Monday, June 24, 2013

Basic Facts Regarding Weight Reduction Surgery

By Kathy Kaufman


Weight reduction surgery or bariatric surgery describes a series of surgical procedures that are performed on obese persons. In the process the stomach is reduced in size by removing a portion. This is achieved by use of what is referred to as sleeve gastrectomy or a simple gastric band. Another option involves the resection and diversion of the small gut to the stomach. Such a procedure is very beneficial to persons that have underlying medical conditions such as diabetes and hypertension. It reduces the risk of complications in these persons.

It is recommended for people with a minimum body mass index of forty and those with existing medical conditions in which obesity is a predisposing factor. Such conditions may include diabetes, hyperlipidaemia, hypertension and impaired glucose tolerance. Surgery is considered when all other programs including exercise, diet and drug therapy have failed.

Pros and cons of such a procedure should be taken into account before the procedure is done. Certain post-operative complications such as gall bladder disease and malabsorption may arise. Psychiatric screening should also be done as there is possibility of patients falling in to depression after the operation.

There are three main categories of surgery to consider. They broadly include the restrictive, malabsorptive and mixed. The malabsorptive technique is one that results in a malabsorption state of the gut. An example here is what is referred to as billiopancreatic diversion with duodenal stitch or BDS/DS. What this means is that a portion of the stomach is cut and removed and the remaining is fashioned into a smaller pouch that is connected to the small intestine bypassing the jejunum and duodenum. Side effects are mainly related to vitamin and mineral deficiency.

Restrictive procedures are done to reduce the amount of food eaten by reducing the size of the stomach. The person that has had this surgery will usually experience earlier satiety than was the case in the previously. A common technique used to achieve this is the vertical banded gastroplasty. In this technique, permanent staples are put on the stomach and this effectively reduces the volume.

In sleeve gastrectomy, the stomach is reduced to 85% its original size. A huge portion of the stomach following the greater curvature is removed. This makes the stomach look more like a tube or shaped like a banana. It is a permanent procedure done under laparoscopy. Although the volume of the stomach is reduced, it still works normally and the patient can be able to take in small amounts of food at a time.

There is a need to make dietary changes after operation. The food types that should be taken include liquids such as broth, juices and sugar-free gelatin desserts. These should be maintained until full recovery of the gut takes place. As one recovers, the next foods to be introduced include blended substances that should also be sugar free.

Adverse effects of weight reduction surgery are common. Due to reduced calcium absorption, patients can develop metabolic bone disease in form of secondary hyperparathyroidism and osteopenia. Rapid weight loss can also result in gallstones. In addition, reduced absorption of nutrients such as thiamine, folate, iron and vitamin B12 can lead to nutritional derangements. Defective renal handling has also been reported.




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