Why do so many get pancreatitis after a bypass?

It's good that you are doing your research. We all need to get all the information we can before going forward with weight loss surgery. Getting our guts rearranged is a big deal and we must be prepared to take care of ourselves and follow all the rules after making that choice.

I have been a part of this community for 10 years now and I do not recall that many people who developed pancreatitis post weight loss surgery. It's not something I ever worried about. I do know of several people who have a problem with kidney stones, but I also know non-WLS people who also have problems with kidney stones, so I'm not sure there is a correlation.

I found THIS on the ASMBS website which summed it up for me:

As your body size increases, longevity decreases. Individuals with severe obesity have a number of life-threatening conditions that greatly increase their risk of dying, such as type 2 diabetes, hypertension and more.

Data involving nearly 60,000 bariatric patients from ASMBS Bariatric Centers of Excellence database show that the risk of death within the 30 days following bariatric surgery averages 0.13 percent, or approximately one out of 1,000 patients. This rate is considerably less than most other operations, including gallbladder and hip replacement surgery. Therefore, in spite of the poor health status of bariatric patients prior to surgery, the chance of dying from the operation is exceptionally low.

Large studies find that the risk of death from any cause is considerably less for bariatric patients throughout time than for individuals affected by severe obesity who have never had the surgery. In fact, the data show up to an 89 percent reduction in mortality, as well as highly significant decreases in mortality rates due to specific diseases. Cancer mortality, for instance, is reduced by 60 percent for bariatric patients. Death in association with diabetes is reduced by more than 90 percent and that from heart disease by more than 50 percent.

Also, there are numerous studies that have found improvement or resolution of life-threatening obesity-related diseases following bariatric surgery. The benefits of bariatric surgery, with regard to mortality, far outweigh the risks. It is important to note that as with any serious surgical operation, the decision to have bariatric surgery should be discussed with your surgeon, family members and loved ones.

Wonderful, thoughtful, in-depth response.

Not sure why you deleted your response to me or why you seem to think a BMI of 37 is OK. It's still obese. I did find THIS study about pancreatitis after weight loss surgery. The incidence is 1%. The risk of dying from comorbidities due to your obesity is much higher than 1%. Even if you do not have any health issues now, most likely you will in the future.

It does not sound like you are ready for weight loss surgery. Good luck.

The incidence of AP in this cohort is 1.04 %, which is higher than that reported for the general population (~17/100,000, 0.017 %). Most cases were clinically mild and managed conservatively with good outcomes. Rapid post-operative weight loss and the presence of gallstones or sludge on post-operative ultrasound were significant risk factors for AP.

I deleted it because I put it in the wrong place. I cut it so I could paste it under your reply. But then the past didn't work, and I didn't feel like re-writing it, as I couldn't remember exactly everything I wrote. I think it basically just said that I'm not afraid of dying from the surgery and that I'm just trying to learn about the other types of risks. Im not sure how that gives you the idea that I'm not ready for surgery...lol....but what ever. Good luck to you too!

I would have to agree with Laura -- there's really nothing wrong with not being ready right now for the surgery. You really need to be comfortable and committed. Don't let anyone rush you into your decision.

I am only three years out -- both Laura and Grim have YEARS AND YEARS on me -- but we are all here pretty much every day "passing it on" -- and in my three years, I can only think of one time that I have seen pancreatitis as a "complication."

Would that person have gotten pancreatitis even if they hadn't had WLS? People tend to blame their WLS for every single issue that arises in their health after surgery. Consider that most people, maybe 95%, have eaten bread in the 48 hours before they have been in a car accident. That doesn't mean that eating bread causes car wrecks.

The average person who gets WLS is typically older than 35, has several co-morbidities -- aren't typically in the best of health to start and are likely not eating a healthy diet. According to WebMD and the Pancreas Foundation the biggest risk factors to getting pancreatitis include being over 35 and:

gallbladder disease --- gallbladder disease is higher in obese patients.

Type 2 diabetes -- much higher rates in the obese population.

abdominal trauma (e.g., injury, surgery). --- WLS is surgery to the abdomen.

A high level of fat (triglycerides). -- Obese people nearly always have elevated levels.

high levels of estrogen. -- Obese women have elevated estrogen as fat stores.

Smoking and alcohol abuse. -- Obese patients have far higher rates of smoking.

Additionally, certain medications also can increase the risk for pancreatitis. Many of these are far more common in obese patients, because they are more likely to suffer the effects of the disease/conditions they treat due to obesity. These drugs include the following:

• Azathioprine, 6-mercaptopurine (immunosuppressive drug used to treat rheumatoid arthritis and following organ transplant; e.g., Imuran®)
• Diuretics (used to reduce edema [swelling] in patients who have chronic heart failure [CHF], liver disease, and kidney disease; e.g., furosemide [Lasix])
• Didanosine or ddI (used to treat HIV infection; e.g., Videx)
• Estrogens (oral contraceptives; used to prevent pregnancy)
• Pentamidine (used to treat some types of pneumonia; e.g., Nubupent)
• Tetracycline (antibiotic used to treat bacterial infections; e.g., Sumycin)
• Valproic acid (anticonvulsant used to treat complex partial seizures; e.g., Depakene)

Therefore, I would conclude that if the rate of pancreatitis is higher in WLS patients, it's likely because it's higher in obese patients as a whole. With a BMI of 37, you are clinically obese and therefore already suffering the risk factor of not only pancreatitis but a myriad of other complications as well. You cannot hear my tone in written words, so please understand that this is not meant to be snarky at all. Just be sure to investigate the ramifications and risks of complications of your current status as deeply as you do the risk factors of your proposed surgery.

Health Consequences via the CDC:

People who are obese, compared to those with a normal or healthy weight, are at increased risk for many serious diseases and health conditions, including the following:

• All-causes of death (mortality)
• High blood pressure (Hypertension)
• High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (Dyslipidemia)
• Type 2 diabetes
• Coronary heart disease
• Stroke
• Gallbladder disease
• Osteoarthritis (a breakdown of cartilage and bone within a joint)
• Sleep apnea and breathing problems
• Cancer (especially endometrial, breast, colon, kidney, gallbladder, and liver)
• Low quality of life
• Mental illness such as clinical depression, anxiety, and other mental disorders
• Body pain and difficulty with physical functioning

Wow. That's a whole bunch of science. Great post Kat. I'd copy it so I can paste it the next time this question comes up. But since this is the first time I've seen this question in the past 4 years, I'd probably misplace it.

Your right. I just cancelled my surgery date. Please let me know when you think I'm ready ok?

I've been learning about what all the possible risks/side effects from surgery are, along with everything else, for months. But then I ran into a thread with a ton of people complaining about pancreatitis and I hadn't heard of that one before. So I guess I'm not ready for surgery. Sorry I asked the question. If I come upon someone talking about a complication that I have never heard of before, then I will ignore it, and I will know this means that I'm not ready for surgery. Right? Thanks so much for the great advise!!

I took a lot of time to answer your question in a thoughtful way and answering your original query.

Obviously, no one suggested that you shouldn't research surgery or contemplate possible complications.

I am not really sure why you saw fit to respond to my response, that was obviously quite time consuming, in such a snarky way. I will be sure not to bother next time.

What are you talking about? You said I wasn't ready for surgery. So I am taking your advise. What is snarky about that??