Digestive system disorders after bariatric surgery

There is a systematic increase in the incidence of obesity and overweight. This primarily affects highly developed countries. The World Health Organization alerts that the problem of obesity affects 400 million adults. The most alarming situation is the increase in people with this problem in the under-18 age group. Also in Poland, there is a noticeable increase in cases of obesity and overweight, the cause of which is improper nutrition and low physical activity, for which technological progress is responsible, due to which the energy expenditure resulting from daily functioning has decreased. Irrational nutrition involves overeating, consuming large amounts of sugars and fats in food, as well as fast – food dishes.

What is bariatric surgery?

Bariatric surgery is very often the only effective and long-term method in the fight against obesity. Surgical treatment offers a chance not only to achieve a healthier BMI, but also to change the current lifestyle of patients struggling with obesity. Bariatric surgery, which involves shrinking the stomach, results in a change in energy balance and fat metabolism that causes improvements in body function. Changing the anatomy of the gastrointestinal tract affects the production of intestinal hormones (known as the hormone ghrelin), resulting in a reduction in feelings of hunger and appetite with an increase in feelings of satiety, prompting individuals to be more physically active.

What does bariatric surgery consist of?

Bariatric surgery consists of:

Laparoscopic sleeve gastrectomy (also known as gastric sleeve), which is a reduction of the stomach’s volume by 75 or 80%. This results in the consumption of smaller portions of food while maintaining all its digestive functions. The patient has a sense of satiety after eating much smaller amounts of food, resulting in weight restriction, improved body function, which gets rid of diseases associated with obesity.
Laparoscopic gastric bypass, which involves connecting a small part of the stomach to the small intestine. The bypassed part of the stomach continues to produce digestive juices, helping to improve the digestive tract. The effect of the operation is to reduce the amount of food consumed, and its fall into the small intestine reduces the time for digestion and absorption of nutrients, resulting in a weight loss of 65 or even 85% within the first year after surgery.
Laparoscopic mini-gastric bypass, which involves bypassing the stomach completely, thanks to the creation of a gastric pouch, connected directly to the small intestine. Food does not enter the stomach at all, which, by producing digestive juices, aids the digestion process.
The insertion of an Orber intragastric balloon. This is a non-surgical method of treating obesity, involving the insertion of a fluid-filled balloon inside the stomach, which presses against its walls, causing a feeling of satiety. The procedure is safe and has the intended effect of reducing body weight.

What disorders of the digestive system can occur after bariatric surgery?

Because bariatric surgery introduces changes in the anatomy, as well as the operation of the stomach and small intestine, the digestive system must adapt to the new conditions, which can take up to several months. This process is accompanied by characteristic complaints such as:

• Nausea usually caused by a feeling of satiety, improper chewing of food, pain medications, hypersensitivity to odors, dehydration.
• Vomiting caused by fast eating, including eating too large and dry portions, lying down for a long time after a meal, and eating forbidden foods after this type of surgery.
• Dehydration caused by vomiting, which can manifest as feelings of fatigue, lower back pain or cystitis, and even fainting.
• Disturbed bowel movements. Immediately after surgery, stools may be loose, and constipation may be a consequence of eating less and less food.
• Flatulence due to shortening of the small intestine.
• Thrush resulting from the administration of antibiotics after surgery.
• Anemia due to iron deficiency, as well as hair loss as a result of the weight reduction process.