By: Shelagh McNally for Reflux1Changes in lifestyle and diet have created a population struggling with weight. Today more than 97 million Americans are overweight and approximately 5-10 million people suffer from morbid obesity. Anyone with a body mass index of 40 percent, carrying an extra 100 pounds or more is considered morbidly obese and at risk for heart disease, stroke, diabetes and other medical conditions. Losing weight becomes critical but unfortunately many of the traditional non-surgical methods of weight loss prove ineffective. For someone who has tried other methods, bariatric surgery (surgery on the stomach and/or intestines) may be the key to weight reduction. The safest and most frequently performed bariatric procedure is gastric bypass. It can help a patient lose up to 85 percent of excess weight.
Roux-en-Y gastric bypass (RNY) evolved from the Vertical Banded Gastroplasty (VBG) popular in the 1980s. VGB used staples to create a small pouch that filled quickly giving a person a full feeling after eating very little. The procedure met with limited success since the staples did not stop the stomach from eventually stretching. Patients often regained their weight. The RNY uses the same principles of stapling but is less invasive surgery with more consistent results. Using a laparoscopy the doctor puts staples into the stomach wall to create a smaller pouch separated from the lower stomach. This pouch is then attached to the small intestine to create a stomach that holds less than one cup of thoroughly-chewed food (a normal stomach holds one quart.) Since the patient must eat smaller meals of two to six ounces, food intake is drastically reduced but without feelings of hunger. The other contributing factor to weight loss is a reduction in the amount of calories and nutrients absorbed. Since the stomach is smaller, food does not come into contact with digestive enzymes until a few feet down the intestine. This delay in the mixing of food and digestive juices means less calories and nutrients are absorbed by the body resulting in weight loss. Dietary supplements such as a multivitamin with iron, calcium and vitamin B12 are often prescribed to counter this reduced absorption.
The RNY is relatively safe procedure since no other bodily functions are altered and the procedure is easily reversed. The operation requires a three-day hospitalization with a return to full activity in one week to 10 days. Some doctors are now performing Mini Gastric Bypass (MGB) where the operation and recovery time is less than 24 hours.
After the initial bypass, a liquid protein and soft diet is suggested for the initial recovery but afterwards the patient can eat all types of food; just in smaller portions. Food must be thoroughly chewed and any mixing of solids and liquids should be avoided at first. Sugary foods must be restricted because of the “dumping” effect. Since food is being digested much further down in the intestine, the body is not able to handle sugar flooding the system and dumping occurs. The symptoms are similar to food poisoning: Nausea, vomiting, diarrhea, abdominal cramps, flushing and palpitations.
RNY surgery is not a cure for morbid obesity but merely a tool to help patients manage weight loss. Extensive dietary, exercise and medical guidelines must followed to keep the weight from returning. Eligible candidates for RNY must be able to demonstrate they have tried and failed at more traditional weight loss methods. You should consult your doctor before proceeding.
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