Gastric Bypass Reversal

Gastric bypass surgery is a great option when weight loss hasn’t occurred through traditional means, such as diet and exercise. But sometimes, even after following all your doctor’s recommendations, significant complications still arise after your gastric bypass surgery, leading to the consideration of alternative options.

In some cases, gastric bypass reversal is considered. To fully understand if gastric bypass reversal is right for you and to make an educated decision, you need to understand gastric bypass surgery, potential complications that may lead to gastric bypass reversal and the nature of the reversal surgery.

What to expect with gastric bypass surgery

Gastric bypass is the most common type of bariatric surgery to combat obesity. The surgery produces long-term weight loss and can lead to an improvement in chronic obesity-related illnesses such as heart disease and diabetes.

During gastric bypass surgery, a small pouch is created from the stomach and connected to the small intestine. Per its name, part of the stomach and small intestine is bypassed and less food can be processed.

Gastric bypass surgery changes how your digestive tract handles the food you eat. Because the stomach is significantly smaller, you feel full after eating less food and stay satisfied for longer periods of time, leading to weight loss.

In most patients, gastric bypass surgery leads to positive outcomes and significant weight loss.

While gastric bypass is the most common bariatric surgery, it is also the most complex and has the potential for more complications. Even though it can be a great option for many, significant long-term side effects may cause a patient to consider gastric bypass reversal.

When should I consider gastric bypass reversal?

While your surgeon likely talked with you about the potential complications of gastric bypass surgery, such as long term vitamin or nutrient deficiencies requiring life-long supplementation, the surgery is generally safe and yields great outcomes for most patients.

But for some, side effects from surgery are too significant and gastric bypass reversal is considered.

Here are some reasons gastric bypass reversal may be needed:

• Severe food intolerances and nutritional complications. Food intolerances, such as the inability to eat solid foods, can become a significant problem for some patients after gastric bypass surgery.
• Malnutrition. Without being able to absorb enough vitamins and minerals due to the changed anatomy of the gastrointestinal tract, patients can develop malnutrition. Sustained malnutrition can lead to a variety of other health complications.
• Sustained nausea, vomiting, or chronic abdominal pain. Some patients experience chronic nausea, vomiting, or severe abdominal pain that doesn’t go away. If your symptoms become so severe that your daily functioning is impacted, it’s time to talk with your doctor.
• Metabolic complications such as postprandial hypoglycemia. After eating a meal, your blood sugar should rise due to the sugars in the food. With the metabolic condition called postprandial hypoglycemia, your blood sugar drops within four hours of eating a high carbohydrate meal, causing symptoms including anxiety, dizziness, headache, sweating, weakness, tiredness, or lightheadedness. In severe cases, fainting and seizures can occur.
• Dumping syndrome. Categorized by a group of symptoms including nausea, diarrhea, and lightheadedness, dumping syndrome is a result of rapid gastric emptying. In dumping syndrome, food moves directly from your newly formed stomach pouch into your small intestine without being fully digested, leading to unwanted and uncomfortable symptoms.
• Frequent ulcers and internal hernias. If severe enough, emergent surgery may be required and can lead to consideration of gastric bypass reversal.

If you find yourself struggling with post-surgical side effects, no matter how significant, review some of the educational material you received before and after your gastric bypass to make sure you’re taking the proper steps.

Follow your surgeon’s instructions and be diligent about adhering to guidelines to manage any unwanted symptoms. But sometimes, no matter how closely you adhere to recommendations, unwanted side effects persist and impact your daily life.

This is when gastric bypass reversal should be brought up in discussion with your doctor.

Can gastric bypass be reversed?

Gastric bypass reversal is a safe and feasible surgical option for patients that have severe, unmanageable side effects following gastric bypass surgery. During gastric bypass reversal, the gastrointestinal anatomy is restored to normal.

The reversal can help the patient return to their baseline of functioning and eliminate unwanted side effects from the original surgery. For most patients, it is well tolerated and leads to a resolution of symptoms.

After gastric bypass reversal, weight gain is likely to occur but most of the original side effects may subside. In some cases, the surgeon may recommend a sleeve gastrectomy to support continued weight loss and management during the gastric bypass reversal surgery.

What to expect with gastric bypass reversal

Gastric bypass reversal surgery returns the stomach and intestines back to their original placement. While the surgery can be done, it is complex and has the potential for further complications.

Since it is the second surgery in the area, there is more complexity and risk for leaks, increased bleeding, infection, and scar tissue formation. As such, gastric bypass reversal should only be considered after all other attempts have failed at managing post-surgical side effects.

Since the anatomy of the gastrointestinal system returns to normal with gastric bypass reversal, weight gain occurs after surgery. With a return to the normal anatomical structure, the stomach is able to process more food and the feeling of fullness takes longer to set in.

Since gastric bypass surgery causes such a drastic change to the gastrointestinal tract, gastric bypass reversal is equally as drastic, leading to a high potential for weight gain and exacerbation of obesity-related illnesses.

According to a 2019 study of 48 post-gastric bypass reversal patients, the average amount of weight regained after 4 years was 61%.

Conclusion

Gastric bypass reversal surgery is a potential surgical option if you’re struggling with significant side effects after gastric bypass. While it is a feasible and safe option, it is important to recognize it is not your only option.

Talk with your healthcare provider about your concerns and have a discussion to fully understand all your options.