You will meet your anaesthetist at the time of your gastroscopy prior to your chosen bariatric procedure. This is done to make sure, as best as possible, that you have an acceptable risk of anaesthesia.
Anaesthetists may recommend further medical or cardiac investigations at that time. If this is the case your surgery will have to be postponed until these tests have been completed and evaluated by your anaesthetist.
The pre-operative gastroscopy is designed as stated previously to introduce you to your anaesthetist but also to ensure that there are no other physical abnormalities which would preclude you from having surgery.
In particular, for patients undertaking thegastric bypass, because the stomach is divided and the majority of the stomach is no longer accessible, it is important that this part of your stomach is inspected prior to the surgery.
Bear in mind that after the operation, the majority of your stomach will not be accessible by traditional endoscopy means and it will not be possible to access your bile ducts to remove gallstones using the endoscopic ERCP procedure. Surgery would be required to access your stomach or bile ducts in the future.
Gastric bypass recovery and side effects
In the initial post-operative period it can take some time for you to learn how your new stomach behaves and you can have problems with some discomfort after eating and occasional vomiting.
Following gastric bypass you may experience an intolerance to certain types of food, usually fatty greasy foods, dairy products, and/or sweets (lollies). This may cause unpleasant symptoms similar to sea sickness such as:
- Abdominal pain
- Diarrhoea which lasts from a few minutes to an hour
This is known as ‘dumping’ syndrome. Some patients regard this as a useful side effect as it reinforces their inability to consume high calorie foods. I would prefer that you concentrate on developing a healthy dietary intake post surgery.
You will lose a large amount of weight rapidly in the first few months following gastric bypass. Although this is something you are looking forward to, it is important that you lose this weight in a healthy way to avoid side effects such as fatigue and hair loss.
It is important that you follow the dietary recommendations given to you by your dietician. Your chance of achieving your weight loss goals is enhanced if you follow our bariatric programme after surgery.
Failure to lose weight
Like any bariatric procedure, there are ways to defeat the surgery and fail to lose weight or fail to achieve your maximum weight loss.
If you overeat on a regular basis you can stretch your pouch or dilate your anastomosis leading to eventual weight gain. It is also possible to consume sufficient amounts of high calorie liquid or food such that you do not lose weight.
In general, if you choose a balanced menu, high in protein, eaten at normal times and incorporate regular exercise into your daily routine, the tool that is gastric bypass will allow you to lose weight and keep it off in the longer term.
Eating habits and exercise after a gastric bypass
Studies have shown that on average gastric bypass patients lose their appetite for the first five months after surgery. It is important during this period you take the appropriate amount of calories, protein and vitamins in order to avoid feeling ill, weak and possibly losing some hair.
Your goal is to burn fat, not muscle, so taking in protein to maintain muscle bulk is very important. Your best chance of weight loss with the gastric bypass is in the first nine months.
To get the most out of your bypass take full advantage of the early period of lack of appetite to get into the right eating and exercising habits.
Patients who fail to develop good dietary habits are more likely to regain weight in the longer term. If you go back to high calorie foods such as chips, cookies, soft drinks and do not stay active, then even the best bypass will fail. Your bariatric procedure should be regarded as a tool to aid your weight loss.
The importance of behavioural factors cannot be overemphasised. It is therefore very important that you participate in a patient support group as much as possible and seek dietary and psychological assistance whenever it is recommended or whenever you feel that you are struggling to achieve your goals.
Studies have shown that patients who participate in patient support groups, and have their surgery carried out in a multidisciplinary environment achieve better results.
Unrealistic expectations after a gastric bypass
Weight loss with the gastric bypass can be very rapid. This ongoing weight loss can be psychologically addictive but ultimately it will slow down after six to nine months so it is best that you are prepared for this event.
As has been stated previously, your best chance of weight loss is in the first few months, so this is the period when it is recommended you begin your exercise regime with the assistance of an Exercise Physiologist.
As you lose weight your exercise capacity will increase, making you feel better and fitter. The best average result from a laparoscopic gastric bypass is 70% excess body weight over an 18 month period.
Bear in mind that the goal of surgery is to make you healthier, improve your life expectancy and decrease the problems suffered by obesity related diseases, it is not to get you down to your ideal weight.
The more weight you have to start with, the more weight you will probably lose with surgery and our recommended dietary and exercise regime. Try not to get caught in the trap of comparing your weight loss with others.