Can You Reverse A Gastric Bypass?

Are you considering having gastric bypass surgery, but wondering “Can you reverse a gastric bypass?” Or maybe you’re worried about the permanent change and want to understand your options. In this article, we discuss what gastric bypass surgery entails, why a reversal may be necessary (not the best option), and ways to make your surgery a success.

What is Gastric Bypass Surgery?

Before we discuss if gastric bypass surgery is reversible, we first need to review the qualifications for bariatric weight loss surgery and what gastric bypass surgery entails.

Gastric bypass is also called Roux-en-Y (RYGB). It is recommended for people with a body mass index (BMI) greater than 40. If you have chronic health conditions, such as high blood pressure, type 2 diabetes, or heart disease, you may be eligible for surgery if your BMI is between 35 and 40. If you have a BMI greater than 35, discuss with a bariatric surgeon if you may be eligible for bariatric weight loss surgery.

During gastric bypass surgery, your surgeon reduces the size of your stomach by taking a portion of your stomach and creating a smaller pouch for food to pass. This reduces the amount of food your stomach holds, so you feel fuller faster. In addition, your surgeon reroutes and attaches your stomach to a different section of your small intestine. Thus, “bypassing” where some of your food and nutrient absorption takes place, which leads to weight loss.

Can you reverse a gastric bypass?

The short answer is yes, but this is not ideal and should be avoided unless medically necessary. If you are concerned about needing to reverse your surgery, talk with your surgeon. However, there are some complications and scenarios that can arise where reversal would be necessary.

Why Reversal May be Necessary

Reversal is limited to those who have significant complications that cannot be controlled post-gastric bypass surgery. This means that you and your surgeon have exhausted all other options through medical management. Some of the significant complications that may warrant a reversal are:

• Severe postoperative malnutrition: Since gastric bypass surgery bypasses the area where some of your nutrient absorption takes place, nutritional deficiencies are common after surgery. However, there are some cases where severe nutritional deficiencies cannot be controlled with supplementation and lead to
  other health complications. This is when your surgeon and other members of your healthcare team may recommend a reversal.

• Postprandial hypoglycemia: Postprandial hypoglycemia is when you have low blood sugar a few hours after eating. Symptoms can include hunger, weakness, shakiness, etc. If your surgeon determines you are having postprandial hypoglycemia, then they may recommend a reversal.
• Excessive weight loss: Sometimes people who undergo gastric bypass surgery lose weight too quickly or have excessive weight loss. This can lead to other health complications, so a reversal may be recommended.
• Large hernias: Large hernias anywhere along your digestive tract may develop after surgery and lead to an obstruction. 
• Chronic nausea, vomiting, and abdominal pain: If chronic nausea, vomiting, or abdominal pain cannot be controlled by medications or other sources cannot be identified, then gastric bypass reversal may be indicated.
• Other indications: Some other indications for reversal include nonhealing stomach ulcers, leaks, and dumping syndrome. 

This is not an exhaustive list of indications for a gastric bypass reversal. It’s always important to discuss any symptoms you may be experiencing postoperatively with your surgeon. They will help you determine the cause and then discuss your options, as a gastric bypass reversal is not always the best option.

Risks Involved with a Reversal 

There may be some cases where your surgeon may recommend having a gastric bypass reversal. Usually, this is after you and your surgeon have exhausted all other options and attempted medical management. If you decide to have a reversal, there are some risks to consider, which include:

• A reversal is a large operation and often more complex than the original procedure
• You will most likely regain the weight 
• Just like your gastric bypass surgery, potential risks include:
  • Blood clots
  • Infection
  • Post-operative bleeding
  • Pain

For most people who undergo gastric bypass reversal, the procedure is well tolerated and they have symptom resolution. In some cases, your surgeon can convert your gastric bypass to another weight loss procedure. However, this is greatly determined by your symptoms and the surgeon’s recommendation.

Making Your Surgery a Success and Preventing Complications 

Remember, gastric bypass surgery has one of the highest success rates and not every gastric bypass surgery warrants a reversal. Let’s review ways you can make your surgery a success and prevent complications from arising.

1. Start your new lifestyle BEFORE your surgery. To create healthy habits, it’s important to get started on your diet and exercise regimen as soon as possible. This means you need to get started before surgery. In some cases, your surgeon may require that you lose weight before surgery to show you are committed to a new lifestyle and can lose weight. So why not try it before they make the recommendation?
2. Exercise! You can start your exercise routine with walking or other low-impact exercises and then introduce strength training exercises. Also, did you know that walking after surgery prevents blood clots?
3. Don’t smoke! Smoking increases your chances of complications after surgery and impacts wound healing. If you smoke, ask your surgeon for nicotine replacement options to help wean you off smoking.
4. Stick to your diet. After surgery, you will follow a strict bariatric post-op diet, which slowly transitions you back to eating healthy foods. It’s important to stick to each phase of the diet to maintain weight loss and prevent complications.
5. Work on your mental health and have a strong support system. Poor mental health can hinder your weight loss journey. Cognitive behavioral therapy (CBT) can help prevent weight regain after bariatric surgery. It’s also important to have a strong support system at home to help you keep on track. If you don’t have a strong support system, consider joining local support groups, which your surgeon can recommend.
6. Drink plenty of water. Did you know that water is a natural appetite suppressant? After gastric bypass surgery, drinking water is especially important to control appetite and helps you avoid those sugary drinks.
7. Do your research. Before having gastric bypass surgery, do your research and weigh the pros and cons. Or if you think you need a gastric bypass reversal, discuss your options with your surgeon before jumping to conclusions. 

Try some of these tips to make your gastric bypass surgery a success. Remember, while gastric bypass surgery is reversible, it’s not recommended unless medically necessary. If you’re worried that you may need or want a gastric bypass reversal in the future, then discuss this with your surgeon. They are the experts in the field and want to see you succeed!