Gastric Bypass (Roux-en-y)

Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery. Weight-loss surgery can also be called bariatric surgery. It’s often done as a laparoscopic surgery, with small incisions in the abdomen.

This surgery reduces the size of your upper stomach to a small pouch about the size of an egg. Dr.Choi accomplishes this by using surgical staples to separate the upper portion of the stomach. This reduces the amount of food you can eat. 

Dr.Choi then attaches this pouch directly to a part of the small intestine called the Roux limb. This forms a “Y” shape. The food you eat then bypasses the rest of the stomach and the upper part of your small intestine. This reduces the amount of fat and calories you absorb from the foods you eat. It also reduces the amount of vitamins and minerals you absorb from food.

Why Might I Need Gastric Bypass Weight-Loss Surgery?

Gastric bypass surgery is used to treat severe obesity. It’s advised for people who have tried other weight loss methods without long-term success. Dr. Choi may recommend gastric bypass surgery if you are severely obese with a body mass index (BMI) over 40. We may also advise it if you have a BMI between 35 and 40 and a health condition such as sleep apnea, high blood pressure, heart disease, or type 2 diabetes.

Gastric bypass can help you lose about 100 pounds of excess weight. It may also reverse type 2 diabetes and stop heartburn and reflux. Weight-loss surgery can also lower the risk of high blood pressure, sleep apnea, and certain heart problems.

Possible effects over time may include:

• Low levels of vitamins if you don’t take supplements daily 
• Low levels of iron and calcium
• Trouble getting enough protein
• Dumping syndrome. Due to rapid gastric emptying, symptoms like nausea, feeling lightheaded and tired after a meal, and sometimes diarrhea can be experienced.
• Narrowing of the sites where intestines are joined (stenosis or stricture)
• Internal hernia
• Need for additional surgery
• Falling short of achieving desired weight loss
• Weight regain, if you snack on high-calorie foods and don’t exercise

There might be a need to undergo health clearances before the surgery. To be fully guided through your weight loss journey, be sure to talk with your healthcare team about any concerns or inquiries you may have.

What Happens After Roux-En-Y Gastric Bypass Surgery?

You may stay in the hospital for 1 to 2 days after the surgery. You’ll be able to speak with Dr. Choi and his staff about wound care, safe pain medicines, and when you can start physical activity.

Should you have any of the following, please inform us right away: 

• Fever
• The wound exhibits warmth when touched, fluid secretion, or pain
• Coughing or breathing discomfort
• Vomiting and diarrhea
• Pain in the abdomen, chest, shoulder, or legs
• Any other problems or symptoms

You will likely only have liquids for the first 1 to 2 weeks after surgery. Dr.Choi may slowly add soft food and then regular food to your diet about a month after surgery. You will need to chew slowly and fully, and not drink 30 minutes before or after you eat.

Your initial weight loss may occur quickly, so it’s important to get all of the nutrition and vitamins you need as you recover. Dr.Choi will prescribe vitamin and mineral supplements to compensate for potential limitations in your body’s ability to absorb them solely from food.

To prevent nutritional problems after gastric bypass surgery,

Dr. Choi advises:

• Daily multivitamins. You should take a daily multivitamin that contains 200% of the daily values.
• Daily calcium supplements. Multivitamins with calcium may not protect bone health. You may need 1,600 to 2,000 IU of vitamin D and 1,600 mg of calcium daily. Take a calcium supplement at least 2 hours after your multivitamin.
• Vitamin B-12 supplements. Doctors advise vitamin B-12 supplements for all people who have had weight-loss surgery to help prevent bone fractures. You can take this by mouth several times a week. Or you may have B-12 injections every month.
• Oral vitamin D supplements. You may need this if you have low levels. Dr.Choi may prescribe 50,000 IU of vitamin D2 taken by mouth once a week for 8 weeks. Some people need lifelong vitamin D supplements.
• Iron supplements. After gastric bypass surgery, the amount of iron in a multivitamin may not be enough to prevent anemia. You may need an additional 50 to 100 mg of elemental iron a day. Taking vitamin C will help your body absorb iron. Ask Dr.Choi about the recommended dose for you.

Because nutritional inadequacies can happen after this surgery, experts recommend that your blood be tested at least every 6 months for the rest of your life to ensure that you are getting the right amount of vitamins and minerals.

Throughout the process of weight loss, you may experience bodily discomfort, fluctuations in mood, dry skin, temporary hair thinning, as well as feelings of fatigue and sensitivity to cold. As your weight stabilizes, these problems should go away. 

The duration of weight loss typically spans around one year, after which it tends to stabilize and reach stagnation. After a year, there is a possibility that you may have an increased capacity to consume food if the gastric pouch expands or stretches. You should use the first year to develop good eating and exercise habits that will keep you from re-gaining weight.

Along with follow-up appointments with your general doctors and surgeon, you will likely see a dietitian who will teach you how and what to eat with your reduced stomach size. You may also need to see a psychologist to help you deal with the feelings and concerns over your changed lifestyle.

Ready to get started? Contact us today for your free consultation.

Office: 305-821-3795