You do not have an ongoing problem with alcohol
• You do not have an untreated depression or another major psychological condition
• You are between 18 and 65 years old

How is the operation performed?
Many surgeons perform this surgery laparoscopically. You will be admitted to the hospital the morning of your surgery and the expected length of stay is 1-3 nights post surgery. The surgeon will make a series of small incisions in your upper abdomen, through which he/she will pass fine laparoscopic instruments and a camera. The expected length of surgery is between 1-3 hours. In some patients that are very obese, or who have had previous abdominal surgery, it is possible that they might not be a candidate for laparoscopic surgery but may need ‘open’ surgery instead. Recovery may take a little longer but weight loss will be just the same. Some patients may have nausea or vomiting but medication is available to rectify this promptly. Some discomfort and limited mobility is also to be expected but prescribed medication is available to control this. You can be assured of immediate care and attention at all times. Please inform the hospital staff of your concerns and this will be dealt with immediately and efficiently.

What to expect following surgery
Patients 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 will be very soft, so as to pass through the small, newly formed pouch and stoma. One of the main issues during this period will be adequate fluid intake, and dehydration can be a problem for patients recovering from this surgery. Approximately one month after the gastric bypass surgery, the patients can expect to advance to a transitional diet. They begin to take more regular table foods, but will often still go back to eating the pureed foods that they have tolerated well. They will still be learning how to eat right, including chewing food carefully, learning to drink most of their liquids between rather than with meals, and learning that eating the wrong foods, such as sweets or fatty foods, can make them ill.

Patients experience the most rapid weight loss during this period. They are often thrilled to see the weight coming off, sometimes at the rate of 10 kgs a month, but it is not an easy time. Patients feel the loss of calories taken in, and are sometimes low in energy. Their small pouch will make them uncomfortable when they eat too much or too fast. They may have diarrhoea, which can usually be controlled by avoiding certain foods or by taking medication. They may experience hair loss, though the hair usually begins to grow back within a few months.

6 months after the gastric bypass surgery, the patients will probably be on their long-term maintenance diet, which is more or less what and how they will eat for the rest of their lives. The maintenance diet for the most part consists of regular table foods, but in small portions. Most patients describe their meals as child sized, and they often do not finish what they are served. The patients generally become comfortable eating these small meals, and almost always say the loss of the ability to enjoy large meals or certain foods is more than compensated for by being able to successfully control their weight.
Patients may expect to lose approximately 70% of their excess body weight during the first 2 years following surgery. Sometimes a weight regain of about 10% is seen between years 2 and 5, perhaps because the small pouch increases several ounces in size, and perhaps because the patients learn how to take in extra calories without making themselves sick.

The surgical community involved in gastric bypass surgery is very concerned about this late 10% or any other weight regain. An effort is made in order to keep patients involved in support groups and in follow-up with their doctors to reinforce what they had been taught after surgery, and what had worked for them the first 2 years. Long term success with this operation requires a team effort of both the patients and their doctors. A monthly meeting at Dubai Mall Medical Centre is one such support network encouraging each other to push forward and live life to the full.
Gastric Bypass Surgery patients take in less food and absorb less of what they take in, making them at risk for developing nutritional deficiencies. They must also make a life- long commitment to taking vitamin, mineral, and possibly protein supplements, and may become very ill if they don't.



 
 
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