At Rattinan Clinic in Bangkok, TH, we often have clients come in at the end of their rope. They have tried for years to lose weight, but they aren’t seeing success. They suffer from devastating symptoms of obesity. If this describes you, have hope. Today, we reveal everything you need to know about gastric bypass.
What Happens During a Gastric Bypass Procedure?
The gastric bypass procedure is performed under general anesthesia to ensure your comfort throughout the entire process. There are two steps to this procedure.
Step One: Make the Stomach Smaller
The first step of this procedure is to reduce the size of the stomach. This is achieved by using staples to separate your stomach into a large bottom section and small upper section. The upper portion of the stomach, known as the pouch, is where the food you eat will go.
The size of this pouch is comparable to a walnut. It can hold roughly 28 grams (a single ounce) of food. Due to the new effective size of the stomach, you will eat smaller portions and lose weight.
Step Two: The Bypass
The second step of this procedure is the bypass itself. A small part of your small intestine, known as the jejunum, is connected to a small hole in the top part of your stomach. When you eat, the food travels from the new, smaller stomach via the new hole and into your small intestine. Due to this, your body will absorb fewer calories.
How Is the Procedure Performed?
There are two ways this procedure may be performed. During the open method, a large incision will be made in your abdomen. The bypass is achieved by operating on your small intestine, stomach, and other organs. The other method is known as the laparoscopic method.
The Laparoscopic Method
The laparoscopic method, also known as laparoscopy, involves the use of a tiny camera known as a laparoscope. The laparoscope is inserted into your abdomen and allows your bariatric surgeon to see inside your abdomen. To perform this procedure, only four to six tiny incisions are necessary. The camera and instruments are inserted into these cuts.
The video feed is connected to a video monitor inside the operating room. This allows the surgeon to see inside your abdomen without needing to open up your stomach. This procedure takes only two to four hours.
What Happens Before the Procedure?
Before you undergo this procedure, you will undergo several tests and visit multiple health care providers to ensure this procedure is right for you. For instance, you will undergo a complete physical exam. You will also receive blood tests, an ultrasound image of your gallbladder, and several other tests, such as heart and lung strength.
Your doctor must confirm that any medical conditions besides obesity that are affecting you are under control. These include heart and lung problems, hypertension, and diabetes. You will receive nutritional counseling before this procedure. You will attend classes to learn what will happen during and after surgery. A counselor will ensure you are emotionally prepared for the procedure.
Other Things to Consider
If you smoke, you must stop six weeks before the procedure. You may not smoke until at least six weeks post-op. We strongly recommend that once you stop before your procedure, you never consume nicotine again. Nicotine elevates your blood pressure by constricting your blood vessels. During your initial consultation, tell us if you need help to quit.
You must also tell us if you are pregnant or think you might be pregnant. Let us know of any vitamins, minerals, herbs, or medications you are currently taking. This includes over-the-counter medications you may be taking, including their doses. Certain medications and nutritional supplements thin the blood.
What to Expect the Week Before Your Procedure
The week before your procedure, you must stop taking any medications or supplements that impair blood clotting. These include, but are not limited to, NSAIDs and warfarin. Your doctor will tell you which pharmaceuticals and supplements you may still take on the day of your procedure. Prepare your home for post-op recovery.
What to Expect the Day of Your Procedure
On the day of your procedure, stop eating and drinking as instructed. It is very important that your stomach be empty so the anesthesia is effective. Take any necessary medications with a tiny sip of water or dry-swallow them. Arrive at your appointment on time.
What Happens After the Procedure?
Depending on the technique used to perform this procedure, you may be in the hospital for one to four days post-op. On the day of your procedure, you should sit on the side of the bed and walk a short distance. You will wear compression stockings while you are in the hospital and receive injections and pain medications.
When you go home, you may consume liquid or pureed foods. You may move around as you feel ready. You may take oral pain medications. However, you will not need analgesics via IV or injection.
The sooner after your procedure you are physically active, the smoother your recovery will be. During the first week post-op, you will be mobile. You may shower and walk up and down stairs as usual. However, you should listen to your body and rest when you need to.
With the laparoscopic technique, you should be fine in two to four weeks. If you have an open bariatric procedure, it may be up to three months before you can resume your typical daily activities.
How Active Should I Be?
You do not need to join a fitness center to be active post-op. If you have not exercised in a while, start slowly and rest when you need to. As a good general rule of thumb, start walking for five to 10 minutes per day. Slowly work your way up until you are walking 15 minutes twice per day.
What to Avoid After
Until your surgeon tells you to do so, do not lift anything greater than five to seven kilos (10 to 15 pounds). Do not push or pull anything. Increase your activity level slowly.
Do not drive or operate heavy machinery if you have taken a narcotic within 24 hours. These medications will make you drowsy, and you may be unable to operate the equipment safely.
A team of medical professionals will help to ensure your procedure was successful. Before you leave, you will schedule a follow-up appointment with your surgeon for a few weeks out. You will meet with him several times in the first year post-op. You may also have appointments with psychologists, and hematologists.
A psychologist can help you stick with your diet and exercise guidelines and support you emotionally through this massive change in your life. A hematologist will confirm that your body is receiving adequate nutrition.
What Can I Eat After Gastric Bypass?
After your procedure, your diet will change in stages. Everyone passes through these stages at a different rate. However, there are universal guidelines that must be followed. For instance, you must consume half a gallon of water daily. Liquids must be sipped between meals. There should be at least a 30-minute interval between hydration and eating.
Alcohol must be avoided. Caffeine must be limited. Lean, protein-rich foods should be eaten daily. Foods and beverages must be consumed slowly. Vitamin and mineral supplements must be taken daily as directed by a physician. Foods should be chewed to a pureed consistency before being swallowed.
For roughly the first day post-op, you may only drink clear liquids. Roughly from the second day to the eighth day post-op, you may have other liquids. These include:
- Decaffeinated coffee or tea
- Unsweetened juice
- Skim or 1% milk
- Sugar-free popsicles or gelatin
Pureed Food Diet
When you are ready to move on to the pureed diet, you may eat pureed and strained foods. The consistency of these foods must be that of a thick liquid or smooth paste. There may be no solid pieces of food in the puree.
You should consume three to six small meals per day. Portion sizes of these meals will be roughly four to six tablespoons of food. You should take half an hour to consume each meal. Foods that puree well include:
- Strained cream soups
- Soft fruits
- Cooked vegetables
- Soft scrambled eggs
- Cottage cheese
- Lean fish, poultry or ground meat
Solid foods may be blended with a liquid, such as skim milk, broth, unsweetened juice, or water.
After a few weeks on the pureed food diet, you may begin to incorporate soft foods to your diet. These small, tender pieces of food should be easy to chew. At this time, you may eat three to five small meals daily. The portion size for these meals is between 1/3 and 1/2 cup of food. Each bite of food should be chewed until it has a pureed consistency. Soft foods you may eat include:
- Cottage cheese
- Flaked fish
- Ground lean meat or poultry
- Cooked veggies without skin
- Canned or soft fresh fruit with no skin or seeds
Roughly eight weeks into your diet, you may incorporate firmer foods into your diet. At this point, you will be eating three meals daily. The portion size of these meals will be between 1 and 1.5 cups of food. You must stop eating before you feel completely full. Try one new food at a time. We strongly recommend avoiding the following foods:
- Fried foods
- Red meat
- Tough or gristly meats
- Carbonated drinks
- Raw veggies
- Nuts and seeds
- Highly seasoned or spicy foods
How Should I Eat After the Procedure?
Eat and Drink Slowly
The most important thing to do after your procedure is to eat and drink slowly. You should take at least half an hour to eat your meals. You should also take 30 to 60 minutes to sip eight ounces of water. Finally, make sure you don’t drink within half an hour of any meal.
Keep Meals Small
After your procedure, you should consume six small meals daily. This ensures you do not stretch your stomach out excessively. After a few weeks of that, you may move on to four small meals per day. Your surgeon will advise you when you can eat three meals per day of larger portions.
Drink Enough Water
Everyone, regardless of body weight, local climate, or activity level, should drink at least half a gallon of water daily. Water is essential for overall health and plays a key role in every bodily function. After your procedure, it is even more important that you remain adequately hydrated as your abdominal organs heal.
If you take half an hour to drink a cup of water and drink eight cups of water daily, you are committing four hours of your day to hydration. If you’re not confident you can commit this kind of time to hydration, focus on eating foods that are rich in water and incorporating a lot of broth into your diet.
What Results Can I Expect After the Procedure?
Most of our clients lose 4.5 to 9 kilos (10 to 20 pounds) per month for the first 12 months post-op. After the first year, weight loss tends to slow. The more fastidiously you follow your diet and exercise plan, the more weight you will lose. In the first two years post-op, you can expect to lose no less than half of your excess fat.
Many of our clients choose to maintain a liquid diet until they experience health benefits from this procedure. For instance, people often seek this procedure to treat GERD (gastroesophageal reflux disease), asthma, joint pain, and high blood pressure. Whether you extend your time on the liquid diet or not is up to you.
Why Is This Procedure Performed?
A bariatric procedure is only performed as a last resort. It is usually reserved for the morbidly obese. However, in certain cases, you may be a candidate if you are “just” obese. In all cases, you must have tried and failed to lose weight on multiple occasions with a healthy diet and regular exercise.
The most common factors we look at to determine candidacy for this procedure are body mass index (BMI) and obesity-related health conditions. For instance, type 2 diabetes and hypertension are strong indicators that you could benefit from this procedure.
What BMI Do You Look for?
The best candidates for this procedure have a BMI of at least 40. An individual with a BMI of 40 has at least 45 kilos (100 pounds) of excess body fat. The healthy BMI range is between 18.5 and 25.
We will consider a client with a BMI between 35 and 39.9 if he or she also has a serious medical condition that may be improved by significant weight loss. Weight-related conditions include hypertension, high LDL levels, high overall cholesterol levels, heart disease, obstructive sleep apnea, joint pain, and type 2 diabetes.
Learn More About Bariatric Procedures Today
Do you believe gastric bypass would drastically improve your quality of life? Have you tried for years to diet and lose weight on your own? Do you feel hopeless without the opportunity for medical weight loss? If this sounds like you, you may be a good candidate for this procedure.
To learn more about bariatric procedures, please contact us at Rattinan Clinic in Bangkok, TH today to schedule your initial consultation. Bariatric procedures are life-changing. This procedure just may save your life.