Doctor insights on:
What To Do If Your Pouch Stretches After Gastric Bypass
Try Bagel Test: After a bypass, you can test your pouch size and emptying by a bagel test. Eat mini bagels until full (in morning without any fluids). Record number of bagels (could be up to two for normal). Then wait 30 minutes. Don't drink anything. Try eating mini bagels again. Ideally, most of the pouch should still be full and you should only be able to eat one.See 1 more doctor answer
Is there a diet that I can go on to shrink my gastric bypass pouch back down to the size that it was. Have lost over 200+ want to go another 50 lbs.?
Probably not: Diet alone will not shrink the pouch. However, limiting your portion sizes should help. Be sure you are limiting high fat foods and carbohydrates. Most people eat too much of these. If you limit them you should lose weight. Also, are you exercising? If you walk daily it should help with weight loss. Be sure to talk with your doctor about a good goal weight. Good luck!
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
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
Key word: I would like to emphasize the importance of seeking coe listed surgeon. There are plenty of surgeons that offer services and have *much* worse outcomes. Dr st laurent is in my area and has an excellent reputation.See 2 more doctor answers
Typically surgery is: Recommended for patients with morbid obesity (BMI>40), patients who are obese (BMI > 35) with other medical conditions like diabetes or heart disease, and now many people are also recommending surgery for those with BMI > 30 (overweight) with other high risk med problems. There are many options for weight loss surgery (bypass, sleeve, band); see a good bariatric surgeon to discuss. Good luck!
Absolutely: Bariatric surgery represents the single most effective therapy of losing weight and potentially resolving medical conditions such as diabetes, high blood pressure, sleep apnea, high cholesterol etc… surgery should not be taken lightly. It is work, but worth the effort. Find a reputable surgeon with a good dietitian and after-care program willing to follow you and help you be successful for life.See 1 more doctor answer
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
Potential risks: Gastric bypass is a major surgery - never to be approached casually. As with any major surgery, there exist complications - even the possibility of dying! On the other hand, when a person has multiple "co-morbidities" of obesity (diabetes, high blood pressure, sleep apnea, etc.), the benefits may outweigh the risks. Talk to your doctor, your family, and yourself as you make this important choice.See 3 more doctor answers
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
Surgical risks: Every surgery carries risks and gastric bypass is no exception. There can be issues related to underlying medical conditions in surgery, anesthesia, postoperative infection or leak. Patients are also left with loose skin that often requires plastic surgery (not often covered by insurance) to remove the excess skin. Discuss all this with a bariatric surgeon.See 1 more doctor answer
Bread is hard: To eat after any weight loss surgery unless it is toasted and crunchy. The doughy breads get stuck and do not go away quickly. Toasted breads with "melt" with saliva and, if it gets stuck, will eventually go away. Avoid raw bread, toast it. Really should limit bread intake though. Focus on hard, solid protein like fish and chicken.See 1 more doctor answer
No one must.: It may be advised for difficult obesity situations, and of course, beneficial for some patients; but they should have appropriate treatment with conservative methods, ie eating management and exercise; also drug management; before they proceed with surgical intervention. I have had a few patients lose and maintain a weight a weight loss of of over 100 lbs without surgical intervention.See 2 more doctor answers
Center of Excellence: Hi, please research the facility you wish to consult for bariatric surgery. One of the cedentials is "the center of excellence" although that is not absolute credential ask friends who have had the procedure donethe more the procedures reflects a level of experience. True that doing many procedures might produce more complications-but it can also mean that they are capable of handling complications.See 1 more doctor answer
Not bad. 2 weeks: Most of our patients are up walking and sipping liquids right after surgery. With tiny catheters that drip numbing medicine into the skin, most patients use only oral pain meds on the first day after surgery. Most go home the day after surgery. Most go to work in two weeks.See 2 more doctor answers
Bypass: Completely different procedures band is simpler and less effective. Restriction only bypass is more involved however has much better results in between you find the sleeve an option worth looking into. Kind of the best of both for committed patients.
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