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Bypass Surgery
Health Risks of Gastric Bypass Surgery
The risk of gastric bypass surgery is mainly the same risk of having
any abdominal operation. It is the act of having an operation, not
the particular procedure, that causes most of the risk. Severely obese
persons are well known to be at a disadvantage when having surgery,
and their risks are higher than they would be at a normal body weight.
Complications of Surgery
Lung Problems
Partial collapse of a part of the lung, pneumonia, and pulmonary embolism
are complications that can arise from any surgery. However, from breathing
and lung exercises to preventive courses of antibiotics to leg compression
devices, we are experienced and well-prepared to handle any lung problems
that our gastric bypass patients may face.
Infection
Wound infections and abscesses are prevented by placing drains near
the incision site. If an abscess or wound infection does occur, we
drain them, use antibiotics, and treat them with methods developed
specifically for obesity surgery patients. In rare cases, use of a
catheter can lead to a bladder infection which is usually eradicated
with antibiotics.
Bleeding
Delayed bleeding may occur after gastric bypass surgery in some patients
and we observe closely for this and adjust the blood thinning medication
as necessary. Sometimes a blood vessel may begin to bleed several
hours after obesity surgery. This can cause a hemorrhage, with a return
to the operating room needed in rare cases.
Transfusions
When blood loss occurs, a transfusion may be needed. We have performed
surgery successfully on many occasions under the Bloodless Surgery
Program, when patients decline to receive blood or blood products
for religious reasons.
Bowel Obstruction
After any abdominal operation, adhesions will form in the abdomen.
Sometimes, even many years after the original gastric bypass, the
bowel becomes kinked around an adhesion and becomes obstructed. This
must be relieved surgically. Occasionally a bowel obstruction can
occur within a few days after obesity surgery when the adhesions are
much softer and will often come apart on their own.
Leakage of Bowel Connections
If a complete seal isn't formed where the bowel is connected during
gastric bypass surgery, fluid from the gastrointestinal tract leaks
into the abdomen and can cause a serious infection.
Obstruction of the Stomach Outlet
Scarring may cause the opening between stomach and bowel to become
too small, keeping food from getting through after gastric bypass.
The treatment is quite simple and can be done as an outpatient procedure.
Nutrient Deficiencies
Nutritional problems are quite rare after gastric bypass surgery.
They are readily avoided by using the proper vitamin and mineral supplements
and by eating a healthy high-protein diet.
Side-Effects of Obesity Surgery
Side-effects occur with any operation. Although they are less serious
than complications, they may be permanent, and may require a change
in lifestyle to avoid continuing discomfort.
Nausea
After gastric restriction, if a patient gets a full feeling and continues
to eat, chances are an episode of vomiting will result. During the
first few days to weeks following gastric bypass surgery, another
kind of nausea may result from delayed function of the Y-limb, which
spontaneously resolves with time.
Food Intolerance
Red Meats
Red meats are not well-tolerated and may cause vomiting after gastric
bypass or gastric banding. We advise patients to avoid red meats
until their stomach is functioning very well, usually after at least
3 - 4 months.
Sugar
After gastric bypass a condition called "dumping syndrome"
may occur when sugar is taken on an empty stomach, passes rapidly
through the stomach into the intestine, and draws a large amount of
fluid into the bowel. The result is a condition like shock: one turns
ghostly pale, breaks out in a profuse sweat, feels butterflies in
the stomach, a rapid pulse, and a feeling of prostration. Nausea and
vomiting, cramps and diarrhea may follow. The problem of dumping is
avoided by avoiding sweets.
Milk and Milk Sugar
After gastric bypass, milk and milk products may not be fully digested.
Farther downstream they are fermented by bacteria, and this causes
gas, cramps and diarrhea.
Changed Bowel Habits
After restrictive obesity surgery the quantity of roughage consumed
may be much smaller. Correspondingly, the amount of bowel movements
will be diminished, causing constipation. If this becomes a problem,
a stool softener supplement may be needed.
Transient Hair Loss
One side effect of rapid weight loss can be inactivation of 30 -
40% of hair follicles, causing noticeable amounts of hair to fall
out. This resolves for gastric bypass patients when nutrition and
weight stabilize.
Loss of Muscle Mass
If muscle is not regularly used for exercise it will be consumed by
the body to meet energy needs. It is very important during active
weight loss after obesity surgery to exercise vigorously every day.
Pregnancy
Many morbidly obese women are infertile. The fatty tissue soaks up
the normal hormones and makes some of its own as well, completely
confusing the ovaries and uterus, and causing a lack of ovulation.
After gastric bypass surgery this situation may change quickly. It
is important to avoid conception during the phase of rapid weight
loss – about one year after surgery – to maintain adequate
nutrition.
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