Bypass Surgery

Intragastric Balloon   |   Gastric Banding   |   Bypass Surgery

bypass.pngRaux-en Y gastric bypass (RYGBP), RYGBP
Combines restriction and malabsorption principles.
Biliopancreatic diversion (BPD), including the duodenal switch (BPD-DS) variation; and distal gastric bypass (DGBP) are other variety of procedures

Life after Weight Loss Surgery
It’s normal not to have an appetite for the first month or two after weight loss surgery. If you are able to consume liquids reasonably well, there is a level of confidence that your appetite will increase with time.

What should I do to get good results after surgery?

The basic rules are simple and easy to follow:

Immediately after surgery, you will be provided with special dietary guidelines.You will need to follow these guidelines closely.

In the first 2 weeks only liquid diets are allowed, then moving to semi-solid, pureed foods for another two weeks, and later, sometimes weeks or months later, solid foods can be tolerated without risk to the surgical procedure performed. The gastric band needs time to get fixed to the stomach to avoid complications
Eat 3 meals per day, no more. Protein in the form of eggs, low-fat cheese, low-fat cottage cheese, tofu, fish, other seafood, chicken (dark meat), turkey (dark meat).

  • Foods should be cooked without fat e. Avoid fatty sauces, gravies, butter, margarine, mayonnaise and junk foods.
  • Never eat between meals. Do not drink flavoured beverages, even diet soda, between meals.
  • Drink at least 2-3 litres of sugar free fluid, more of water each day. Water must be consumed slowly, 1-2 mouthfuls at a time.
  • Exercise aerobically every day for at least 30 minutes (brisk walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be added 3-4 days per week.

What is the right amount of exercise after weight loss surgery?
Exercise is an essential component of success after surgery. Exercise actually begins on the afternoon of weight loss surgery – the patient must be out of bed and walking. The goal is to walk further on the next day, and progressively further every day after that, including the first few weeks at home. The type of exercise is dictated by the patient’s overall condition. Some patients who have severe knee problems can’t walk well, but may be able to swim or bicycle. Many patients begin with low stress forms of exercise and are encouraged to progress to more vigorous activity when they are able.
Contact your original surgeon – he or she is most familiar with your medical history and can make recommendations based on knowledge of your surgical procedure and body.

bypass.pngIs pregnancy after weight loss surgery possible?
You should consult your surgeon as you plan for pregnancy
It is strongly recommended that women wait at least one year after the surgery before a pregnancy. Approximately one year post-operatively, your body will be fairly stable (from a weight and nutrition standpoint) and you should be able to carry a normally nourished fetus.

Oral contraception after surgery
Most patients have no difficulty in swallowing these pills.
In the case of bypass surgery.

What happens to the lower part of the stomach that is bypassed?
In some surgical procedures, the stomach is left in place with intact blood supply. In some cases it may shrink a bit and its lining (the mucosa) may atrophy, but for the most part it remains unchanged. The lower stomach still contributes to the function of the intestines even though it does not receive or process food – it makes intrinsic factor, necessary to absorb Vitamin B12 and contributes to hormone balance and motility of the intestines in ways that are not entirely known.

How big will the stomach pouch really be in the long run?
In the Roux-en-Y gastric bypass, the stomach pouch is created at one ounce or less in size (15-20cc). In the first few months it is rather stiff due to natural surgical inflammation. About 6-12 months after surgery, the stomach pouch can expand and will become more expandable as swelling subsides. Many patients end up with a meal capacity of 3-7 ounces.

What will the staples do inside the abdomen?
Is it okay in the future to have an MRI test?
Will I set off metal detectors in airports?

Each staple is a tiny piece of stainless steel or titanium. The staple materials are also non-magnetic, which means that they will not be affected by MRI. The staples will not set off airport metal detectors.

Taking medications
Most pills or capsules are small enough to pass through the new stomach pouch. Initially, your doctor may suggest that medications be taken in liquid form or crushed.
Most of the medication that need to be continued, can be swallowed, absorbed and work the same as before surgery. No change in dose is required.
Two classes of medications should be used only in consultation with the surgeon, these are diuretics (fluid pills) and NSAIDs (most over-the-counter pain medicines). NSAIDs (ibuprofen, naproxen, etc.) may create ulcers in the small pouch or the attached bowel.
Patient with high blood pressure and/or diabetes mellitus may have to readjust the dose of the medication, as these medical problems get better after weight loss surgery.

bypass.pngSexual activity
Patients can return to normal sexual intimacy when wound healing and discomfort permit. Many patients experience a drop in desire for about 6 weeks.

How to prevent lots of excess hanging skin?
Many people heavy enough to meet the surgical criteria for weight loss surgery have stretched their skin beyond the point from which it can “snap back.” hey have lost their excess weight.
Exercise is good in so many other ways that a regular exercise program is recommended. Unfortunately, most patients may still be left with large flaps of loose skin. In such cases plastic surgery me be needed to reduce the excess skin flaps.

What if you are really hungry?
This is usually caused by the types of food you may be consuming, especially starches (rice, pasta, potatoes). Be absolutely sure not to drink liquid with food since liquid washes food out of the pouch.

Hair loss after weight loss surgery? How can you prevent it?
Many patients experience some hair loss or thinning after surgery. This usually occurs between the fourth and the eighth month after surgery. Consistent intake of protein at mealtime is the most important prevention method. Also recommended are a daily zinc supplement and a good daily volume of fluid intake.
Most patients experience natural hair re-growth after the initial period of loss.

Snack between meal
Snacking, nibbling or grazing on foods, usually high-calorie and high-fat foods, can add hundreds of calories a day to your intake, defeating the restrictive effect of your operation. Snacking will slow down your weight loss and can lead to regain of weight.

Red meat after surgery
You can, but you will need to be very careful, and we recommend that you avoid it for the first several months. Red meats contain a high level of meat fibers (gristle) which hold the piece of meat together, preventing you from separating it into small parts when you chew. The gristle can plug the outlet of your stomach pouch and prevent anything from passing through, a condition that is very uncomfortable.

Spicy food
Most patients are able to enjoy spices after the initial 6 months following surgery.

bypass.pngDrinking alcohol
Even small amounts of alcohol will affect you quickly. It is suggested that you drink no alcohol for the first year. Thereafter, with your physician’s approval, you may have a glass of wine or a small cocktail.

Vitamins supplement?
Vitamin supplement is recommended, especially by patients with bypass surgery.
B12 injections are sometimes suggested once a month for the first year and every six months thereafter. B12 may also be taken orally or sublingually (under the tongue) by many patients.

Can weight loss surgery help other physical conditions?
A recent comprehensive clinical review of bariatric surgery data showed that patients who underwent a weight loss surgery procedure experienced complete resolution or improvement of their co-morbid conditions including diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea.

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