The gastric bypass is primarily a bariatric (weight loss) procedure, but due to the way in which it is performed it also delivers excellent results for acid reflux sufferers. If you have a BMI over 35 and are suffering with chronic reflux, the gastric bypass is an option that must be considered. The gastric bypass, like fundoplication, is a very long established surgical procedure and there are many studies around the world that can attest to the excellent weight loss and reflux results it delivers.
It is important to stress that the gastric bypass procedure has implications for patients in terms of their long term diet, lifestyle and vitamin/mineral supplementation. It is not therefore an option to be taken lightly as a reflux patient taking this route would need to be satisfied they are happy to make the behavioural changes it requires.
The diagram above shows the stomach and bowel after bypass surgery. In summary, the stomach is cut to make a smaller stomach into which your food will pass. The bowel is then cut and reconnected to this new stomach. The large ‘remnant’ stomach is then connected to the bowel further down which means that the food you eat goes through your small stomach into your bowel without going through the large remnant stomach, hence it is bypassed.
With regards to acid reflux, the excellent outcomes we see after bypass are due to the fact that the contents of the large stomach can no longer reflux up into the oesophagus. Some studies show that 95% of gastric bypass patients report that their reflux is cured.
For most patients the gastric bypass is unlikely to be the best anti-reflux surgery option, but if your body mass index is over 35, you are aged over 40 and you are prepared to consider lifestyle changes that will enable you to address your weight and your reflux then it is an option for you.
If you are likely to be a candidate for gastric bypass surgery, your consultant will discuss it with you at your appointment.
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Gastric Bypass FAQ’s
What are the complications of gastric bypass ?
As with any surgical procedure, there are operative risks but the major post-procedure complications are nutritional deficiencies and dumping syndrome. Gastric bypass surgery can result in reduced absorption of key micronutrients and without supplementation, deficiencies of can occur, resulting in anaemia and bone disease eg osteoporosis. Dumping syndrome is caused by sugar consumption and if bypass patients consume a high sugar diet, they can experience abdominal cramping and diarrhoea.
What are the lifestyle changes that are required ?
With a gastric bypass, you may eat most foods that don’t cause you discomfort but in much smaller quantities. It is important to include foods rich in protein but low in fat and sugar. To avoid the health consequences of nutrient deficiencies, all bypass patients are required to take intensive vitamin and mineral supplementation for life.
How much weight might I lose?
On average, we expect gastric bypass patients to lose around 70% of their excess weight