Research Question: The Consequences of Malabsorption Syndrome in Post-Operative Gastric Bypass Patients
Rationale: Gastric bypass operative procedures are a group of techniques that divides the stomach into a small upper pouch and a much larger lower pouch, then rearranges the small intestine so that it connects with both. There are a number of techniques to reconnect the intestine, but all lead to a considerable reduction in the volume of the stomach, also accompanied by an altered physiological response to food. Despite media advertising, these procedures are major surgeries that are usually only prescribed to treat morbid obesity, type-2 diabetes, serious hypertension or sleep apnea. Typically, 15% of patients have negative complications, and .5% dies within six months of surgery due to post-operative complications (USDHHS, 2009).
The surgery itself, regardless of the technique, typically reduces the stomach by about 90%. When the patient eats even a small amount of food, the first response is stretching of the wall of the stomach pouch, which then stimulates nerves that tell the brain the stomach is full. The patient feels as if they ate a large meal with only a tiny amount of food, also teaching the patient to eat slowly and many very small meals. Recent research shows that changes in food intake are only partially responsible for weight loss, with no real evidence in most patients of significant malabsorption of calories. Instead, the research shows that the 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.
P: The patient (population) in this particular study is the post operative gastric bypass patient.
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 or bariatric surgery, as defined by the American Society for Metabolic and Bariatric Surgery, is a surgery that “works by changing the anatomy of your gastrointestinal tract” or by “causing different physiologic changes in your body that change your energy balance and fat metabolism.” Weight loss surgery ultimately changes a person’s desire
A gastric bypass weight loss program is for those who are recuperating from gastric bypass surgery to assist them to heal and alter bad eating habits. Gastric bypass surgery is among several weight-loss surgical procedures presently carried out. The operation itself has gone through several modifications through the years. The process being used today is known as the Roux-en-Y gastric bypass. It should not be mistaken with other weight-loss surgical procedures, like the biliopancreatic diversion with duodenal switch, that is a more aggressive surgery. Your physician or perhaps a registered dietitian will talk to you concerning the diet you will need to follow after surgery, explaining what kinds
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
Some treatments would be for more severe cases than others, like Malabsorptive / restrictive surgeries. This surgery, like I said before would be for more serious cases. It restricts that amount of food the stomach can take in. It also makes the food not go through all the process for your body will not absorb all the calories from the food. Another type of surgery is restrictive surgeries. Those types of surgeries are more physical. A normal stomach can hold somewhat of about 3 pints of food. After the surgery at first the stomach will most likely be able to hold only about only one once. Although later in the process you would be able to hold more food. It would be able to stretch and hold 2 - 3 ounces. If you haven’t caught on to it, The smaller the stomach, the less you eat. The less you eat, the more weight you lose. There are a large amount of surgeries that can be done for the individual. Those are only a
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
Feld et al (2003) randomized thirty obese patients undergoing gastric bypass into two groups: one receiving sevoflurane and fentanyl while the other group received a sevoflurane and non-opioid regimen. The non-opioid regimen
On December 17, 2014 I went to the hospital, I weighed 382lbs and had the gastric sleeve surgery. During the Gastric Sleeve procedure, my surgeon tapered my stomach, which is generally about the size of a football, into a thin vertical sleeve, about the size and shape of a banana. The remainder of my stomach
Long-term weight loss is the desired end-result following gastric bypass surgery. However, this long-term goal is contingent upon lifestyle changes, including nutrition and exercise. More importantly, postoperative gastric bypass patients often have limited knowledge with regard to how to maximize weight loss. In order to measure changes and progress, two critical concepts to achieve optimal weight loss results are body mass index (BMI) and calculation of daily caloric intake. It is imperative to find out the status of respondents in post gastric bypass surgery (P), if ongoing nutrition and lifestyle training (I) compared to standard postoperative guidance (C) result in greater weight loss and decreased BMI (O) over a period of time (T)?
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
Obesity surgery helps you lose weight by changing the way your body digests and absorbs food. Your body digests food to break down what you eat into small pieces of nutrients. When the pieces are small enough, the cells of your body absorb the nutrients to give you energy.
The Gastric Emptying Study is a procedure that measures the speed that food leaves your stomach.The study help patient that have symptoms that may be do to less common emptying of the stomach.The main symptoms for slow emptying are nausea, vomiting,and abdominal pain. The main symptoms for faster emptying are diarrhea,weakness or pigheadedness after eating. The study is performed when the patient eats a meal with radioactive material in it. The meal consisted of a solid and a liquid.Then a scanner is put over the stomach to monitor radioactivity. As the amount of radioactivity decreases it show how fast the food left your system.To be eligible for this study you must not take and medication or drugs 48-72 hour
This surgery is reversible if the patient chooses to for whatever reason they might have. On the other hand Gastric Bypass surgery involves the stomach to be removed and put aside while the lower intestine is brought up to the bottom of the esophagus and a new 1oz pouch is created which will now be the new stomach. The patient can now only fit a very small amount into their stomach , however if for any reason, the patient is unsatisfied with the results this surgery is not reversible.