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Overview of Human Digestion

Roux-en-Y Gastric Bypass Procedure

Advantages of Obesity Surgery

Risks and Considerations of Surgery

An Overview of the Digestive System

It is important that a patient first understand how the gastrointestinal track works and how the body absorbs food.

• Chewed food travels from the mouth through the esophagus and to the stomach
• In the stomach, digestive acid and juices break the food down so it is easily absorbed
• The Pylorus, a small, round, muscle between the stomach and the small intestine allows the food to travel into the first portion of the small intestine once it has been well digested.
• The small intestine is made up of three individual sections that serve specific functions in order to digest and absorb nutrients properly.
• The food passes into the first section of the small intestine, the duodenum , and absorbs much of the iron and calcium used by the body as it mixes with bile and pancreatic juices.
• In the jejunum , the middle section of the small intestine, most of the nutrients are absorbed from food.
• The final section of the small intestine, the ileum , is responsible for absorbing fat-soluble vitamins A, D, E, and K and remaining nutrients.

Roux-en-Y Gastric Bypass Procedure

A surgical treatment is the only proven method for achieving long-term weight control for patients who struggle with morbid obesity. The gastric bypass procedure improves your eating behavior by reducing the amount of caloric intake and ensuring that a patient changes their eating habits because the procedure requires that they eat smaller amounts of food slowly, and chew it completely.

• The stomach is divided into a small stomach pouch.
• The small intestine is divided between the duodenum and jejunum.
• The jejunum is then connected to the newly formed stomach pouch so that food from the formed stomach empties into the lower portion of the jejunum bypassing calorie absorption.
• The original, larger portion of the stomach is not removed but is divided off from the stomach pouch bypassing both it and the duodenum.

Advantages of the Roux-en-Y Procedure

• Scientific studies have shown a significant reduction in health risk in morbidly obese patients after having gastric surgery. Most importantly, this study has shown that the risk of death due to obesity related health issues returned to normal   when compared with non-obese people between 25 and 64 years of age after having the gastric surgery procedure.
• The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with purely restrictive procedures.
• One year after surgery, weight loss can average 77% of excess body weight.
• Studies have shown that after 10-14 years, 50-60% of excess body weight loss has been maintained by some patients.
• A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depressions) were improved or resolved.

Risks and Considerations of Obesity Surgery

Because the duodenum is bypassed as a result of the Roux-en-Y Gastric Bypass Procedure, poor absorption of iron and calcium can occur in the body resulting in a number of health related risks. The good news is that preventative measures such as a proper post-operative diet and vitamin supplements are taken to help avoid some of the following deficiencies:

• Iron deficiency anemia caused by a lowering of the total body iron.
• Women should be especially aware of the potential for heightened bone calcium loss.
• Metabolic bone disease resulting in bone pain, loss of height, humped back, and fractures of the ribs and hip bones.

Some other possible risks associated with Gastric Bypass surgery can include:

• Chronic anemia due to Vitamin B12 deficiency can occur. This is usually managed with Vitamin B12 pills or injections.
• Dumping Syndrome may occur.
• In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is left larger that 15-30cc.
• Re-routing of the bile, pancreatic and other digestive juices beyond the stomach can cause intestinal irritation and ulcers.