Doctor insights on:
Ketosis And Gastric Bypass
For someone who has undergone gastric bypass, and has reactive hypoglycemia, what would be a good Fat:Protein:Carb ratio to achieve ketosis? Exercise?
See DR: Get off the internet and see the by-pass team. They will be in the best position to supervise you. Do exactly as they say.
Ketosis describes a state of increased ketone bodies in the blood stream. Ketone bodies are generated from the breakdown of lipids (fat) when there are low levels of blood sugar or cells are not able to absorb the blood sugar present, as in diabetic ketoacidosis. Some diets which limit carbohydrates cause low blood sugar and may also result in ketosis. Ketone bodies disrupt the acidity of blood and when dangerously elevated can overwhelm the buffering ability of the body and ...Read more
Mini gastric bypass: The mini gastric bypass is not endorsed by any asmbs or any of the top academic bariatric surgery programs in the country. It is safe, but it is basically a billroth 2 operation which can cause bile reflux. The fix for that problem is a roux-en-y gastric bypass meaning that for 50 years we have known that a roux-en-y is better than a billroth 2. The b2 is just easier for the surgeon to do.See 2 more doctor answers
Yes you can: The standard bypass does not remove any parts, so re-connecting the stomach pouch to the remnant stomach and removing the roux small bowel limb are possible. Reversal is rarely done since most problems causing patients to consider reversal can be treated with other means. The procedure has higher risk than the first operation since the surgeon is working with altered anatomy.See 1 more doctor answer
Very safe.: Bariatric surgery has come a long way in the last 20 years. The major complication rate is in the range of 1-2 % but varies considerably between surgical groups. Find a skilled group who focuses on bariatrics and are fellowship trained in it. The bottom line is that the risk of death from living with morbid obesity is higher than the risk from surgery, by far.See 2 more doctor answers
Caution: The procedures are effective at helping you lose weight, but I have many patients in my practice who have had the procedures in the past and now have terrible nutritional deficiencies. They require pretty frequent iron infusions, which now must be done in the hospital at least where I am. I would never recommend the procedures.See 1 more doctor answer
Some risk: Modern gastric bypass surgery is much safer than it used to be, with a risk of death around 1% and other complications around 40%. The risk seems to be worth it though because the risk of death after successful surgery goes down 89% over five years. So if 100 people have gastric bypass, about one will die from the surgery, but 89 will survive longer than they would have without the surgery!See 1 more doctor answer
Complications: The worst complication is a leak which occurs 3% of the time nationwide (but about. 5% of the time if you go a very experienced surgeon). Bleeding, infection, bowel obstruction, anesthesia complications are others, and these typically occur at 1% or less of the time. It is a safe operation, but go to someone that has done thousands of them. For example, my group has done over 5000.See 2 more doctor answers
Not much: Unfortunately, as your waistline starts to shrink, your skin stays pretty much where it was. This results in significant laxity of your skin. Your skin tends not to retract back very much, leaving you with excess, hanging skin.See 3 more doctor answers
Very little: You may drink some non-carbonated alcohol. The absorption is rapid and effect is quick. There is some data that a small percentage might fall into alcohol abuse, since they get rapidly intoxicated, then quickly sober, then drink again, chasing the quick "high". Best to keep verylimited, like one half glass of wine.See 1 more doctor answer
Bypass and band: Gastric bypass is the gold standard, been around for 50yrs, results in the greatest weight loss, highest cure rates for diabetes, hypertension, etc, but has a slightly higher risk. It is an excellent operation and accounts for the majority of weight loss operations done in the us. It is safe if done by a surgeon who has done thousands of cases.
Yes: Regaining weight frequently happens. It used to be thought that it had to do with enlargement of the gastric pouch, but more recent studies suggest that it is related to a gradual widening of the gastrojejunal anastomosis (the joining between the stomach pouch and small intestine that is created).See 2 more doctor answers
Doubt it: I have heard of some bariatric centers offering some weight control surgery to kids as young as 16, but not younger. These limits are subject to change over time as the treatment standards evolve.
Yes, but? Need: Many bariatric programs routinely do a pouch leak test in the early post-operative period, some the day after, some waiting 5-7 days after surgery. The overall leak rate is low and does not always pick up all leaks, especially if done too early. In one study from UCLA, routine pouch leak studies after laparoscopic gastric bypass did not contribute signi? Cantly to postoperative patient care
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