WARNING TO PRE-OPS: Think twice, cut once -- or else!

Dumping syndrome. When stomach contents are literally “dumped" more rapidly into the small intestine. Dumping syndrome is usually triggered by too much sugar or large amounts of food, dumping syndrome doesn’t pose a serious health risk, but its symptoms aren’t fun: nausea, weakness, sweating, faintness, and diarrhea. Some patients can prevent dumping syndrome by avoiding taking sweets after surgery.

Bowel problems. After gastric bypass surgery, there may be a period of intestinal adaptation. During this time bowel movements can be frequent with diarrhea. This bowel complaint, frequently accompanied by bloating, gas and foul smelling stools, may reduce with time.

Narrowing or “stricture" of the stoma of anastomosis between the stomach and intestine is a rare complication. When foods are not chewed properly and get stuck or have difficulty passing through the stoma, they cause scarring. When scarring occurs, it becomes more difficult for the food to pass. It is suspected when vomiting occurs most of the times after food. The stoma can be stretched by a gastro enterologist in the outpatient with a dilating tube that is passed to the stomach through the mouth (endoscopic dilatation).

Ulceration of the small intestine to the upper part of the stomach may occur in 5 percent of people who have gastric bypass surgery. Ulcers are more common in people who take aspirin or other medications called non-steroidal anti-inflammatory agents.

Malnutrition: Almost a third of patients may develop nutritional deficiencies. Because the duodenum is bypassed in this procedure, the body cannot absorb important minerals like: iron, calcium, zinc, selenium and other nutrients efficiently after gastric bypass surgery. Fortunately, these deficiencies can usually be controlled with proper diet and vitamin supplements.

Iron deficiency anemia. Duodenum is bypassed in this procedure, the body doesn’t absorb iron and calcium very well after surgery, which can lead to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during menstruation or from bleeding hemorrhoids. Taking a tablet daily of multivitamin and iron will prevent or reverse this process.

Osteoporosis. Because the body doesn’t absorb calcium properly after surgery, there is a greater risk of developing osteoporosis. Daily supplementations of calcium will prevent osteoporosis.

Metabolic bone disease. Also caused by bypassing the duodenum, some patients experience bone pain, loss of height, humped back and fractures of the ribs and hip bones.

Chronic anemia. A type of anemia caused by a deficiency of vitamin B12 can usually be managed with pills or injections, which will be taken life long.