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Bariatric Surgery - The Roux-en-Y Gastric Bypass

The Roux-en-Y Gastric Bypass ("RYGB") is a surgical procedure that significantly reduces the amount of food that can be eaten at one time and somewhat reduces the amount of calories and nutrients the body absorbs. The lower portion of the stomach and first segment of the small intestine (Duodenum) are bypassed.

With the new arrangement of stomach and intestine, gastric contents enter the jejunum directly after leaving the stomach pouch. When concentrated sweets are ingested, the patient may experience symptoms known as the "dumping syndrome". This syndrome is characterized by gastrointestinal symptoms of gastric fullness, nausea, abdominal cramping and diarrhea, as well as, flushing, sweating, weakness, rapid heartbeat, and tiredness. The effects of the syndrome will pass in about 45 minutes. This syndrome is a tool - discouraging the patient from eating too fast and making poor food choices.

Food entering the new small stomach (pouch) causes a sensation of fullness, and then slowly empties into the jejunum (middle segment of the small intestine) through the "new" small outlet. This re-routing causes food to bypass the lower part of the stomach and duodenum. Digestive juices from the lower stomach and duodenum flow to mix with food lower down the intestinal track, thus permitting the digestion of food.

For approximately six to eight months after the RYGB, the patient will progress slowly through a carefully designed dietary guideline of liquids and soft foods, designed for maximum protein and nutrient intake and minimal discomfort. Lifetime vitamin intake is mandatory after any malabsorptive surgical procedure. The program has designed a vitamin guideline specific to each surgery and will be reviewed regularly with each patient.

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