It is important to remember that there are no ironclad guarantees in any kind of medicine or surgery. There can be unexpected outcomes in even the simplest procedures. The Roux-en-Y gastric bypass procedure carries significant risks, including the possibility of death. Additional risks are listed below.
In this procedure the stomach size is substantially reduced. This reduction lowers the production of stomach acid that is important in the absorption of iron and calcium. As a result, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss due to poor absorption of dietary calcium.
Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back, and fractures of the ribs and hip bones. All of the deficiencies can be managed through proper diet and vitamin supplements.
Because the food bypasses the duodenum, a chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections. In addition, absorption of thiamine (vitamin B1) is also altered. Lack of this vitamin causes confusion and nerve damage to nerves of the leg. This problem is avoided by taking your vitamin supplements.
A condition known as "dumping syndrome" can occur as the result of rapid emptying of stomach contents into the small intestine. This is triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness, and diarrhea after eating. Some patients are unable to eat any form of sweets after surgery.
The effectiveness of the procedure may be reduced if the stomach pouch is stretched. This can occur by overeating. In addition, once carbohydrates are restarted at about six months, patients can begin to regain weight. This is avoided by carefully following the nutrition program.
The majority of the stomach duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding, or disease should occur. Treatment of these conditions if they occur may require further surgery.
Patients who undergo gastric bypass are at increased risk to develop blood clots in their legs that can travel to their lungs. Early walking, the use of compression boots, anti-embolism stockings, and small doses of blood thinning agents help lower this risk.
Other Post-Surgery Issues
Patients who undergo bariatric surgery must make a lifelong commitment to eat healthy, exercise, and adhere to strict dietary guidelines. The lifestyle changes can seem overwhelming at first and can strain relationships within families and between married couples. To help patients achieve their goals and deal with the changes surgery and weight loss can bring, Memorial Health Bariatrics offers support groups, counseling, and continuing education.
Ultimately, the decision to have the procedure is entirely up to you. After having heard all the information, you must decide if the benefits outweigh the side effects and potential complications. This surgery is only a tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise, and lifestyle changes.