What is gastric bypass surgery?

When uncontrolled diabetes made it difficult for Union finance minister Arun Jaitley to lead a healthy life, he opted for gastric bypass surgery. The minister lost 17 kg in three weeks after the surgery and his sugar levels are normal and under control. The creatinine levels have also lowered from four to two indicating significant improvement in kidney functioning, state the doctors.

Those patients who are diabetic and obese but unable to manage their diabetes are advised to opt for this surgery. But only those whose Body Mass Index is more than 33 and have related co-morbidities are advised to take up this surgery.

There are three types of surgeries, gastric bypass, sleeve gastrectomy and bilio pancreatic diversion which are found to resolve the problem of diabetes in 86 per cent of the patients. Experts state that gastric sleeve has no physiological effect on the body. But the other two procedures require constant monitoring for vitamin and mineral deficiency.

What is gastric bypass surgery?

It is a type of bariatric surgery where the size of the stomach is reduced from 1.6 litres to 80 millilitre. The journey of the food is also cut down by 2/3 and food goes directly into the intestine. In a normal person, food takes two hours to reach the intestine but after the surgery it reaches the intestine in 30 minutes. This short-cut does not allow the sugar levels to rise in the body. But the surgery can cause deficiency of vitamins and minerals in the body and ultimately weakness. Hence these patients have to be on vitamin and mineral supplements after the surgery.

‘Weight loss sets in immediately’

Gastric bypass has proved to be the best option for management of diabetes if it can’t be controlled with medicines. As soon as the surgery is done, weight loss begins and the hormonal changes in the body lead to normalisation of sugars. Dr Venugopal Pareek, senior bariatric surgeon at Care Hospitals, explains, “This surgery is considered as the Gold Standard Treatment for management of uncontrolled diabetes and obesity. The procedures started in 2005-2006 and the follow-up of last eight years have shown that a majority of those who opted for the surgery are leading healthy lives with no diabetes, blood pressure and joint pains and in obese women, the fertility rate has improved.”

But the flipside is that as a vital part of the intestine is bypassed patients develop deficiencies. Dr Pareek explains, “Patients are counselled and made to understand that that they will have to be on vitamin supplements after the surgery as there is bound to be deficiency of calcium, iron, vitamins and also proteins.”

‘Gastric sleeve is a better and Safe procedure’

This procedure helps to improve the metabolic rate of the patients. It increases stamina and does not starve the body of vitamins. Dr B. Rajnesh Chander Reddy, senior consultant, department of bariatric surgery at Apollo Hospitals, says, “Gastric sleeve is a safe procedure and does not require hospitalisation for long. The patient can be discharged after the third day of operation. In this procedure, follow-up is required once in a month, followed by consultations with a dietician.” All the three surgeries help to achieve the targeted weight loss but after that a strict diet plan is to be maintained and also a proper set of exercises must be followed. Dr Reddy adds, “In gastric bypass, management of uncontrolled diabetes is immediate but the flipside is it creates deficiency.”

Who can opt for this surgery:

• Those whose BMI is more than 33.
• Women who have irregular periods and are not able to conceive due to obesity.
• Patients suffering from type 2 diabetes.

Who must not opt for this surgery:

• Those who are suffering from diabetes for more than 20 years.
• Those who are diabetic but lean can’t opt for this surgery.

FACT FILE:

• Every month, 1,800 bariatric procedures are done across all private hospitals in India.
• Patients can opt for the surgery even at the age of 40 to 45. There will be no weight gain for 10 years if the dietary patterns are followed properly.
• It can be done on patients till 75 years of age after taking into account their other health parameters, say doctors.