Gastric Bypass: Healthy Performance

GASTRIC BYPASS SURGERY/G.I. ISSUES

Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss.

The most common gastric bypass surgery is a Roux-en-Y gastric bypass.

In normal digestion, food passes through the stomach and enters the small intestine, where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted.

In a Roux-en-Y gastric bypass, the stomach is made smaller by creating a small pouch at the top of the stomach using surgical staples or a plastic band. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum).

This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach).

What To Expect After Surgery

Most people can return to their normal activities in 3 to 5 weeks.

After surgery, you'll need to make big, permanent changes in how you eat:

You can eat only a few ounces of food at a time. Your new stomach will only hold a tiny amount of food.
You must eat very slowly and chew your food to mush. Otherwise, you may vomit often and have pain.
You won't be able to drink for 30 minutes before you eat, during your meal, and for 30 minutes after you eat. There won't be room in your stomach for both drinks and solid food.
You probably will need to take vitamins and supplements like the ones listed above from Healthy Performance.
You may have to avoid foods that contain simple sugars-like candy, juices, ice cream, condiments, and soft drinks. Simple sugars may cause a problem called dumping syndrome. This happens because food moves too quickly through the stomach and intestines. It can cause shaking, sweating, dizziness, rapid heart rate, and often severe diarrhea.

Other Gastrointestinal Disorders

Functional disorders are those in which the bowel looks normal but doesn’t work properly. They are the most common problems affecting the colon and rectum, and include constipation and irritable bowel syndrome (IBS). The primary causes for functional disorders include:

Eating a diet low in fiber
Not getting enough exercise
Traveling or other changes in routine
Eating large amounts of dairy products
Being stressed
Resisting the urge to have a bowel movement
Resisting the urge to have bowel movements due to pain from hemorrhoids
Overusing laxatives (stool softeners) that, over time, weaken the bowel muscles
Taking antacid medicines containing calcium or aluminum
Taking certain medicines (especially antidepressants, iron pills, and strong pain medicines such as narcotics)
Being pregnant

Constipation is the difficult passage of stools (bowel movements) or the infrequent (less than three times a week) or incomplete passage of stools. Constipation is usually caused by inadequate "roughage" or fiber in the diet, or a disruption of the regular routine or diet. Constipation causes a person to strain during a bowel movement. It might include small, hard stools, and sometimes causes anal problems such as fissures and hemorrhoids. Constipation is rarely the sign of a more serious medical condition.

Treatment of constipation includes increasing the amount of fiber you eat, exercising regularly, and moving your bowels when you have the urge (resisting the urge causes constipation). If these treatment methods don’t work, laxatives are a temporary solution. Note that the overuse of laxatives can actually aggravate symptoms of constipation. Always follow the package instructions on the laxative medicine, as well as the advice of your doctor.

Irritable bowel syndrome (IBS) (also called spastic colon, irritable colon, or nervous stomach) is a condition in which the colon muscle contracts more readily than in people without IBS. A number of factors can trigger IBS including certain foods, medicines, and emotional stress. Symptoms of IBS include abdominal pain and cramps, excess gas, bloating, and a change in bowel habits such as harder, looser, or more urgent stools than normal. Often people with IBS have alternating constipation and diarrhea.

Treatment includes avoiding caffeine, increasing fiber in the diet, monitoring which foods trigger IBS (and avoiding these foods), minimizing stress or learning different ways to cope with stress, and sometimes taking medicines as prescribed by your health care provider.

Structural disorders are those in which the bowel looks abnormal and doesn’t work properly. Sometimes, the structural abnormality needs to be removed surgically. The most common structural disorders are those affecting the anus, as well as diverticular disease and cancer.

Hemorrhoids are swollen blood vessels that line the anal opening caused by chronic excess pressure from straining during a bowel movement, persistent diarrhea, or pregnancy. There are two types of hemorrhoids: internal and external.

Internal hemorrhoids are normal structures cushioning the lower rectum and protecting it from damage by stool. When they fall down into the anus as a result of straining, they become irritated and start to bleed. Ultimately, internal hemorrhoids can fall down enough to prolapse (sink or protrude) out of the anus. Treatment includes improving bowel habits (such as avoiding constipation, not straining during bowel movements, and moving your bowels when you have the urge), using elastic bands to pull the internal hemorrhoids back into the rectum, or removing them surgically. Surgery is needed only for a small number patients with very large, painful, and persistent hemorrhoids.

External hemorrhoids are veins that lie just under the skin on the outside of the anus. Sometimes, after straining, the external hemorrhoidal veins burst and a blood clot forms under the skin. This very painful condition is called a pile. Treatment includes removing the clot and vein under local anesthesia in the doctor’s office.

Diverticulosis is the presence of small outpouchings (diverticula) in the muscular wall of the large intestine that form in weakened areas of the bowel. They usually occur in the sigmoid colon, the high-pressure area of the lower large intestine.

Diverticular disease is very common and occurs in 10 percent of people over age 40 and in 50 percent of people over age 60 in Western cultures. It is often caused by too little roughage (fiber) in the diet. Diverticulosis rarely causes symptoms.

Complications of diverticular disease happen in about 10 percent of people with outpouchings. They include infection or inflammation (diverticulitis), bleeding, and obstruction. Treatment of diverticulitis includes antibiotics, increased fluids, and a special diet. Surgery is needed in about half the patients who have complications to remove the involved segment of the colon.

There are several types of colitis, conditions that cause an inflammation of the bowel. These include:

Infectious colitis
Ulcerative colitis (cause not known)
Crohn's disease (cause not known)
Ischemic colitis (caused by not enough blood going to the colon)
Radiation colitis (after radiotherapy)

Colitis causes diarrhea, rectal bleeding, abdominal cramps, and urgency (frequent and immediate need to empty the bowels). Treatment depends on the diagnosis, which is made by colonoscopy and biopsy.