Gastric bypass surgery

Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat.

After the surgery, your stomach will be smaller. You will feel full with less food.

The food you eat will no longer go into some parts of your stomach and small intestine that absorb food. Because of this, your body will not get all of the calories from the food you eat.

Why the Procedure is Performed

Weight-loss surgery may be an option if you are very obese and have not been able to lose weight through diet and exercise.

Doctors often use the body mass index (BMI) and health conditions such as type 2 diabetes (diabetes that started in adulthood) and high blood pressure to determine which people are most likely to benefit from weight-loss surgery.

Gastric bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of what you eat, and exercise. If you do not follow these measures, you may have complications from the surgery and poor weight loss.

Be sure to discuss the benefits and risks with your surgeon.

This procedure may be recommended if you have:

  • BMI of 40 or more. Someone with a BMI of 40 or more is at least 100 pounds (45 kilograms) over their recommended weight. A normal BMI is between 18.5 and 25.
  • A BMI of 35 or more and a serious medical condition that might improve with weight loss. Some of these conditions are obstructive sleep apnea, type 2 diabetes, and heart disease.

Risks

Gastric bypass is major surgery and it has many risks. Some of these risks are very serious. You should discuss these risks with your surgeon.

Risks of having anesthesia and surgery in general include:

  • Allergic reactions to medicines
  • Breathing problems
  • Bleeding, blood clots, infection
  • Heart problems

Risks for gastric bypass include:

  • Gastritis (inflamed stomach lining), heartburn, or stomach ulcers
  • Injury to the stomach, intestines, or other organs during surgery
  • Leaking from the line where parts of the stomach have been stapled together
  • Poor nutrition
  • Scarring inside your belly that could lead to a blockage in your bowel in the future
  • Vomiting from eating more than your stomach pouch can hold

Before the Procedure

Your surgeon will ask you to have tests and visits with other health care providers before you have this surgery. Some of these are:

  • A complete physical exam.
  • Blood tests, ultrasound of your gallbladder, and other tests to make sure you are healthy enough to have surgery.
  • Visits with your doctor to make sure other medical problems you may have, such as diabetes, high blood pressure, and heart or lung problems, are under control.
  • Nutritional counseling.
  • Classes to help you learn what happens during the surgery, what you should expect afterward, and what risks or problems may occur afterward.
  • You may want to visit with a counselor to make sure you are emotionally ready for this surgery. You must be able to make major changes in your lifestyle after surgery.

If you smoke, you should stop several weeks before surgery and not start smoking again after surgery. Smoking slows recovery and increases the risks for problems. Tell your doctor or nurse if you need help quitting.

Tell your surgeon or nurse:

  • If you are or might be pregnant
  • What medicines, vitamins, herbs, and other supplements you are taking, even ones you bought without a prescription

During the week before your surgery:

  • You may be asked to stop taking medicines that make it hard for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and others.
  • Ask your doctor which medicines you should still take on the day of your surgery.
  • Prepare your home for after the surgery.

On the day of surgery:

  • Follow instructions about when to stop eating and drinking.
  • Take the medicines your doctor told you to take with a small sip of water.
  • Arrive at the hospital on time.

After the Procedure

Most people stay in the hospital for 1 to 4 days after surgery.

In the hospital:

  • You will be asked to sit on the side of the bed and walk a little on the same day you have surgery.
  • You may have a (tube) catheter that goes through your nose into your stomach for 1 or 2 days. This tube helps drain fluids from your intestine.
  • You may have a catheter in your bladder to remove urine.
  • You will not be able to eat for the first 1 to 3 days. After that, you can have liquids and then pureed or soft foods.
  • You may have a tube connected to the larger part of your stomach that was bypassed. The catheter will come out of your side and will drain fluids.
  • You will wear special stockings on your legs to help prevent blood clots from forming.
  • You will receive shots of medicine to prevent blood clots.
  • You will receive pain medicine. You will take pills for pain or receive pain medicine through an IV, a catheter that goes into your vein.

You will be able to go home when:

  • You can eat liquid or pureed food without vomiting.
  • You can move around without a lot of pain.
  • You do not need pain medicine through an IV or given by shot.