Specific Risks of Gastric Bypass Surgery
There are a number of potential risks and complications associated with gastric bypass surgery, including:
Anastomotic Leakage
The surgical connection between the stomach and the bowel or between two parts of the bowel is called an anastomosis. If the body doesn’t heal properly after gastric bypass surgery, fluid from within the gastrointestinal tract can leak into the abdominal cavity and cause an infection and abscess formation. This risk occurs in about 2% of gastric bypass procedures. Use of antibiotics or immediate reoperation is needed.
Anastomotic Stricture
As the anastomosis heals, it forms scar tissue, which shrinks over time, making the opening smaller. The passage of food through an anastomosis keeps it stretched open. If the inflammation and healing process occurs faster than the stretching process, there is a risk that the scarring may make the opening so small that even liquids can no longer pass through it. The solution is a procedure called gastroendoscopy which may have to be performed more than once to achieve lasting correction.
Anastomotic Ulcer
There is a risk of ulceration of the anastomosis. Possible causes of such ulcers are:
- Restricted blood supply to the anastomosis
- Anastomosis tension
- Gastric acid
- Helicobacter pylori
- Smoking
- Use of Non-steroidal anti-inflammatory drugs
This condition can be treated as follows:
- Use of Proton pump inhibitors, e.g., Nexium
- Use of a Cytoprotectant and acid Buffering agent, e.g., Sucralfate
- Temporary restriction of the consumption of solid foods
Dumping Syndrome
The release of food into the bowel is regulated by the pyloric valve at the lower end of the stomach. When the gastric bypass patient eats a sugary food, the sugar passes rapidly into the bowel. This leads to a physiological reaction called dumping syndrome, which causes for the patient to feel his/her heart beating rapidly, break into a cold sweat, and have a “sky is falling” type of anxiety. This lasts for about 30-45 minutes.