The gastric bypass Roux-En-Y works by using surgical staples to create a small pouch at the top of the stomach. A segment of the small intestine (the jejunum) is then attached to this pouch. Food, therefore, bypasses most of the stomach and the first part of the small intestine (the duodenum).
Because the newly formed pouch empties directly into the lower portion of the intestine, calorie absorption is bypassed. The stomach is stapled and the small space holds only one ounce of fluid. The procedure also constructs a tiny stomach outlet, which slows the speed food leaves your stomach. Because of the smaller size of the stomach one feels full with a smaller amount of food and for a longer period of time.
The Consensus Panel of the National Institutes of Health (NIH) recommended the following criteria for consideration of bariatric surgery, including gastric bypass procedures:
- People who have a body mass index (BMI) of 40 or higher. Or,
- People with a BMI of 35 or higher with one or more related co-morbid conditions.
Patients are advised to start changing dietary, lifestyle, and behavioral changes pre- and post-surgery. Pre-Surgery changes include:
- Eat slowly and chew food thoroughly
- Watch portion sizes
- Stop eating when you feel satisfied
- Drink adequate fluid to avoid dehydration. Avoid fluids with meals, and wait 30 minutes after a meal to resume drinking.
- Avoid carbonated beverages and beverages containing sugar or caffeine
- Read food labels. Food choices should be no sugar added and low in fat.
- Limit high fat foods. Low fat means 3 grams or less of total fat per ounce or per serving on a food label.
- Protein is the most important nutrient you need to consume after surgery You need at least 60-80 grams of protein a day
- Exercise!
- Avoid “last supper” eating
- Vitamin and Mineral Supplementation
The Roux-En-Y gastric bypass surgery has been found to be the most effective bariatric surgery performed. Studies have shown that gastric bypass surgery significantly decreases overall mortality as well as the development of new health-related conditions in morbidly obese patients.
The endocrine system and hormones play a huge role in body weight and metabolism. There have been studies done to see the early effect of Roux-En-Y gastric bypass on hormones involved in body weight regulation and glucose metabolism. This study proved that Roux-En-Y gastric bypass determines considerable hormonal changes before significant BMI changes take place. This supports the hypothesis of an endocrine effect as the possible mechanism of action of Roux-En-Y gastric bypass. The overall research has shown that Roux-En-Y gastric bypass results in excellent weight loss and low complication rates. Like most bariatric surgeries patients can gain some of their weight back if they do not follow their diet and exercise plan.
There are many health benefits to this procedure. Some include:
- Up to 96 percent of patients see a cure or improvement of their diabetes.
- Up to 90 percent of patients see a cure or improvement of their high blood pressure.
- Up to 90 percent of patients see a cure or improvement of their high blood cholesterol
- Up to 80 percent of patients see a cure or improvement in their sleep apnea.
- Patients see a lessening of pain related to osteoarthritis.
- Patients see a lessening of their gastric reflux symptoms.
- Some patients see an improvement in their fertility.
As with any major surgery there are risks involved some of which may include:
- Some patients experience what's known as the dumping syndrome, which is a major discomfort, if they eat something too high in sugar or fat.
- Because the stomach is divided and the small intestines are rerouted, leakages can occur right after surgery.
- Complications such as pulmonary embolism, bleeding, infection, stricture, which is a severe narrowing of the hookup of the stomach to the intestine due to scar tissue, hernia, and even death.
- Ulcers can occur at the hookup of the stomach to the intestine.
- Patients may regain some of the weight they've lost if they don't watch their diet and follow an exercise regimen.
- Patients for the rest of their life are at a slight risk for intestinal obstruction.
- Patients have to modify their diet and make long-term behavioral and lifestyle changes.
- Patients may experience more-frequent bowel movements.
- Patients usually experience nutritional deficiencies and, therefore, they have to take nutritional supplements for the rest of their life.
- The surgery to reverse Roux-en-Y gastric bypass is more difficult than Roux-en-Y itself, so the reversal surgery is not readily performed.
The results show that as with any surgery there are risks involved. However, the benefits of this particular surgery outweigh the risks.
