The small intestine, also referred to as small bowel, is a tubular structure that is a part of the digestive tract. It carries the food from the stomach to the large intestine or colon. Small intestine is that part of the digestive tract, where most of the digestion and absorption of food particles happens. The small intestine is divided into three parts: duodenum (which receives partly digested food and chemicals from the stomach), jejunum (that part of the small intestine, where most of the absorption of nutrients happens) and ileum (that part of the small intestine, where the nutrients that are not absorbed by the ileum are absorbed). The first part of the small intestine (duodenum) is connected to the stomach and the last part of the small intestine (ileum) is connected to the first portion of the large intestine. The length of the small intestine is estimated to be around 3 times the height of an adult.

Bariatric and Metabolic Surgery

Obesity is a worldwide problem of increasing prevalence. Ideally, and in its less severe stages, obesity can be controlled with diet management and a regular exercise program. At times, obesity may be so severe that it is termed morbid obesity. Weight loss surgery, including gastric bypass and the gastric sleeve are surgical procedures whose utility in combating morbid obesity are recognized by both medical and surgical specialists. Patients who have a BMI greater than 35 or those with a BMI of 30 or more who are also suffering from life-threatening illnesses curable with weight loss are considered as possible candidates for bariatric surgery.

Pre-op Bariatric Diet

Phase I – Pre-Surgery Clear Liquid Diet

The first phase of clear liquids will actually start five days prior to surgery. You will be advised to drink only clear liquids and be expected to adhere to this for the five days prior to surgery regardless of which operation you will be undergoing. We allow two protein supplements per day for the first two days of this five day period.

Health Benefits of Bariatric Surgery

Anyone who has lived with obesity for any length of time will be well aware that the negative effects of carrying excessive weight are not limited to physical appearance. Overweight and obesity can impact upon every system in the body, leading to a host of health problems that limit quality of life and life expectancy. The social stigma carried by obesity can have a significant detrimental effect upon self-esteem and psychological wellbeing, whilst the physiological changes associated with the condition can lead to multiple life-threatening co-morbidities.

Gut Bacteria

The microbial population of the gut, or gut microbiota is extremely dense, predominantly comprising bacteria. Whilst a core community of gut microbes—approximately one third—is common to most healthy adults, the composition of each gut microbiota varies according to factors including genetics, diet, age, state of health and geographical location. Microbes are considered important—but probably not essential—to digestion. This is primarily because the gut microbiota breaks down substances that the gut alone is unable to digest and is also involved in synthesis of vitamins.

Sleeve

Laparoscopic sleeve gastrectomy is a restrictive procedure that reduces the size of the stomach but does not alter the gastrointestinal tract or the pylorus. Because the route of ingested food through the gastrointestinal tract is not altered, nutrients are better absorbed. The patient is less dependent on vitamin supplements as the food is absorbed in a more natural manner.

What Digestive Changes Occur After Gastric Bypass Surgery

There are major changes to the digestive system, changes that make this approach to bariatric surgery very effective in significant weight loss. Post-operation, the diet is typically all-liquid for several weeks and then only soft or mashed foods until the post-surgical swelling in the digestive system heals. At the same time, a gastric bypass is more than a surgical procedure; it is also part of a lifestyle change.

Laparoscopic Gastric Bypass Surgery

What occurs during laparoscopic gastric bypass? Roux-en-Y Gastric Bypass works by temporarily decreasing hunger and cravings, restricting the amount of food you can eat at one time and reducing the absorption of calories. The Roux-en-Y Gastric Bypass is considered by many experts to be the current gold standard procedure for bariatric surgery. Although the surgery is typically not reversible, it is the most popular form of bariatric surgery.

Pregnancy After Bariatric Surgery

There are various recommendations regarding the timing of planned pregnancy after weight loss surgery which are based on a theoretical understanding of what occurs after the operation. A truly controlled scientific study evaluating the risk and benefit of pregnancy after surgical weight loss is difficult to design. We employ a common sense approach based on surgical literature as well as an understanding of the changes that occur after surgical operations for weight loss.

Understanding Your Decision

At your second or pre-surgical office visit with Dr. Belsley, you will take a short quiz so that you can have an additional discussion regarding various important issues prior to your operation. The purpose of the quiz is to assist your understanding and provide a source of conversation regarding the risks and benefits of the procedure. You will also be asked to review, initial and sign a consent form that discusses a number of important possibilities of your operation.