Malabsorption syndrome: Its consequences and the usefulness of evidence-based practice Gastric bypass surgery has been found to be profoundly helpful for some morbidly obese individuals who have struggled to reach a healthy weight using the tools of diet and exercise alone. However, the surgery is a serious undertaking and should not be regarded as a 'quick fix.' One of the most common complications of gastric bypass surgery is malabsorption syndrome. To some extent, the purpose of the surgery is interrelated with this unpleasant 'side effect.' Through the surgery, "the food stream is rerouted so that approximately 60% of the small intestine (the primary site for the absorption of nutrients) is bypassed" (Bariatric Surgery, 2013, ASMB). Because food is in contact with the small intestine for a shorter period of time than in normal individuals, fewer nutrients can be used by the body. On one hand, this has a positive effect in the sense that fewer calories and carbohydrates are available. On the other hand, this also means that fewer vital nutrients can be extracted to support vital life functions. Patients must often consume nutritional supplements to counteract this effect of the surgery. Secondly, "by virtue of this food rerouting, there is less mixing with bile and pancreatic enzymes. Contact with bile is necessary for absorption of fat, and pancreatic enzymes are necessary to break down proteins, fats and complex carbohydrates for absorption. The mixing of
G.) Would absorption of nutrients be substantially altered in the small intestine following Chloe’s gastric bypass surgery?
There seem to be an increasing application of Roen-en-Y gastric bypass today by some surgeons. This is a restrictive procedure that has minimal mal-absorption issues and it makes part of an array of bariatric surgeries. However, the most commonly used procedure is biliopancreatic diversion or Scopinaro, which have been used for more than two decades and are popular in with many surgeons more so in the developing countries. This process is intended to inhibit absorption of fat in a bid to trigger massive weight loss in patients who are morbidly obese. It restricts gastric thereby diverting bile and pancreatic fluids to the distal ileum (Consensus Development Conference Panel, 1991). This procedure therefore exposes a limited area of small bowel for the absorption of nutrients that need biliary and pancreatic fluids. The procedure and its variations are still common as indicated above including; biliopancreatic diversion with duodenal switch, which also result in malabsorption. It is however noted that most patients who undergo this procedure also experience severe protein and fat related malabsorption problems.
When it comes to surgery, there is an intensive pre-operative and post-operative procedure to ensure that the patient is well-prepared and healing mentally and physically, respectively. Now depending on the type of surgery performed, there are a specific set of health risks. Two types of weight loss surgery are currently being utilized, Roux-en-Y gastric bypass, a form of stomach stapling to curb food intake, and adjustable gastric banding, a placing of an adjustable band around the stomach to restrict food intake. With Roux-en Y Gastric Bypass, the health risks include Infection at incision points, narrowed links between the stomach and the intestines, loosened staples, vomiting, diarrhea, and hernia. Gastric Banding has health risks, including bleeding, infection, erosion of the band into the inside of the stomach, blockage of the stoma, and band slippage, occurring when moderate food intake does not take place, thus inducing vomiting. Other concerns for both these types of surgery is the after effect and the true effectiveness of the procedure, and the careful and strict adherence to diet, exercise, mental support groups, body contouring, etc. A 2006 group of obese teens who have undergone surgery will be interviewed again in 2011 to determine the actual effectiveness of their
Weight loss surgery, also known as bariatric surgery is recommended by many physicians to people who are unable to benefit from traditional weight loss methods. However, choosing to undergo weight loss surgery isn’t an easy decision. It is an important decision that will drastically and permanently impact a person’s life. Therefore, before making such a significant decision, an individual should be aware of both the risks and benefits associated with weight loss surgery (McGowan & Chopra ix).
Gastric bypass is a surgical procedure that involves removing a large chunk of your stomach and attaching the remainder to your small intestine, making you feel full with less food. I’ve chosen this weight loss surgery as the method for you because of its speedy surgery and easiness. In the article “Reversal of Type 2 Diabetes Mellitus
Surgeons’ have an easy approach to doing the surgery. They have more of the right tools to do the procedure with. It results in the surgery being done correctly. Those who have gastric bypass know it is not an easy ticket out. This surgery is to help reduce and keep weight off; those that experienced it have to manage their diet, physical activity and psychological change. There required to think positive about their weight loss approach. Although, many insurers cover this surgery (“Is”). Most people who qualify are afraid to get the procedures, but bariatric surgery has been proven to be effective” Is gastric surgery the solution to America’s Obesity problem? Well for most of it yes, according to research more people are starting to get gastric surgery than a little bit. There are more people who have decided to get this procedure done. However, obesity may explain why weight loss interventions accumulate financial and social support in the past may prove to be the ultimate expansion of gastric surgery
In their meta-analysis, Treadwell and colleagues reviewed post–gastric bypass complications in six studies that included a total of 131 patients. No operation related hospital deaths occurred, but one death occurred in a child 9 months after gastric bypass who contracted severe Clostridium difficile colitis and experienced multisystem organ failure. Shock, pulmonary embolism, postoperative bleeding, severe malnutrition, and bowel obstruction occurred postoperatively, but because of variability in the way these complications were reported, the authors of the meta-analysis were unable to calculate actual incidences. Protein-calorie malnutrition and micronutrient deficiency were also reported, but their overall incidence in adolescents was unclear
In Bijal P. Trivedi’s report, “The Bypass Cure” she details the history of gastric bypass surgery, its effect on type 2 diabetes, and the how one doctor is using his understanding of modern gastric bypass applications to save the life’s of his patients. The patient, Nancy Rubio was nearly twice the normal weight of a person her height. Her weight had slowly increased throughout her life, due to her unhealthy diet and having two kids. She eventually developed type two diabetes, which then led to other health issues, such as arthritic knee pain, high blood pressure, cholesterol and blood sugar. Fearing for her life, Rubio opted to receive a modern version of the Roux-en-Y. The Roux-en-Y involves reducing the lining of the stomach to a small pouch, which reduces the patient’s appetite and eating. The pouch is then connected to the lower section of the intestine. Do the nature of the surgery Rubio will lose weight very fast, but miraculously have her type 2 diabetes become remitted or possibly abolished.
Rationale: Roux-en-Y gastric bypass surgery is a surgery that bypassed the distal stomach, duodenum, and proximal jejunum while creates a gastric pouch to help with drainage and to avoid bile reflex. After this surgery, patients will experience malabsorption including nutrition and medications. The absorption of the
SIBO is considered a malabsorption syndrome. The intestinal microbiota are crucial for the integrity and function of the GI tract. They help protect the body from pathogens, stimulate the immune system, and even help synthesize vitamins and nutrients (Gasbarrini, et al., 2007). In SIBO, there are bacteria in excess that interfere with metabolism and absorption of carbohydrates, proteins, lipids, and vitamins. Common symptoms of SIBO include diarrhea, steatorrhea, chronic abdominal pain, bloating, and flatulence (Uday, et al., 2017). Diarrhea is caused by metabolites of the bacteria that have enterotoxic effects, such as ammonia, peptidoglycans, D-lactate, and serum amyloid-A (Uday, et al., 2017). These toxins promote inflammation and damage
“Indeed, intermittent fasting might achieve much of the benefit seen with bariatric surgery, but without the costs, restriction on numbers and risks associated with surgery.”
Only a few studies in nursing research provide some kind of study that looks into experiences of patients who choose to undergo bariatric surgical procedures or investigation. Within the growth of science in bariatric nursing, there is that need of information to support both the patient that is receiving the care and the physician that is providing the care and the support. In this time of continues growth in this bariatric procedures, it is a most that all healthcare providers initiate and Evaluate necessary changes in practice that will enhance the well-being and health of patients that undergo this procedure. With the current increase in the rate of obesity, people have now turned to bariatric surgery because they
Digestion occurred in tube 1 because it contained the lipids, bile salts, and pancreatic lipase. The rate of digestion was also faster because of the presence of
Significance: Pancreaticoduodenectomy (PD) is the treatment of choice for periampullary cancer and precancerous tumor. The physiologic change after PD might be thought very similar with Roux-en-Y Gastric Bypass surgery (RYGB). Among reasons which cause similar physiologic change, total resection of duodenum is one of those reasons. Several evidences suggest that the duodenum is a key metabolic signaling center and the mucosal surface may manifest with some form of maladaptation when exposed to unhealthy nutrients through fat and sugar ingestion. These imply a role of the duodenum in regulating insulin action and developing pathogenesis of related metabolic diseases, including obesity. This is main hypothesis of duodenal mucosal resurfacing and duodenal-jejunal bypass liner, EndoBarrier Gastrointestinal Liner, for morbid obesity patients.
The purpose of the study was to determine the efficacy of a specialized diet in the late postoperative stage of a 68-year-old patient who had underwent several bowel resections; this patient had, but was not diagnosed with, protein-energy malnutrition, as well as intestinal insufficiency and high-output ileostomy. Due to postoperative complications and a weight loss of 8.2 kg, the patient was re-admitted to the hospital 8 months after the last resection. For a total of 133 days at the hospital, she was given parenteral and enteral nutrition support as well as an oral diet. The oral diet was low in insoluble fiber, fat, lactose, and concentrated sweets, and was high in soluble fiber and complex carbohydrates. However, the patient continued to