2007年11月21日星期三

Gastric Bypass Surgery as the Ultimate Solution to Morbid Obesity?

Obesity is a condition that has no single effective solution, considering that the problem may not lie on simple matters of changing lifestyle and health choices. With more and more people being diagnosed as clinically obese, it would seem that health concerns cannot be addressed by diet and exercise alone, which is why medical experts recommend gastric bypass surgery as a last resort to attempt to correct where diet and exercise have failed.

Not for everyone.
The first thing to remember is that not all obese individuals are candidates for gastric bypass surgery. Gastric bypass surgery is only advised for the morbidly obese, or those who are at least 50 kgs over their ideal weight. People with moderate weight problems are better off changing their diets and undergoing an exercise regimen rather than undergoing this drastic procedure.

Gastric bypass surgery is also not a magic procedure that will end all future weight gain. It will require that a patient maintain a lifetime of commitment to healthy eating and fitness. Most insurance policies also do not cover this procedure, which may cost upwards from $15,000.

What happens in a gastric bypass operation
Basically, a bariatric surgeon will perform two procedures: reduce stomach size with gastric staples or a gastric silastic ring and change the way food works in the body by bypassing a part of the small intestine so food does not remain there.

Gastric bypass surgery will require general anesthesia since the surgeon will be dividing the stomach into two parts, separating each with two rows of staples. An incision is made between the staples. The top section or pouch usually holds only about a tablespoon of food (the stomach can hold a quart). Eventually, this will expand to contain as much as one cup.

The logic of the operation is that once the stomach is decreased in size, the patient will feel full with less food intake. With the duodenum and jejunum bypassed, the number of calories absorbed by the body is also decreased since food goes directly from the stomach to the ileum which is the latter portion of the intestines.

The procedures that are used for these types of surgery include the roux-en-y, biliopancreatic diversion and fobi pouch bypass.

What to expect after undergoing gastric bypass surgery
Most complications arising from gastric bypass surgery may be corrected and improved upon. However, the patient should understand that his digestive process is not what it used to be. He will need to watch his diet, take supplements, medications, eat specially-prepared food and work with medical professionals who will closely monitor his condition. And this is what he will have to deal with for the rest of his life.

Some concerns after surgery
Vomiting
As the patient slowly adjusts to his new condition, he might make the mistake of eating more than his stomach can hold. Since gastric bypass surgery prevents food from passing out of the stomach, he might vomit the excess as a result. The patient will also need to chew his food very well since bigger particles might stretch his stomach pouch.

Dumping
Because the pyloric valve is bypassed, there is a tendency for food to leave the stomach too quickly and enter the digestive tract immediately. This action causes the body to release adrenalin which sets off some stressful symptoms like palpitations, nausea, diarrhea and sweating. Dumping is not necessarily a health risk but it is very uncomfortable for the patient. It is less likely to occur after a duodenal switch.

Vitamin deficiency
This operation will significantly lower the body's efficiency in absorbing vitamins and minerals, which is why it is very important for patients to take nutritional supplements.

Hernia
At least 10% of patients suffer from abdominal hernias after surgery, caused by straining and vomiting. To reduce the risk, laparoscopy-assisted surgery may be considered instead.

Health Problems
Post-operation, some patients may suffer from gastritis, infection and gallstones. If weight is lost too quickly, they may also experience unsightly loosening of skin. There is also a risk that they will regain weight after a few years.

The gastric bypass bottomline
Gastric bypass surgery is a major operation and the there are significant risks of complications. In fact, most gastric bypass operations are irreversible which is why potential patients are well advised to communicate with their doctors and understand completely what is involved and what they can realistically expect.

More than anything, potential patients must also try to consider the drastic change in their lifestyle that gastric bypass surgery will cause. It will not only change their body shape and weight, it will also require them to change their diet and eating habits. Immediately after surgery, patients will have to adhere to a strict regimen of proper nutrition and exercise. They might also want to consider joining support groups after they undergo gastric bypass.