Roux-en-Y Gastric Bypass Procedure: Pros and Cons

Risks Associated with Roux-en-Y Gastric Bypass May Not Outweigh the Benefits of Roux-en-Y Gastric Bypass Procedure

During a Roux-en-Y gastric bypass procedure, the stomach is divided. One section of the stomach is formed into a pouch the size of an egg. This pouch is reattached at a midpoint of the small intestine, effectively bypassing part of the small intestine. Making the stomach smaller restricts the amount the patient eats and helps the patient feel full sooner. The process of circumventing a portion of the small intestine creates a detour around sections of the tract that would otherwise aid in food absorption, thereby reducing the amount of food that is absorbed. This process of malabsorption causes the patient to lose additional weight. A brief guide of some important pros and cons of Roux-en-Y gastric bypass, or RYGB, will help you decide whether this procedure is right for you and what questions to ask your physician.

Excess Weight Puts the Heart at Risk

Weight loss isn’t the only advantage of RYGB. Once you start shedding pounds, your risk of developing obesity-related illnesses lowers, and preexisting conditions can go into remission.

Being overweight raises the risk of coronary heart disease, or CHD. CHD is the buildup of wax-like plaque in the coronary arteries, which connect oxygen-rich blood with the heart. Hardened plaque can rupture, forming a blood clot, and the clot can travel to your heart, causing a heart attack, or to your brain, causing stroke.

Obesity can lead to hypertension, which can lead to CHD, heart failure, kidney failure, and stroke. The entire body may suffer damage from hypertension. High blood fats plague people who are obese and reduce the amount of good cholesterol in the body and increase bad cholesterol and triglycerides. Metabolic syndrome, which increases risk of CHD, stroke, and diabetes, poses a threat to those who are overweight.

Obesity Often Causes Type 2 Diabetes

Those with increased body fat also have a greater risk for type 2 diabetes. The American Diabetes Society calculates almost twenty-one million people in the United States have type 2 diabetes, and fifty-four million people have prediabetes. Of those with the condition, the Center for Disease Control lists 51 percent as having a body mass index, or BMI, of at least 30, and 80 percent of this latter group have a BMI of at least 35.

Roux-en-Y gastric bypass is highly effective against metabolic disease such as type 2 diabetes, high cholesterol, hypertension, and sleep apnea. The Journal of the American Medical Association published statistics for bariatric surgery patients in 2004. The remission rate among these patients for type 2 diabetes was 76.8 percent. Hypertension was eliminated in 61.7 percent of patients. High cholesterol was reduced by over 70 percent for patients, and sleep apnea was eliminated for 85.7 percent of them.

Nutrient Deficiencies Following Gastric Bypass

The process of creating malabsorption in a Roux-en-Y patient’s digestive tract has ill effects as well as good ones. Fatty foods bypass absorption, but essential vitamins and minerals remain unabsorbed for the same reason. This can cause severe deficiencies of calcium and iron, potentially leading to anemia and osteoporosis. Lack of Vitamin A may cause night blindness. In addition, these patients suffer from deficiencies of B, D, E, and K vitamins. Patients are prescribed supplements to combat this deficit of nutrients, and most have no problems. Lifetime visits with the surgeon and regular blood tests are required following Roux-en-Y. These regular habits keep physicians apprised of any health issues. Patients who fail to follow their vitamin, exercise, and post surgery diet plan are often the ones who experience problems.

Digestive Tract Adapts after Surgery

Slow or halted weight loss has been reported by some patients. It’s possible for the altered digestive tract to adapt to the changes made during surgery and to begin absorbing larger quantities of food, but it is not common. Patients who undergo gastric bypass surgery hit plateaus in their weight loss. They usually report having lost more than forty pounds when the weight loss stalls. It is normal for anyone to plateau with weight loss or strength training, and many of the patients begin losing weight again after several months.

Leakage and Dumping Syndrome

Sometimes, leakage occurs at the staple line where the intestines and stomach are attached. Digestive juices and sometimes food can escape the digestive tract. This can become serious, but it is normally caught and treated with medicine. Leakage occurs in 1 to 2 percent of patients, and on rare occasions, emergency surgery must be performed.

Gastric dumping syndrome occurs when digestive juices carry food too quickly to the small intestine. Symptoms include flushing, fainting, diarrhea, nausea, and rapid heartbeat. If following your prescribed diet does not stop the problem, you will be prescribed medication. A second surgery is rarely necessary.

Strictures, Hernia, and Gallstone

When the passage from your stomach to your intestines starts to narrow, it is called a stricture. The passage is easily reopened with a simple balloon procedure, and surgery isn’t necessary. Hernias may occur at the incision site as well as near the intestines. Gallstones commonly form after surgery. If the doctor doesn’t choose to remove the gallbladder, you will receive medicine to prevent gallstones.

Comparison of Pros and Cons

Although complications may arise in RYGB patients, they do not happen frequently. Problems are usually solved with a change in diet or medicine. As with other surgeries requiring anesthesia, a slight risk of death is involved. It is important to know that the surgery is not reversible, since so much of the stomach is removed. Serious problems can be surgically corrected, however. If you suffer a comorbid condition such as sleep apnea or type 2 diabetes, you should speak with a health-care professional. An evaluation by a doctor is necessary to judge how the surgery may affect you and your conditions. According to statistics, it’s common for a postoperative Roux-en-Y gastric bypass patient to eventually see improvement in all comorbid conditions.