A gastric bypass is a surgical procedure that is one of the several methods used to treat morbid obesity. Morbid obesity is defined as having a large amount of excess weight which is stored as fatty tissue and which cannot be reduced by conventional weight-loss methods. Gastric bypass surgery reduces the size of the stomach and, consequently, the amount of calories consumed every day. The number of calories consumed will now be much lower than the number of calories burned, which results in rapid and drastic weight-loss. In average cases, morbidly obese patients will loose between 60% to 80% of their excess body weight.
The Gastric Bypass Explained
A gastric bypass is that surgical procedure whereby the stomach is divided into two pieces ending with an extremely small piece on top and a much larger piece at the bottom. The small intestine is then divided at a point just past the jejunum (a region of the small intestine beyond the duodenum) and the end that is still connected to the large intestine is then attached to the upper piece of the stomach. This procedure effectively bypasses the larger, lower, half of the stomach – hence the name ‘bypass’ surgery – which remains in the abdominal cavity with the small intestine’s duodenum and jejunum still attached, but connected to nothing else.
An alternative form of the procedure involves stapling the stomach together along the proposed division instead of completely detaching the two pieces but this is all that is different between the two forms and small intestine is still adjusted as described above. There are, however, two distinct ways of readjusting the small intestine – the Roux en-Y (proximal) and the Roux en-Y (distal) – as well as two varieties of gastric bypass surgery. One variety uses a normal sized incision and the other, the laparoscopy, uses several very small incisions, through which tiny cameras are inserted so that the surgeon can manipulate the organs and simultaneously watch what he is doing.
Gastric bypass surgery has a profound effect on nutrition and eating habits and a patient basically has to re-learn how to treat his digestive system.
Changes In Eating Habits Following A Gastric Bypass
Gastric bypass patients will now quickly lose interest in eating and will also feel full after eating only a few forkfuls of food as the amount of food their stomach can hold before the stretching stomach lining will send the ‘I’m full’ feeling to the brain has been greatly reduced. Patients will now also be restricted to three small meals per day as snacking or grazing between meals could reduce the efficiency of the bypass.
The disconnection of the duodenum and the jejunum from the small intestine also forces a patient to take various types of nutritional supplements, as there are some minerals and vitamins that are only absorbed by these two organs and, if they are out of the loop, the substances will just pass through the body without being absorbed.
Although the nutritional and gastro-intestinal effects of gastric bypass surgery have been greatly studied and are quite thoroughly understood, not much research has been done into the surgery’s psychological effects. Patients often experience profound depression during the first few post-surgery months as they can no longer rely on excess food to meet their emotional and psychological needs.
Effects Of A Gastric Bypass On Specific Nutritional Substances
As the digestion of certain substances is location specific – they are only able to be absorbed in a specific place – and as this place may now no longer be part of the digestive system, alternative plans have to be made to ensure that patients consume the required amounts of the substances involved. The following is a short summary of which substances are affected and how their deficiencies are treated.
Vitamins: vitamins are contained in our food and if the amount of food consumed is reduced, so is the amount of vitamins, especially Vitamin B. In order to supplement reduced Vitamin B levels, it is suggested that sublingual Vitamin B12 be taken as this dissolves under the tongue and is immediately absorbed into the bloodstream;
Proteins: proteins are essential for a patient’s continued wellbeing and can be supplemented by either liquid protein drinks or by the patient just eating their proteins first, before they become full;
Minerals: most minerals are absorbed in the duodenum and, as this organ is no longer part of the digestive system, mineral supplements will have to be taken. The most common supplements include iron and calcium.
Gastric Bypass Surgery: The Bottom Line
Gastric bypass surgery is incredibly successful for sufferers of morbid obesity but does come with many potential complications. If a patient has a good support system, however, the pros generally outweigh the cons and the surgery is then highly recommended.