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Gastric Bypass – Beneficial or Not?

Surgery could lower patients’ development of future medical issues.

Scientists and researchers further investigating gastric bypass surgery and its side effects might be onto something.  A recently published study following patients post-procedure has shed light on new developments that are detrimental to comorbidities such as diabetes. Sigrid Bjerge and colleagues feel that “knowledge of symptoms is important for prevention.”  With an increase in knowledge there will be a decrease in side effects.

Taking place in Central Denmark from March 3rd to July 31st of 2014, 2,238 postoperative bypass patients were surveyed if their procedure was between January 1, 2006 to December 31, 2011. Only 1,429 patients responded to the surveys for review. To compare data, 89 individuals comprised a cohort group based on sex, BMI, and no evidence of gastric bypass surgery.  Outcomes were measured by no contact to hospitalization as stated in the article.

After about four years following surgery, 1,266 patients self-reported one or more symptoms.  Of the reported surveys, the median patient age was 47 years old.  The mean BMI for patients was about 29 kg/m2 and population surveyed comprised of 20% men.  It was found that 1,219 felt their well-being improved after surgery versus 113 patients feeling that their health medically declined.  In relation to symptoms, 1,266 patients reported them, while 966 of those patients sought out medical attention and 416 ending with hospitalizations.  Of the individuals in the cohort group, 31 contacted medical professionals with six being hospitalized.

Patients reported abdominal pain as one of the most common occurrences after surgery, accounting for 34.2% (489 patients). Fatigue accounted for 34.1% (488 patients) as another common occurrence. Following behind the two close symptoms was anemia with 27.7% (396 patients). Receiving a majority of the symptoms were women with a prevalence ratio of 1.23, patients younger than 35 years of age (PR: 1.24), smokers (PR: 1.1), unemployed individuals (PR: 1.15), and people who exhibited symptoms pre-op (PR: 1.34).

Although a large number of patients from the population reported symptoms and required hospitalization, gastric bypass can prevent and even improve certain medical conditions.  In reference to a study conducted by Ian J. Douglas and other researchers, there were reports of  a dramatic four year post surgery weight reduction in patients.  Additionally, there were improvements with type 2 diabetes as well as a decrease in the development of diabetes.  This study can be further reviewed at http://www.ncbi.nlm.nih.gov/pubmed/26694640.

Practice Pearls:

  • Bariatric surgeries range from gastric bypass, sleeve gastrectomy, adjustable gastric band, and even biliopancreatic diversion.
  • For most, the benefits outweigh the negatives
  • We are still learning about possible benefits and risks involved to gastric bypass

Gribsholt, Sigrid et al. “Prevalence Of Self-Reported Symptoms After Gastric Bypass Surgery For Obesity”. JAMA Surgery (2016): 1-9. Web. 12 Jan. 2016.

Healio.com,. “Gastric Bypass Surgery Yields High Rate Of Symptoms, Hospitalization”. N.p., 2016. Web. 12 Jan. 2016.

Medicalxpress.com,. “High Rate Of Symptoms, Hospitalization Following Gastric Bypass Surgery For Obesity”. N.p., 2016. Web. 12 Jan. 2016.

Douglas, Ian J. et al. “Bariatric Surgery In The United Kingdom: A Cohort Study Of Weight Loss And Clinical Outcomes In Routine Clinical Care”. PLoS Med 12.12 (2015): e1001925. Web. 12 Jan. 2016.

American Society for Metabolic and Bariatric Surgery,. “Bariatric Surgery Procedures – ASMBS”. N.p., 2016. Web. 12 Jan. 2016.    

Researched and prepared by Samantha Ferguson  Doctor of Pharmacy Candidate FAMU College of Pharmacy, reviewed by Dave Joffe, BSPharm, CDE