Side Effects of Gastric Bypass
Gastric bypass is one of the most common types of bariatric surgery aimed losing weight. It is a form of restrictive and malabsorptive surgical procedure and is also known as “Roux-en-Y gastric bypass. It is often done laparoscopically, however, can be done by open surgery. For every surgical intervention, many side effects are to be expected. These may involve relatively transient and harmless side effects or adverse effects.
Following a gastric bypass surgery, the stomach has now become small in size, the effective portion of the small intestine has been significantly reduced and the absorptive surfaces also reduced. These lead to some side effects.
Dumping Syndrome
This occurs as a result of interference with the reservoir capacity of the stomach, disruption of its innervation, and abnormal pyloric emptying mechanism. The incidence can be seen in up to 50% of patients after laparoscopic Roux-en-Y gastric bypass (Kanth, 2016).
Based on the time of onset after the meal, dumping syndrome can either be early or late. Symptoms of early dumping syndrome occur 30-60 minutes after a meal (Kanth, 2016). Symptoms are thought to result from accelerated gastric emptying of hyperosmolar contents into the small intestine leading to movement of fluid into the bowel lumen, resulting in rapid small bowel distention. Patients may present with early satiety, abdominal cramps, vomiting, and diarrhea
Late dumping occurs 1-3 hours after a meal. It is due to rapid dumping and absorption of glucose into the bloodstream leading to increase in insulin secretion. This results in hypoglycemia (low blood glucose). Symptoms include excessive sweating, headache, flushing, dizziness, and palpitations. Eating a small meal at a time and following the dietary guideline set by your physician will help minimize this condition.
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Dehydration
Depletion of body fluid can be a side effect of gastric bypass surgery. This is as a result of a reduction in the absorptive surface of the intestine. Thus, it is important to take adequate fluid following gastric bypass surgery. If not properly treated, the patient may develop nausea, vomiting, which will further worsen the dehydration.
Gallstones
One of the major side effects of gastric bypass is the formation of gallstone. This occurs postoperatively during the period of rapid weight loss. Obese patients tend to have high blood cholesterol level and malfunctioning gallbladder. The incidence can be as high as 36%, with a peak at 6months post-surgery (Shiffman, Sugerman, Kellum, Brewer, & Moore, 1991). Many patients will be asymptomatic while some will have severe symptoms necessitating surgical removal of the gallbladder.
Hair loss
Nutritional deficiency, excessive weight loss, or body response to surgery may lead to loss of hair. However, the hair is expected to grow back after about 3-6 months, or the following supplementation with the deficient nutrients such as co-enzyme Q/10, biotin, flax seed oil, zinc, etc. It can also be prevented by supplementing the diet with magnesium, calcium, zinc, vitamin B before the hair loss sets in.
Also See: Hair Loss after Gastric Sleeve
Fecal Incontinence
This usually occurs in patients with background weakened anal sphincter. The dumping syndrome leads to increase in fecal fluidity, thus exposing the underlying weakened sphincter that was originally hidden.
Other side effects include difficulty swallowing, indigestion, teeth and gum disease, renal stones. Most of these side effects are preventable by strict adherence to your dietary plan as prescribed by your doctor.
References
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