Weight reduction surgery, also called bariatric surgery refers to a series of procedures carried out on overweight people. The size of the stomach is either reduced or a portion of it removed. This is possible either through use of a gastric band or sleeve gastrectomy respectively. Gastric bypass can also be done by resecting and diverting the small intestine to the stomach. Research has shown that this procedure helps in improving the condition of diabetic patients and reducing the risk of cardiovascular risks.
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.
There are a number of advantages and disadvantages associated with this surgery. All these need to be taken into account before a decision is made on whether the procedure is necessary. Some of the possible complications that should be anticipated include malabsorption of nutrients and gall bladder disease. The risk of depression is also high and as such these persons should be counselled.
Surgical procedures are grouped in to three main categories. These are malabsorptive, restrictive or mixed. The most commonly performed is the malabsorptive procedure. Malabsorptive operations aim at creating a physiological state of malabsorption. Biliopancreatic diversion combined with duodenal switch (BDS/DS) is one such undertaking. A section of the stomach is resected, creating a smaller pouch which is then directly connected to the ileum, bypassing the duodenum and jejunum. The malabsorption that results can be severe enough to cause serious deficiency diseases such as osteoporosis and anemia unless vitamins and mineral supplements are administered.
The restrictive procedure is one that minimizes eating by restricting the stomach volume. Persons that have undergone this type often get satisfied earlier than normal. Vertical banded gastroplasty is one of the procedures that can be used here. It involves the permanent placement of staples on the stomach in a manner that results in the creation of a smaller pouch. It is the safest.
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.
In the immediate post-operation period, one should only take liquid foods such as fruit juices and broth and gelatin desserts which are sugar-free. One should eat these foods until the gut fully recovers from the operation. Other diets to be introduced slowly include skimmed milk, cream soup, protein drinks and blended foods.
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.
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.
There are a number of advantages and disadvantages associated with this surgery. All these need to be taken into account before a decision is made on whether the procedure is necessary. Some of the possible complications that should be anticipated include malabsorption of nutrients and gall bladder disease. The risk of depression is also high and as such these persons should be counselled.
Surgical procedures are grouped in to three main categories. These are malabsorptive, restrictive or mixed. The most commonly performed is the malabsorptive procedure. Malabsorptive operations aim at creating a physiological state of malabsorption. Biliopancreatic diversion combined with duodenal switch (BDS/DS) is one such undertaking. A section of the stomach is resected, creating a smaller pouch which is then directly connected to the ileum, bypassing the duodenum and jejunum. The malabsorption that results can be severe enough to cause serious deficiency diseases such as osteoporosis and anemia unless vitamins and mineral supplements are administered.
The restrictive procedure is one that minimizes eating by restricting the stomach volume. Persons that have undergone this type often get satisfied earlier than normal. Vertical banded gastroplasty is one of the procedures that can be used here. It involves the permanent placement of staples on the stomach in a manner that results in the creation of a smaller pouch. It is the safest.
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.
In the immediate post-operation period, one should only take liquid foods such as fruit juices and broth and gelatin desserts which are sugar-free. One should eat these foods until the gut fully recovers from the operation. Other diets to be introduced slowly include skimmed milk, cream soup, protein drinks and blended foods.
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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