Gastric bypass surgery is a weight loss method used for individuals 100 or more pounds overweight, or for those close to 100 pounds overweight with a significant medical condition such as high blood pressure or diabetes. Gastric bypass is not without risk; however, informed and motivated patients are more successful than patients who fail to consider all possible outcomes.
Safety
A National Institute of Health (NIH) study reported in the July 2009 New England Journal of Medicine "found the risks of bariatric surgery have dropped dramatically and now are no greater than gallbladder or hip replacement surgery." The mortality rate from either Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding was found to be only 0.3 percent at 30 days after surgery. The study tracked 4776 patients at 10 hospitals from 2005 to 2007 and is the first large-scale study of its kind.
Surgical Complications
Surgical risks include reactions to anesthesia, difficulty breathing, blood loss, blood clots, heart attack or stroke during the procedure, injury to other organs surrounding the surgical site and death. Of these, the most common complication is blood clots, developing in the legs and traveling to the lungs, brain or heart. The use of intermittent pneumatic compression--soft boots applying pressure to the legs while lying prone--has dramatically reduced the incidence of potentially fatal blood clots.
Short-term Complications
In the initial weeks after gastric bypass surgery, the primary complications are wound infection and, with malabsorptive procedures which alter the structure and connectivity of the stomach and small intestine (such as the Roux-en-Y gastric bypass), leaks along the suture or staple line, requiring emergency surgery to correct. The incidence of wound infection is lower with laparoscopic procedures than those requiring a large incision. Vomiting due to overeating is common in the early weeks as getting used to a much smaller stomach takes time and experience.
Nutritional Complications
With malabsorptive procedures, such as the Roux-en-Y gastric bypass, the body's ability to gather vitamins and minerals from food is altered. In particular, vitamins B1 (thiamine) and B12, folic acid, iron and calcium may be affected. A daily multivitamin plus an iron supplement are required. Chewable calcium supplements are highly recommended to reduce or delay the onset of osteoporosis. B12 shots or nasal spray may be prescribed.
With all types of gastric bypass procedures, it is important to maintain a healthy balance of food types rather than gravitate toward a few staples. Eating several small meals a day--instead of just three--with different food groups at different times can help.
Other Complications
Psychological and emotional complications are often ignored but can be as troubling as physical complications. Eating very small portions while others feast on a buffet can be emotionally difficult, especially in the early weeks. Family and friends reaction to weight loss can also have a big impact on well-being--both positively and negatively. Support groups are very helpful in dealing with these types of complications, but don't be afraid to seek professional assistance to help with the adjustment.
