Gastric Bypass
What is gastric bypass?
Gastric bypass is the most widely performed surgical procedure for weight-loss. Gastric bypass works in two ways: by restricting large amounts of food and through the malabsorption (difficulty absorbing) of nutrients from food.
Patients simply can't eat as much as they did before surgery, because this new, small pouch has a lessened capacity to hold food. Because most of the stomach and some of the small intestine has been bypassed, some of the nutrients and calories in your foods will not be absorbed. Additionally, the stomach can now only hold a few ounces of food at a time, causing significant weight loss.
What does gastric bypass surgery entail?
A small thumb-sized pouch is created at the top of the stomach. The remainder of the stomach is not removed, but is completely divided from the stomach pouch. The small intestine is divided and rearranged to provide an outlet to the small stomach, while maintaining the flow of digestive juices at the same time. Food enters the second part of the small intestine within about ten minutes of beginning the meal.
What are the different types of gastric bypass surgery?
There are two common types of gastric bypass surgery: laparoscopic and open.
Laparoscopic Procedure
Specially designed instruments are inserted through small incisions into the abdomen. Surgical video cameras called laparoscopes are also inserted so the surgeon can see inside the body. Surgeons watch on monitors as they perform the surgery.
Open Incision Procedure
This procedure involves a major incision from the breast-bone to the belly-button.
What is recovery from gastric bypass like?
Gastric bypass is major abdominal surgery; your body will need time to adjust. It's common to experience nausea and pain, some fatigue and in some cases depression may occur. These occurrences are generally short-lived.
Expectations for “the time to heal” may be distorted. It is true that with the laparoscopic approach, physical healing time may be faster than with the open technique (two to four weeks instead of four to six weeks). Forming a scab, however, does not constitute complete healing. Many patients feel fatigue, experience nausea and even vomit frequently for the first 2 - 12 weeks following their operation.
It is important that patients do not expect to go back to work at full speed right away. Many patients go back to work as early as two to four weeks, but you may need longer. It would be beneficial to have contingency plans in place. Your surgeon and care team will determine what will work best with your recovery.
Food Plan
Your new stomach will be irritable for the first several weeks following surgery. You will start on clear liquids (water, broth and Jell-O) for a week, and then advance to soft proteins and eventually to all varieties of food.
Gastric surgery may cause some patients to experience a heightened sense of smell. Food, perfume and cigarette smoke may be offensive and cause nausea. If nausea or complete lack of appetite occurs in the early postoperative phase; you can expect those symptoms to generally resolve in four to six weeks. By three to four months, nearly everyone is able to tolerate most food well.
Many patients feel frustrated, weepy and even depressed after surgery. This is a common occurrence, and a normal part of the physical and emotional healing process. For a very long time, you have been focusing on having this life-altering procedure. You may feel an emotional letdown as your energy reserves are drained. Be positive, this too will pass, and in a few weeks to months, your energy and positive attitude will return. Psychological support, counseling and/or medications may be helpful for some.
If you are a patient who feels more pain than you expected, or experience nausea or depression, remember this can be normal. What you eat one day may stay down and the exact same meal tomorrow may not. We will want you to call the office if you vomit all food and liquid in a 24-hour period. The caring nursing staff at Mercy is here to help you adjust to the unexpected. Do NOT hesitate to ask questions.
What can I expect after my recovery?
Your anatomy is changed significantly by gastric bypass and thus requires a very careful dietary plan. After surgery it’s important to note that:
- Food will not go into the lower part of your stomach or the first portion of your small intestine, but both will still contribute enzymes for digestion in the lower intestines. Because the pouch restricts what you can eat, overeating can cause pain, nausea and vomiting.
- Foods that are high in sugar can dump into the intestines and cause severe nausea and diarrhea.
- Alcohol similarly can be absorbed quickly and can cause toxicity at surprisingly low levels.
- Decreased absorption of certain vitamins and minerals means all bypass patients require lifetime vitamin and calcium supplements.
