Gastric bypass involved dividing the stomach to create a small stomach "pouch". A portion of the intestine is divided and connected to the stomach pouch. This also results in a small segment of intestine being bypassed; meaning, food does not travel through it. With the small stomach pouch, patients can only comfortably eat a small meal, so caloric intake is drastically reduced and patients lose weight. The procedure itself typically takes between two and three hours. After a hospital stay of three to four days, patients can usually return to work in two weeks.
The Roux-en-Y gastric bypass technique actually reduces the amount of food absorbed in the digestive tract. This procedure routes food to pass directly from a small pouch created for food intake directly into the small intestine, bypassing much of the stomach, duodenum, and upper intestine which also inhibits your body from absorbing calories.
Because a portion of the intestine is bypassed, metabolic changes occur which can literally cure diabetes overnight. Nutritional deficiencies can also occur so patients must take common supplements such as a multi-vitamin, vitamin B-12, calcium, and sometimes iron or other vitamins for the rest of their lives.
• The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with purely restrictive procedures.
• One year after surgery, weight loss can average 77% of excess body weight.
• Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained.
• A study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved.
• Because the duodenum is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.
• Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
• A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
• A condition known as "dumping syndrome" can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating. Some patients are unable to eat any form of sweets after surgery.
In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15-30cc.
• The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.