Gastric bypass, also known as Roux-en-Y, is bariatric surgery for obese patients whose weight poses a significant risk to their health. This procedure involves removing a substantial portion of the stomach and creating a small pouch connected to the small intestine. The newly created pouch is usually the size of a walnut, which can only hold 24-28 grams of food at once, drastically reducing the quantity of food a person can consume.
A gastric bypass is also the most common type of bariatric surgery performed nowadays. However, not everyone can qualify for this; gastric bypass surgery is reserved for extremely overweight people, and dietary changes have little to no effects on their overall weight. People who smoke and abuse drugs are also not eligible for this surgery, as any bariatric surgery requires a lifelong commitment to changing their entire diet.
This surgery may be done for a variety of reasons which may have arisen from a person being overweight, like gastroesophageal reflux disease, high cholesterol, diabetes, cancer, infertility, stroke, cardiovascular diseases, high blood pressure, and sleep apnea. A gastric bypass is reserved for people with a body mass index over 40, meaning anyone suffering from class 3 diabetes.
It might also be prescribed to patients with a BMI of 35 and above if they have some accompanying conditions like type 2 diabetes, high blood pressure, and sleep apnea. A gastric bypass can also be performed on people with a BMI between 30 to 35, only if their weight poses critical risks to their life.
There is also an extensive screening process for patients selected for this procedure; they will have to make permanent changes to their diet for their entire life. The recovery period is long and needs constant monitoring to see which foods are accepted by the body and which are not.
This is because, after the surgery, the body takes quite a while to get used to eating normal food again. Patients will be limited to liquid and pureed foods for the first couple of weeks.
Additionally, the quantity of the food also plays a big role, as the stomach is reduced to the size of a walnut, and people might not understand how much food they can intake at once. This might lead to vomiting, nausea, bloating, abdominal pain, or above.
Drinking too much water is also not recommended as it might stretch the newly created pouch beyond its physical limit, leading to ruptures and anastomotic leaking, which can be life-threatening if not diagnosed early. However, the symptoms of any such leak are pretty noticeable as a patient would have an elevated heart rate with fever and a general feeling of being unwell.
A gastric bypass also carries some risks, like any other surgery. For example, gastric bypass, chest pain after eating, heartburn, acid reflux, constipation, and other stomach problems.
However, these can usually be controlled using medicines to reduce the stomach’s acidity. Several other risks include internal bleeding, infection due to leaking, blood clots, lung problems, and bad reactions to anesthesia which are far more harmful and can be life-threatening if not treated quickly.
The surgery also carries some long-term risks like bowel obstruction, dumping syndrome, gallstones, hernias, low blood pressure, perforation of the stomach, ulcers, and malnutrition because the stomach loses its ability to absorb a lot of nutrients and vitamins naturally from food.
Bowel obstruction can happen years after surgery due to the bunching of connective tissues leading to a blockage. This condition must be resolved and remedied as quickly as possible before the lack of blood starts deteriorating the intestine’s condition.
An operation is usually required to fix this issue, and there is a risk of developing bowel necrosis which is the worst-case scenario. The bowels start decaying within the body due to improper blood circulation.
Symptoms Of Blockage After Gastric Bypass
The most common symptom noticed due to the obstruction of the bowel passage is a hernia. After the bariatric surgery, the patient might develop a hernia close to the opening for the laparoscopic surgery. It should be considered that the higher a person’s body mass index, the more they are at risk of developing this condition.
The treatment for an abdominal blockage is to fix the hernia using laparoscopy, and an intestinal resection may be required depending on how severe the condition is. This usually takes place if the intestine is perforated.
A bowel obstruction is one of the most serious complications related to bariatric surgeries. If a patient has small blockages, they can usually be resolved with nasogastric decompression, fluid resuscitation, or resting of the bowels. However, if someone is suffering from intestinal ischemia, a different procedure might need to be performed.
After any bariatric surgery, complete or partial blockage of the bowels may occur, leading to the patient being unable to pass gas or feces, leading to bloating and pain. Surgery is usually required quickly to fix this issue.
Even though the risk of bowel obstruction is low during gastric bypass surgery, patients should always be on the lookout for any symptoms that might point to this complication. Stenosis is also a potential risk during gastric bypass surgery, which causes the hole between the pouch and the small intestine to narrow.
This can happen due to using staples instead of stitches and reduced blood flow to that area. Additionally, if a person smokes and takes aspirin or other anti-inflammatory nonsteroidal medicines too often, they are also at risk of developing stenosis. These conditions must be diagnosed and rectified as soon as possible to prevent further deterioration.