Gastrointestinal Surgery
There are several options when deciding to undergo this type of surgery. The overall goal is for the patient to lose weight and improve their health. Two major methods, each with variations, work to quickly and dramatically decrease a person’s weight. The procedure can limit the amount of food one is able to eat, or avoid parts of the digestive process so that a lot fewer calories and nutrients are being absorbed into the body, thereby helping the person to lose weight.

Restrictive Operations
This is a surgical method of portion control. Obviously, it’s more complicated than that, but basically this operation will “restrict” the amount of food a stomach can handle. The doctor will make a little pouch at the top of the stomach where food enters. A ¾ inch pouch is created in the lower part of the stomach where the food is released into the digestive tract is located. This delays the rate that food leaves the stomach creating a full feeling sooner.

The person loses the ability to eat a lot of food at one time. After the surgery, a person will only be able to eat about ¾ - 1 cup of food without feeling sick or uncomfortable. There are two versions of this restrictive operation 1) Adjustable Gastric Banding (AGB) and 2) Vertical Banded Gastroplasty (VBG). The difference is basically in the way the stomach is closed up and made smaller.

Risks: Vomiting (the small stomach can be overstretched by particles of food that aren’t chewed well making a person ill), Band slippage, Saline leakage all can result from the AGB. The band or staples can dissolve after having the VBG procedure. In very few cases, the stomach juices can leak into the abdomen requiring the patient to have immediate surgery so the acid won’t wear away other organs. In less than one percent of cases, the surgeries can lead to infection or death.

Malabsorption Operations
This is the most common type of GI surgeries for weight loss. This method combines the above process of restricting food intake, but adds a second component. This operation will not allow the body to absorb all of the calories and nutrients that enter the body. This can be achieved through one of two procedures 1) Roux-en-Y gastric bypass (RGB) is the most common and successful of the malabsorption surgeries. A small stomach pouch is created to restrict the amount of food a person can eat. A Y-shaped section of the small intestine is attached to this pouch, thus, the food takes a detour and bypasses the lower stomach causing the body to absorb less calories and nutrients.

2) Biliopancreatic Diversion (BPD) is the more complicated of the procedures because a portion of the stomach is actually removed. The small pouch that remains shoots directly to the end of the small intestine. A variation of this is called the duodenal switch which leaves a large part of the stomach together and a portion of the small intestine, called the duodenum, in the digestive tract.

The benefit of these surgeries is that there is more weight loss and health risks associated with obesity decrease. Generally a person will lose 2/3 of their excess weight between 1-2 years. Unfortunately, the nutritional deficiencies, anemia, hernias, osteoporosis, and metabolic bone disorders give potential patients something to think about. Vitamins B12, A, D, E, and K can help with these deficiencies.

Dumping syndrome is another possible side effect. Stomach contents are forced to move too quickly through the small intestine. Symptoms are nausea, weakness, faintness, sweating, the inability to eat sugary foods, and sometimes diarrhea after a meal. Duodenal switch can help with this.