Gut peptides

In the course of a meal and after a meal, ingested nutrients activate the entero endocrine cell of stomach, pancreas and small intestine to release a group of hormones. These hormones include cholecystokinin, pancreatic glucagon, amylin, pancreatic polypeptide, oxyntomodulin, GLP-1 and Ghrelin. The release of these hormones varies with nutrient content of the food that has reached the stomach. These hormones have the potential to modulate food intake. The gut hormones signal the brain in response to food intake. This stimulates feedback from the hypothalamus and brainstem, which results in short term post prandial satiety and control in appetite. The hormones are thought to play a key role in initiation and termination of a meal. They may also influence a person against taking the next meal. All except Ghrelin have anorexigenic modulation. This refers to ability to repress appetite. Ghrelin is orexigenic (appetite stimulant). Feedback from the brain is also believed to be involved in the regulation of energy expenditures in people.

Liver

The liver plays an important role in the digestion and processing of proteins, fat and sugar. The liver helps create some of the building blocks of proteins needed for the body known as amino acids. The liver plays an important role in fat digestion as well as the production of fats needed for the function of different organs of the body. Simple sugars are created in the liver by breaking down both proteins as well as more complex sugars known as glycogen. The liver can also convert simple sugar into glycogen which is better for storage. In this way the liver acts as an energy center for the body. It controls the balance of simple and complex sugar storage and releases sugar stores when needed for energy.

Lap - Band Surgery

Laparoscopic gastric banding is a surgery that reduces the capacity of the stomach with the help of a silicone ring and an inflatable balloon that is fitted on the outside of the stomach. The balloon inflates with the injection of fluid through the injection port. This narrows the opening of the upper pouch, wherein the amount of food you eat is controlled while the emptying process of the stomach pouch is slowed.

Duodenum

The duodenum lies at the beginning of the small intestine. Together with the jejunum, and the ileum it forms the small intestine. It is connected to the stomach above and the jejunum below it. When food enters the duodenum, there are multiple feed-back pathways and nervous reflexes that will affect how fast the stomach empties as well as the secretion of other hormones.

Theoretic Hormonal Impact of Laparoscopic Sleeve Gastrectomy Surgery

Classified as a restrictive procedure, laparoscopic sleeve gastrectomy involves modification of the gastric fundus, which expresses various hormones associated with hunger and satiety, insulin secretion and energy balance, and is known to induce rates of type 2 diabetes remission comparable to those observed following malabsorbtive procedures such as the Roux-en-Y gastric bypass (RYGB).

Gallbladder

One of the functions of the gallbladder is to concentrate the bile produced by the liver. Mainly by removing water, the bile is reduced from a fifth to a tenth of its original volume until reaching the maximum capacity of the gallbladder at about 50 milliliters. This concentration is a kind of balancing act. If the gallbladder doesn’t concentrate the bile, then there may not be enough active ingredients to break down a heavy load of fat, resulting in digestive problems. If the gallbladder performs too much concentration, the lack of water may stimulate the formation of gallstones around impurities in the high saturation of cholesterol.

Theoretical Gut Hormone Changes after Gastric Bypass

Roux-en-Y gastric bypass (RYGB) surgery is one of the most commonly performed bariatric procedures, offering significant long-term benefits in terms of weight reduction and remission of obesity-related conditions including type 2 diabetes. These changes are thought to be induced via a combination of mechanisms including reduction in stomach capacity and reduced absorption of fat, in addition to the restrictions placed on consumption of highly osmolar foods such as those high in simple sugars, which can trigger symptoms including nausea, vomiting and dizziness if ingested in excessive quantities. However, these factors alone do not fully account for the success of the procedure. Various hormonal changes have been observed following RYGB surgery, prior to significant weight loss, and it is thought that such endocrine effects could also contribute towards the mechanism of action in RYGB.