Treating complaints after gastric reductionDumping syndrome occurs more often after gastric bypass or tubular stomach surgery. Other complaints are related to the poorer food utilization.
Several thousand people each year voluntarily go under the knife with the goal of losing a lot of weight: They have their stomach reduced to a tube or have a gastric bypass inserted. The reduction in the size of the stomach reduces the amount of food that can be taken in – in the case of the stomach tube to about 200 milliliters, in the case of the gastric bypass to about 15 milliliters. Stomach reduction surgery is now the second most commonly planned surgical procedure at German hospitals.
In gastric bypass, this procedure has two desired consequences: First, the remaining stomach is quickly filled – patients who have undergone surgery feel full very quickly. On the other hand, the shortened small intestine can no longer absorb as much energy from food. Both lead to rapid weight loss: within a year, patients often lose two-thirds of their excess pounds. This also improves secondary diseases of obesity, such as osteoarthritis, high blood prere or diabetes.
What happens during surgery to the tube stomach?
Surgical separation of large parts of the stomach creates a narrow tube stomach that holds much less food. Image gallery
Problems after stomach reduction
But the benefits and risks should be carefully weighed. Because there is also the threat of lifelong consequences that are less pleasing: Four out of five patients who have undergone surgery have permanent and very serious complaints. Heartburn, abdominal pain, flatulence, nausea and bloating, also nutrient deficiencies and muscle wasting often occur. They can lead to extreme floppiness.
Two thirds of all patients also experience the so-called dumping syndrome after gastric reduction: The food pulp rushes uncontrollably from the stomach into the small intestine. As a result, a lot of water flows out of the blood vessels into the intestine at once, and blood prere drops. Dizziness attacks are the consequence.
Shortened digestive tract with gastric bypass
Andreas B. The stomach was surgically reduced: Matthias Riedl uses a pig's stomach to demonstrate how radical the operation was.
In addition, gastric bypass leads to deficient digestion on the artificially shortened intestinal passage. This is because the intestine has different absorption areas for the individual nutrients – but the food mush no longer passes through certain areas. Which section is short-circuited and which is "drained" during surgery? The doctor decides individually in each case, depending on the patient's BMI and the total length of the small intestine.
Digestion can only begin in the deeper sections of the intestine by breaking down the food components. This means that fewer food components are available to the blood, and more undigested food is transported into the large intestine. Fatty foods in particular are less easily absorbed; some sufferers notice this in the form of fatty stools. Sugar-containing food, on the other hand, can trigger unpleasant sensations such as sweating and nausea when eaten in large quantities. Most important rule after stomach reduction surgery: Eating. Drinking must be completely separated. Operated patients should drink 30 minutes before eating or at least 30 minutes after eating, and preferably in sips. A straw helps to dose the amount of drinking: Ten medium-sized glasses, well spread throughout the day, are optimal.
Eat more often and make sure you eat enough protein
After the operation, food intake must be dosed appropriately: There are about four to six meals for the small stomach. Protein should be the basis of the diet – lean meat, fatty fish, dairy products, eggs and legumes. This is important to counteract the muscle loss that is threatened by the massively reduced calorie intake. Suitable snacks for in between meals are eggs, low-fat cheese cubes or wholemeal bread with turkey breast – all containing protein.
Plenty of exercise is essential to maintain muscle mass. Because a loss of skeletal muscle mass easily leads to earlier frailty.
It is not possible without nutritional supplements
Operated patients must also take into account the changed nutritional situation. People with tube stomachs may experience nutrient deficiencies due to the significantly reduced amount of food they eat. After gastric bypass surgery, a deficiency is even more likely: Since our intestines have a very specific absorption range for all micronutrients – for example, vitamin D, minerals such as calcium and trace elements such as iron or iodine – and after a gastric bypass, parts of the small intestine are no longer passed by the food, the body lacks trace elements and vitamins. They must be fed as a dietary supplement, i.e., in tablet form. This prevents permanent nerve damage, bone fractures, anemia and other damage.
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Nutrition after stomach reduction
It is important to separate eating and drinking. The diet should include several small, protein-rich meals.