Bariatric Surgery on Gastroesophageal Reflux Disease

Question: Describe about the Bariatric Surgery on Gastroesophageal Reflux Disease? Answer: Potential side effects for bariatric surgery. Dumping syndrome (early dumping and late dumping): Dumping syndrome is a group of symptoms which occurs if patient stomach is going to surgically bypassed to help the weight loss, also called as rapid gastric emptying. Common symptoms occurs nausea, diarrhoea and abdominal cramps. There are two kind of patient dumping, one is early and other is late. Early dumping syndrome occurs after thirty minutes of eating a meal. Meal containing high percentage of fats, carbohydrates or sugar, which causes these symptoms. Side effects occurs during early dumping syndrome are bloating, diarrhoea, heart palpitation, nausea and vomiting. Late dumping syndrome is a form of hypoglycaemia. It occurs after two or three hours after eating meal. This occurs due to dumping of large amount of sugars into the small intestine. The body releases large amounts of insulin to metabolised sugar, leading low level of sugar in the body. Side effects of late dumping syndrome are sweating, hunger, fainting, and dizziness. Gastro-esophageal reflux disease: The effect of bariatric surgery on the gastro-esophageal reflux disease is that it restricts the amount of food entering the stomach by attaching a band around the fundus which decreases the level of the ghrelin hormone (an appetite stimulating hormone). The abnormal relaxation of the lower oesophageal sphincter. This leads to heartburn, regurgitation, dysphagia, increased salivation and chest pain. Proper diet recommended by the doctors helps to subsides GERD symptoms. Vitamins deficiency: After bariatric surgery, body is vulnerable to vitamin deficiencies because surgery reduces bodys ability to absorb vitamin and doesnt allow body to hold food from which vitamins are withdrawn. If multivitamin supplements are not taken then it causes calcium deficiency which leads to osteoporosis or iron deficiency causes anaemia or vitamin D deficiency which leads to liver and kidney disorders and bone softening disease. Therefore, multivitamin supplements are prescribed daily to prevent vitamin deficiency. Osteoporosis: In bariatric surgery, the primary sites for calcium absorption are bypassed. Patient becomes calcium and vitamin D deficient and then the body up-regulates parathyroid hormone, causing increase production of vitamin D and increased calcium resorption from the bone. Patient who undergo this surgery, the duodenum and proximal jejunum are bypassed, which are primary sites from the calcium absorption in the body. The remaining small intestine can poorly absorb about 20% of dietary calcium. Therefore, multivitamin with calcium are prescribed. Kidney stones: Bariatric surgery changes anatomy of the digestive system to limit the food that can be consumed and the amount of food that the body digest. The potential side effect of the bariatric surgery is kidney stones as a result of gastric bypass. This caused malabsorption by the procedure which significantly affects the composition of the urine, which result in development of kidney stones, especially in patient who experience diarrhoea. Preventing stones after gastric bypass can be done by increasing amount of water intake or taking more citrates into their diets, as citrates increases urge of dairy products, as they have high content of calcium which bind with oxalate in the gut so that calcium oxalate can be excreted rather than storing in the kidney and crystalizing. Reference: Bariatric surgery and kidney stones. https://www.premiermedicalhv.com/news/bariatric-surgery-kidney-stones/. Hadi E.M. 2014. The effect of bariatric surgery on gastroesophageal reflux disease. Can J Surg. 57(2): 139144. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968207/. Life After Gastric Bypass Surgery. https://www.flat-d.com/gastric-bypass1.html. Wang A. 2009. The Effects of Obesity Surgery on Bone Metabolism: What Orthopedic Surgeons Need to Know. Am J Orthop. 38 (2): 77-79. https://hosp.gcnpublishing.com/fileadmin/qhi_archive/ArticlePDF/AJO/038020077.pdf.