Roux-En-Y Gastric Bypass A Complete Guide

Roux-En-Y Gastric Bypass 2023

Roux-en-Y gastric bypass is an advanced weight loss surgery. First, your stomach is cut, and a pouch is formed. The stomach then connects to the small intestine. The procedure is among the most popular bariatric surgery procedures. 

However, it is generally classified as a restrictive procedure because it does not significantly alter the small intestine and only changes the size of the stomach. 

In addition, the contents of the newly constructed stomach will be limited, thus prompting the patient to eat smaller portions throughout the day.

Words of wisdom from a bariatric surgeon on the surgery are not the only thing you will gain from the article. However, some basic facts about Roux-en-Y Gastric Bypass can help you choose that procedure.

What Is The Primary Purpose Of Roux En Y Gastric Bypass?

Roux en y gastric bypass is done to help you reduce the amount of food you can eat. Thus, it prevents the risk of weight-related health issues. An overweight body can lead to high blood pressure, diabetes, and high cholesterol and cause trouble when performing exercises that aid in weight loss.

 A surgeon will evaluate your health before the roux en y gastric bypass surgery. This procedure is designed for some. However, if dieting or exercise does not help you reduce weight, gastric bypass could be a suitable method.

A physician can recommend this weight loss practice if your body weight is causing severe health conditions.

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Why is Roux En Y Gastric Bypass done?

Roux-en-Y surgery can help with the following:

1. To help you lose excess weight.

Roux-en-Y Gastric bypass surgery can help you lose excess weight and keep it off long-term. Also, after surgery, you should be able to eat less and feel full faster than before surgery.

2. To help reduce risks of heart disease.

Roux-en-Y Gastric Bypass surgery has been shown to reduce heart disease risk factors such as high cholesterol and high blood pressure. It’s not yet known whether or not surgery will reduce heart attacks and strokes in the long term. But because it lowers blood cholesterol levels, it may be a promising treatment option for people who cannot control their cholesterol levels with medication alone.

3. Gastroesophageal Reflux Disease (GERD)

GERD occurs when stomach acid flows back into your esophagus or food pipe. GERD can cause painful symptoms like heartburn or chest pain when you eat, drink, or lie down. 

However, after Roux-en-Y surgery, most patients find that their GERD symptoms improve or go away completely within six months of surgery.

4. To help you reduce Cancer risks.

While no surgery is without risk, this surgery is an excellent tool for reducing cancer risks. In addition, since the stomach is reduced in size, it can no longer hold as much food and liquids, which means you are less likely to overeat. 

In addition, with a smaller stomach, there is less room for the cancer-causing agent to grow and multiply.

5. To help reduce infertility risks.

Women who are overweight or obese often experience infertility problems because their body mass index (BMI) puts them at risk for polycystic ovarian syndrome (PCOS). 

PCOS is a condition where an imbalance of hormones can affect ovulation and cause irregular periods, leading to difficulty getting pregnant. By losing weight through dieting and exercise, you can reduce your chances of developing PCOS symptoms and improve your fertility.

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6. To help you reduce Type 2 diabetes risks.

Roux-en-Y gastric bypass surgery may help prevent type 2 diabetes by reducing insulin resistance and improving beta cell function in people who are overweight or obese. 

That is important because if left untreated, type 2 diabetes can lead to heart disease, stroke, and kidney failure.

7. To help reduce Obstructive sleep apnea risks.

Oral appliances can be an alternative treatment for obstructive sleep apnea (OSA). However, they do not work for everyone and are not covered by insurance companies unless you have Medicare coverage, which only covers oral appliances if you have severe OSA. 

Insurance companies cover other types of bariatric surgery because they are proven effective in treating OSA and other medical conditions associated with being overweight.

8. To help reduce High cholesterol risks.

People who have had bariatric surgery have been found to have lower cholesterol levels than before they had surgery. That could be because the smaller stomach makes it harder to eat fatty or sugary foods or the excess weight has been removed from the body. 

Either way, lower cholesterol levels mean less chance of developing heart disease later in life.

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How does Roux-en-Y gastric bypass work?

The Roux-en-Y gastric bypass (RYGB) surgery changes your digestive system, so you can’t eat as much food simultaneously. The size of the stomach pouch is reduced by stapling it shut, leaving only a small upper opening to allow food into the smaller stomach, and that reduces the amount of food your body can handle at once.

To further reduce the amount of food that can be held in your stomach pouch, part of the small intestine is attached to that opening and made into a loop or Y shape before attaching it back to your stomach pouch. That makes it harder for digested food to pass through the rest of your digestive tract and out of your body as waste material.

These changes lead to weight loss within two years in most people who have that surgery, although some regain weight over time.

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How do I prepare for Roux-en-Y gastric bypass?

You’ll need to make some lifestyle changes before and after your surgery. 

Before the surgery:

1. Meet with an expert.

Before gastric bypass surgery, you’ll meet with an expert who can help you ensure that that procedure is right for you. Your doctor will ask about your health history and perform blood tests, including blood counts and glucose tolerance tests, to determine whether you’re healthy enough for surgery. 

You’ll also have X-rays of your chest and spine to see if any issues might affect your ability to recover from surgery or put you at risk.

2. Support system

Before surgery, you must have a support system in place. You will need people who can help with transportation and childcare while you recover from your procedures. 

It’s also wise to stock up on over-the-counter medications to prepare you for any postoperative discomfort or complications.

3. Follow your preoperative instructions closely.

Surgery for weight loss is an invasive procedure with risks including infection, internal bleeding, blood clots, heart attack, or stroke. 

Because these risks are significant, you must take care of yourself before surgery by following your preoperative instructions closely and scheduling any necessary tests or screenings as soon as possible after booking your surgery date.

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4. Stop smoking

You’ll need to quit smoking before surgery because smoking can cause complications during and after the surgery. Your doctor may recommend nicotine replacement therapy such as the patch or quitting support groups.

5. Drink less alcohol

Alcohol is not suitable for anyone, but it is especially bad for people with gastric bypass surgery. If you drink more than two drinks daily, stop drinking before surgery. 

When you have that type of surgery, the surgeon makes a small pouch out of part of your stomach and attaches it directly to the intestine. 

That pouch has a valve that allows food to pass through your intestine, not back into your stomach. 

That valve can be damaged if there is too much acid in it from alcohol. If that happens, the valve may need to be removed so that food can no longer go in and out.

6. Eat a healthy diet

Eat smaller portions of nutritious foods such as lean protein, fruits and vegetables, whole grains, and low-fat dairy products. 

Ask your surgeon about dietary recommendations that may help you lose weight faster or prevent future complications from obesity-related conditions such as diabetes, heart disease, and high blood pressure.

7. Exercise regularly

Exercise regularly with your doctor’s approval. Exercise helps you lose weight and keep it off after surgery. Your doctor recommends exercises based on age, physical condition, and medical history. Your doctor might also prescribe a walking program or other physical activity to help you start a healthy lifestyle after surgery.

Candidates for Roux En Y Gastric Bypass 

If you experience the following, then you might be a candidate for that surgery:

1. Your body mass index (BMI) is 40 or higher (extreme obesity)

With a BMI of 40 or more, you have extreme obesity and are highly overweight and at very high risk for health problems because of your weight. 

If you’re thinking about weight-loss surgery, you may be a candidate for the Roux-en-Y gastric bypass (often called the “RNY” or “RYGB”) procedure. 

The RNY is a surgical procedure used for people with extreme obesity, a BMI of 40 or higher, that can result in dramatic weight loss, often quickly.

2. Your BMI is 35 to 39.9 (obesity)

If you’re between 35 and 39.9 BMI (Body Mass Index), you must speak with your doctor about possible obesity-related health risks. 

A gastric bypass procedure may be a good option for you, and you should know what to expect from that surgery.

Read Also: BMI For Gastric Bypass Surgery

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What are the risks of Roux En Y Gastric Bypass?

Before going under the knife, you should know all the potential risks of Roux-en-Y gastric bypass surgery. These include:

1. Excessive bleeding

Bleeding from any part of your body, including your stomach, bowel, or intestines, is risky with any surgery. After gastric bypass, you may bleed more easily than usual because your blood vessels are smaller than normal. 

Your doctor will monitor your blood pressure and heart rate after surgery to check for signs of excessive bleeding.

2. Infection

Infections are another risk associated with stomach bypass surgery because they can occur when bacteria enter your body through an open wound or bandage. 

The best way to avoid that complication is by following all instructions from your doctor and nurses throughout your recovery process.

3. Failure

The most severe complication associated with Roux-en-Y gastric bypass surgery is a failure, which occurs when there is no weight loss after undergoing that procedure. 

Unfortunately, that happens for many reasons, including not following postoperative dieting instructions and failing to take supplements such as vitamins A, D, and E after surgery.

4. Strictures

Strictures are abnormal narrowing of your gastrointestinal tract that can cause blockage of food or liquids from passing through it properly. 

These strictures may occur at any point along your digestive tract, but they’re most likely to happen near where your small bowel was reconnected after being separated during surgery.

5. Blood clots

You’re at higher risk for blood clots after that surgery. The risk can be even higher if you take birth control pills or hormone replacement therapy (HRT). 

If you do have a blood clot, it can block an artery in your leg and cause pain, swelling, and numbness in your foot or ankle. It may also cause you to lose the use of your leg. 

Sometimes, a blood clot may break loose from its original location and travel to your lungs, which can be life-threatening.

6. Bowel obstruction

A Roux-en-Y loop channel connects your stomach directly to the small intestine. That channel allows food to pass directly from the stomach into the last part of the small intestine before emptying into the large intestine. 

If that connection is not made properly during surgery, you may develop an intestinal obstruction that prevents food from passing through your digestive tract. That can cause nausea, vomiting, and abdominal pain.

7. Lung or breathing problems

Gastric bypass can cause problems with swallowing and breathing that aren’t always corrected by a supplemental gastrostomy tube (SG). 

If you have trouble breathing after the surgery, you may need a tracheostomy, an opening in your neck that allows air into your windpipe.

8. Leaks in your gastrointestinal system

After the surgery, mucus from your intestines may leak into your abdominal cavity and cause an infection called peritonitis. That can lead to severe complications, including death. 

Antibiotics are often given during and after the operation to help fight off any infection from gastrointestinal tract leakage.

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How successful is Roux-en-Y surgery?

Roux-en-Y surgery is one of the world’s most common weight loss procedures. It’s been performed on millions of people with obesity, and most studies report a weight loss of 60% to 70% of excess body weight.

These studies also found that most people could keep their weight off after they stopped eating only soft foods and started eating regular meals again.

Recovery from Roux-en-Y surgery?

Roux-en-Y gastric bypass surgery is a complex procedure with a high success rate but has some risks and complications. Your surgery will depend on your health, weight, and lifestyle.

How long does it take to recover after Roux-en-Y gastric bypass surgery?

Roux-en-Y gastric bypass surgery usually takes about 1 hour to perform. However, the length of the recovery period depends on how much weight you lose and how well you follow your doctor’s instructions during recovery.

You’ll need 2 to 4 weeks off from work after Roux-en-Y gastric bypass surgery. You might have pain or discomfort in your abdomen for the first few days after surgery, which can be treated with medication. In addition, you may have trouble moving around for a few days because of weakness from blood loss during surgery or muscle spasms in your abdomen muscles. Your doctor may prescribe physical therapy exercises to help you regain strength and flexibility in your stomach muscles after Roux-en-Y gastric bypass surgery.

Is Roux En Y Gastric Bypass Painful?

Gastric bypass is designed to reduce the size of the stomach. As a result, it restricts a large amount of food intake. Also, it prevents the body from absorbing many calories from food.

The process might seem painful, but the surgeons introduce anesthesia to keep you asleep and free from pain. Also, they might give you spinal anesthesia to numb the surgery area.

 After the operation, medicines will be given to prevent pain and bacterial infection. You might be required to stay in the hospital for two or three days and return to your regular schedules within 2-3 weeks.

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Benefits Of Gastric Bypass

Roux en y gastric bypass is an effective weight loss procedure that offers more excellent results than any other method. You will likely lose about 40-70% of your excess weight.

Remember, not all patients lose the same amount of weight. It depends on individual circumstances.

Losing weight after the surgery will help reduce the risk of heart failure, hypertension, and obesity issues and improve your quality of life.

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Roux-en-Y gastric bypass is a surgical procedure for people with a high BMI or Body Mass Index. That may entail a significantly higher risk of colon cancer and cardiovascular diseases. Bypass patients have to deal with the consequences of surgical procedures, but the effect is long-lasting. However, one should carefully choose that procedure to avoid potential complications.

Roux-En-Y Gastric Bypass FAQs

Gastric bypass surgery is a safe and reversible operation, but the reverse operation is complicated, and you need to choose a reputable hospital and a very experienced doctor.

In general, gastric bypass and other weight-loss surgeries may be an option for you if:

  1. A body mass index (BMI) is 40 or higher.
  2. Your BMI is between 35 and 39.9, and you have serious weight-related health problems, such as 
  • Type 2 diabetes
  • High blood pressure
  • Severe sleep apnea. 

In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.

The Surgery may be associated with some side effects such as:

  1. Dumping syndrome
  2. Malnutrition
  3. Leakage
  4. Small bowel obstruction
  5. Anastomosis
  6. Gastrogastric fistula
  7. Ulcers
  8. Other complications

    Other complications that may occur after gastric bypass surgery include the following:

    • gallstones
    • Low blood sugar
    • Vomiting

There are many types of gastric bypass surgery, and the type of operation varies according to the patient’s condition, health condition, body mass index, and many other things. These types are

  1. Gastric bypass (classic)
  2. Mini gastric bypass
  3. The double-division gastric bypass (SASI)

Like any other operation, gastric bypass surgery has potential risks and complications. However, the risks caused by obesity are much greater than the risks of the operation.
Because gastric bypass surgery significantly improves weight-related health conditions such as type 2 diabetes, high blood pressure, and cardiovascular disease.
The main point is to choose a skilled surgeon with high experience because this reduces the possibility of complications arising after and during the operation.

Patients lose between 60% and 80% of their excess weight, but they must continue to follow a healthy diet, or they will gain weight again.

Controlling blood sugar and treating type 2 diabetes with gastric bypass have been frequently reported.

An elevation in liver function tests (LFTs) was observed in a patient after gastric bypass surgery.

Because of the high risks and complications, gastric bypass is not usually performed again.

Smoking may increase your chances of serious complications after the operation, so you should avoid smoking for several weeks before and after the operation.

The stomach may expand and return to its previous size if you do not follow the diet instructions given by your doctor.

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This article was Medically reviewed by Dr. Hakan Evrüke

About the author

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Binsy George

Binsy brings over 13 years of expertise to the HayatMed Clinic Blog. With a passion for healthcare communication, she has crafted insightful articles that demystify complex medical topics, empowering readers to make informed decisions about their well-being.
Her wealth of experience ensures that each blog post is a reliable source of knowledge, fostering a deeper understanding of health and medical advancements.

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