In the war against obesity, operations to decrease stomach capacity have become more prevalent. These procedures require radical reduction in food intake with the goal to lose weight.

What Does Bypass Surgery Do?

Gastric bypass surgery results in food bypassing the lower stomach and upper small intestine, which means fewer calories are absorbed. People who have had this surgery should consult a registered dietitian to be certain that what they eat provides proper nutrition and supports the maximum benefit from the surgery.

Types of Gastric Bypass Surgery:

Extensive gastric bypass (biliopancreatic diversion): Is a complicated gastric bypass operation which removes the lower portion of the stomach. The pouch that remains is connected directly to the small intestine, completely bypassing both the duodenum and jejunum. Although this procedure successfully promotes weight loss it is not as widely used because of the high risk for nutritional deficiencies.

Roux-en-Y gastric bypass (RGB):

involves placement of surgical staples or a plastic band at the top of the stomach (vertical banded gastroplasty) forming a pouch. A Y-shaped section of the small intestine is attached to the pouch to allow food to bypass part of the small intestine. The procedure is accomplished with a laparoscope in some people which promotes a rapid recovery time.

Lap Band Surgery:

With gastric banding, a silicone ring is placed around the upper part of the stomach creating a small pouch, which can be adjusted in size. Attached to the ring is a thin tube leading to an access port that is left under the skin. This port allows the doctor to add saline which tightens the band and makes the stomach smaller. The doctor can remove saline if the ring is too tight. Lap band surgery leads to weight loss by reducing the amount of food that a person can intake. Excess will be regurgitated as the stomach will not have the capacity to hold it. This is considered the least invasive of the weight loss surgeries.

Risks of Lap Band Surgery:.

• Band slippage. The band can slip out of place causing belly pain or heartburn (acid reflux) an possibly need for a second operation.
• Access port problems. May have infection around the access port or it could disconnect or leak. The tube that leads from the band to the access port could also become blocked.
• GERD. development of esphagitis or gastroesophageal reflux disease (GERD).
• Esophageal dilation. If the band is too tight or you eat too much, the esophagus could expand causing food to get stuck in your throat.
• Malnutrition. Eating less may restrict nutrient intake.
• Obstruction. The band can block the opening from the upper to the lower stomach causeing pain, nausea, and vomiting

Risks of Gastric Bypass Surgery:

• Pouch stretching (stomach gets bigger overtime, stretching back to its size before surgery).
• Band erosion (the band closing off part of the stomach disintegrates).
• Breakdown of staple lines (band and staples fall apart, reversing procedure).
• Leakage of stomach contents into the abdomen (this is dangerous because the acid can eat away other organs).
• Nutritional deficiencies causing health problems.

Complications From Nutritional Deficiencies:

*Limited absorption of vitamin B-12 and iron can cause anemia.

*Lack of calcium absorption can lead to osteoporosis and metabolic bone disease.

*People who undergo these procedures should take nutritional supplements to prevent these deficiencies.

*The more extensive the gastric bypass surgery, the greater is the risk for complications and nutritional deficiencies.

*People who undergo extensive bypasses require not only close monitoring, but also lifelong use of special foods and medications.

Other Considerations Concerning Bypass Surgery:

*Failure to chew food completely or eating too much will result in discomfort,nausea or vomiting.

*Too many high calorie drinks may retard weight loss, and overeating may cause the pouch to stretch.

*Surgery is considered when body mass index is 40 or more, you have a life-threatening or disabling condition related to weight, have been obese for at least 5 years, have no history of alcohol abuse and do not suffer from an emotional disorder.

*There is a risk of infection, developing gallstones or nutritional deficiency condition leading to anemia or osteoporosis