Doctors have performed gastric bypass for ulcer, tumors and weight loss for almost a century. Worldwide, it was the most common weight loss operation. Today, however, more people choose sleeve gastrectomy because it achieves similar weight loss results without the serious risks of intestinal bypass surgery.

How Gastric Bypass Works

The surgeon creates a small, 1-ounce pouch (about the size of an egg) at the top of the stomach. The rest of the stomach is stapled off, preventing food from entering it but allowing digestive juices to empty into the small intestine.

The small stomach pouch is then tightly connected to a limb of intestine (the Roux limb). Food intake is very restricted due to the small pouch and the small outlet to the Roux limb. Splitting the intestine into two limbs also separates food from digestive juices and limits calorie absorption.

Benefits

Some surgeons still recommend this operation for people with reflux (heartburn) or diabetes. This is a debatable recommendation because sleeve gastrectomy can relieve both of those conditions. You can discuss this further during an office visit and at support groups.

Considerations and Risks

Gastric bypass can be done as safely as sleeve gastrectomy and people generally do very well in the short term. However, problems do tend to develop over time:

• Ulcers (bleeding or perforation) and intestinal blockages can require emergency surgery. Exactly how often this happens is unknown, but occurrence may be as high as 10 to 20 percent over 10 years.
• Many people over age 50 who get gastric bypass often require a blood thinner and might be at very high risk for bleeding from an ulcer.
• Risk of complications goes up in people who smoke, drink alcohol or use anti-inflammatory medications (ibuprofen).
• Vitamin deficiencies and other intestinal bypass problems may also occur.