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Gastric Bypass Roux-en-Y
The Gastric Bypass causes both restriction and some malabsorption of food. The restriction comes from the small size of the new stomach pouch. The malabsorption
comes from the food bypassing a portion of the small intestine (the duodenum and a portion of the jejunum), so fewer calories and nutrients are absorbed. Studies show
that bypassing this portion of the upper digestive tract appears to result in increased levels of a hunger-suppressing hormone called GLP (glucagon-like polypeptide). This
hormone is also partly responsible for the improvement of blood sugar regulation in Type 2 diabetic patients immediately after surgery.
The new stomach pouch can hold about an ounce of food at one time. It is important that you consume food and liquids at a rate not to exceed one ounce every five
minutes. By eating larger amounts of food or by eating too fast, you may stretch the pouch over time.
The majority of your weight loss will occur during the first 12 to 18 months after surgery. The goal during this time is to develop the healthy eating and lifestyle habits that
will enable you to maintain the weight loss for the rest of your life!
Patients who learn to make these dietary and lifestyle changes are able to achieve sustained weight loss. Patients who do not fully commit to the necessary dietary
lifestyle changes may see weight regain. At about 2 years out from surgery, those patients who have not seen weight re-gain when grazing (cheating a little here or there)
and not paying attention to those additional calories being consumed will start to see the weight coming back.
What changes occur to the digestive system after gastric bypass surgery?
The first physical change that occurs is that the size of your stomach is made smaller. The stomach is separated into 2 parts. Your smaller stomach is referred to
as a pouch, which is about the size of an egg.
The stomach is separated with the use of staples to create the small pouch. The small stomach pouch causes the restrictive part of the gastric bypass surgery.
The remaining part of the stomach is left in place to continue producing digestive juices.
The middle part of the small intestine (jejunum) is cut and one part is brought up to the stomach pouch where it is attached (anastomosed) to create the bypass
effect for food. This attachment site is called a gastro-jejunostomy. The food now bypasses the large part of the stomach and the first part of the small intestine
causing malabsorption of food. Malabsorption means a decreased absorption of calories/nutrients.
The other end of the small intestine is attached (anastomosis) back to the small intestine (jejunum). This limb is also known as the Bilio-pancreatic limb. This limb
carries digestive juices from the remaining stomach, pancreas, liver and duodenum into the lower portion of the small intestine.
Gastric Bypass Advantages
The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with purely restrictive procedures.
One year after surgery, weight loss can average 77% of excess body weight.
Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by some patients.
A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and
depression) were improved or resolved.
Gastric bypass surgery results in the complete remission or significant improvement of type 2 diabetes.