Gastric Bypass Surgery - How It Works

Gastric bypass surgery makes your stomach smaller. This causes you to feel full with less food so you consume fewer calories. The procedure also bypasses part of your small intestine, so fewer calories are actually absorbed into your system. Fewer calories will ultimately lead to weight loss.

When you eat food, it passes through the esophagus and enters into the stomach, where gastric acids soften the food and begin to dissolve it. Next, this semi-liquid mixture enters into the small intestine, where most of the calories and essential nutrients are absorbed by your body. Finally, whatever is left passes into the large intestine and eventually through the colon as it is expelled from the body. Gastric bypass surgery restructures the stomach and intestinal system, resulting in intentional malabsorption and limiting the patient's ability to eat large quantities of food.

Common Gastric Bypass Procedures

The most common gastric bypass surgery is a Roux-en-Y gastric bypass. The surgeon will create a small pouch at the top of the stomach using surgical staples. Next, he will connect this smaller pouch directly to the middle of the small intestine (called the jejunum). This causes the food to bypass the lower part of the stomach and the first part of the small intestine (called the duodenum).

Historically, the Roux-en-Y gastric bypass was does as an open procedure, which means the surgeon makes a large incision in the outer stomach wall to access the abdominal cavity. Today, the laparoscopic procedure is more common for those who qualify. This method is performed by making up to five small incisions in the outer stomach wall and using extremely small instruments and a tiny camera to guide them.

Risks and Benefits of Gastric Bypass Surgery

Typically, the surgery requires a two to six day hospital stay, depending on which procedure you have done. Usually, you can return to normal activities within three to five weeks. The type of work you do may require a longer convalescence period.

Some of the benefits of gastric bypass surgery are:

--Most people lose between 60% and 80% of their excess weight over a two to three year period. --The majority of patients manage to keep at least 50% of their excess weight off permanently. --Other obesity-related health problems, such as diabetes and high blood pressure, are often minimized or eliminated.

There are also several serious risks with gastric bypass surgery, such as:

--Peritonitis, a severe infection caused by a leak from the stomach into the abdominal cavity from a ruptured staple or stitch. --The possibility of a blood clot breaking away from the surgical area and getting caught in the lung (called a pulmonary embolism).

However, recent studies indicate that only about 2% to 3% of Roux-en-Y gastric bypass patients die within 90 days of the procedure. (Source: "Gastric Bypass - Let the Morbidly Obese Beware", by Neil Osterweil, Senior Associate Editor, MedPage Today.)

Common Side Effects of Gastric Bypass Surgery

Gastric bypass surgery can also cause several less serious short- and long-term side effects, such as:

--Dumping syndrome, which can occur when food moves too quickly through the small intestine. This disorder causes nausea, weakness, sweating, faintness, and possibly diarrhea soon after eating and is generally caused by eating highly refined foods, like sugars. --Developing gallstones or a nutritional deficiency, such as anemia or osteoporosis. --The connection between the stomach and the intestines can narrow, causing nausea and vomiting after eating. --Patients can develop stomach ulcers or a hernia. --The bypassed part of the stomach can enlarge, causing bloating and hiccups. Of course, any surgery has some risks associated with it. That is why it is essential that you consider all of the benefits and risks associated with gastric bypass surgery and talk them over with your doctor and perhaps even a mental health professional.