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Long Term Complications of Gastric Bypass Surgery from Mayo Clinic

(Thanks Kathy for finding this.)

One complication of gastric bypass surgery may be the development of an ulcer where the small intestine is attached to the upper part of the stomach. Ulcers may occur in 5 percent of people who have gastric bypass surgery. Ulcers are most common in people who take aspirin or other medications called nonsteroidal anti-inflammatory agents (NSAIDs).

A hernia or weakness in the incision occurs in about 15 percent of people who have weight-reduction surgery. This usually requires surgical repair, depending on the symptoms and the extent of the hernia. Patients undergoing laparoscopic surgery have a hernia rate of less than 2 percent.

A rare complication is a narrowing or "stricture" of the stoma (opening) between the stomach and intestine. This also may require another surgery, or more commonly an outpatient procedure that expands the narrowed area with a dilating tube that is passed to the stomach through the mouth.

Mayo Clinic physicians have recognized and reported on a seemingly rare but serious complication following gastric bypass called NIPHS (non-insulinoma pancreatogenous hypoglycemia syndrome) or post-bariatric surgery hypoglycemia. This is characterized by very low blood sugar levels after eating that results in severe neurologic symptoms, including visual disturbances, confusion and (rarely) seizures.

Mayo physicians in Rochester have evaluated and treated several patients with NIPHS. When medical and diet therapy fail, surgical removal of part of the pancreas has resulted in marked improvement of symptoms for most. If symptoms described above occur, patients should notify their physician immediately. Until this condition is controlled, patients should avoid driving motorized vehicles or performing tasks that could effect the safety of those around them.

After weight-reduction surgery, the body may not absorb certain vitamins and minerals. Long-term complications of this malabsorption may include the following:

  • Anemia due to deficiency of iron or vitamin B12
  • Neurologic complications from vitamin B12 deficiency
  • Kidney stone disease due to changes in how the body absorbs calcium and oxalate
  • Possible bone disease due to mineral or vitamin D deficiency

Follow-up visits with the physician will determine which vitamin and mineral supplements are necessary after surgery. The need for vitamin and mineral supplements is especially true for people who have a very long limb Roux-en-Y gastric bypass, because this surgery can be associated with frequent diarrhea and failure to absorb enough calcium and iron.

Dehydration is a possible complication following weight-reduction surgery, as patients are no longer able to drink large quantities of liquid at one time.

In the first three to six months, the patient may experience one or more of the following changes as the body reacts to rapid weight loss:

  • Body aches
  • Feeling tired, like one has the flu
  • Feeling cold when others feel comfortable
  • Dry skin
  • Hair thinning and hair loss
  • Changes in mood
  • Relationship issues

Some changes are due to a slowing of the body's metabolism from weight loss and should resolve with time.

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