Post-gastric bypass nutrition

introduction

The surgical implementation of a gastric bypass is a major intervention in the digestive system.
By bypassing the stomach, which is on the one hand a first collecting reservoir for the ingested food and on the other hand an important station in the digestion of our food components, there are noticeable changes in the digestive process, which can also lead to changes in the bowel movement and sometimes even to discomfort . It is therefore all the more important to pay attention to one or the other specialty in the diet after gastric bypass in order to counteract these from the outset.

Why do you have to adjust your diet?

In the case of gastric bypass, the stomach is deliberately bypassed as a collecting reservoir and first digestive station.
The ingested food is transferred to a small remaining stomach (Stomach pouch) directly into the small intestine, the digestive juices of the blindly closed, left stomach, are only fed into a somewhat deeper section of the small intestine. This means that not all food components can be broken down and absorbed, as a considerable part of this process already takes place in the stomach and duodenum. On the one hand, fewer energy sources such as protein, carbohydrates and fats are absorbed, on the other hand, the absorption of vitamins, minerals and trace elements also suffers.
Care should therefore be taken to ensure that sufficient calories are consumed with the food; if necessary, vitamins or iron, for example, must be substituted. In addition, the Dumping syndromes This can be counteracted by consciously eating several small meals, which prevent overloading of the digestive system and simulate “portioning” of the stomach.

How should I eat after gastric bypass surgery?

Because the digestive juices from the stomach, the gallbladder (bile) and the pancreas (digestive enzymes) come into contact with food later than usual, some food components can only be slightly or not at all split and absorbed through the intestinal mucosa.
So there is a loss of food components that are lost through the stool. It is therefore important that when dieting after gastric bypass it is ensured that sufficient calories are consumed from the outset, so that the need for proteins, carbohydrates and fats is well covered.

The food should therefore be rich in protein and contain a low proportion of carbohydrates that can be consumed quickly. You may have to resort to a protein-rich supplementary diet. In the same way, attention should be paid to a sufficient intake of vitamins, trace elements and minerals, although this is not always possible, so that an additional intake of multivitamin preparations or iron tablets may be necessary. In severe deficiencies, vitamins and iron can also be administered via the vein.

What is dumping syndrome?

The dumping syndrome is a complex of symptoms consisting of abdominal and circulatory problems, altered intestinal motor skills and altered defecation and occurs when the stomach is either significantly reduced in size, removed or bypassed through operations on the stomach. A distinction is made between early and late dumping syndrome, the English word "dumping", which can be translated with the German word "plumpen", already indicates the problem: if the stomach is switched off in its function of the first collecting reservoir, the ingested one arrives Food via the bypass directly into the small intestine - "it plops through".

In the early dumping syndrome, which can occur as early as 20 minutes after eating, the still undigested, undiluted food reaches the small intestine and has an osmotic effect, i.e. it draws water. The result is abdominal pain, diarrhea, nausea and circulatory problems.

Also read our in-depth article on dumping syndrome: What is dumping syndrome

The late dumping syndrome, which can occur approx. 1-3 hours after eating, shows signs of hypoglycaemia, such as cold sweating, nausea and circulatory disorders. The reason for this is that the sugary food reaches the small intestine in unportioned form and thus leads to excess sugar in the blood. To compensate for this, the body also releases excess insulin for sugar intake, which can then lead to hypoglycaemia.

Also read our topic: Symptoms of hypoglycaemia

What diet helps against diarrhea?

Diarrhea after gastric bypass surgery is primarily caused by the fact that the ingested food reaches the small intestine undiluted without "pre-digestion" in the stomach, where it initially has a water-drawing (osmotic) effect. So water is transported from the body into the intestine. The rapid transport of food into the small intestine also causes the intestinal wall to expand, which in a reflex way leads to increased stimulation of the intestinal motor skills. Both cause symptoms of diarrhea.

It can be noticeable that the thin stool appears shiny and has a noticeable smell, which is associated with the insufficient absorption of fats from food (fatty stools). The symptoms of diarrhea can be reduced, on the one hand, by making sure that the meals are significantly smaller, but several at shorter intervals. This prevents “overloading” the digestive system. In addition, care must be taken to ensure that there is sufficient fluid intake, as a lot of water can be lost through the liquid stool. If the diarrhea does not cease in this way, a doctor should be consulted, with whom a drug therapy can be considered.

This article might also interest you: How do I eat properly if I have diarrhea?

What can you do with the diet for gas?

Flatulence occurs when intestinal bacteria, which are mainly located in the large intestine, produce excessive amounts of gases as soon as they break down undigested proteins and carbohydrates. This can sometimes be the case after gastric bypass surgery.

Switching to several small meals a day can help stop the flatulence. In addition, some home remedies such as fennel, caraway or coriander (e.g. fennel-caraway-anise tea) and more exercise can have a soothing effect.

Read more about the topic here: What home remedies are there for flatulence?

What do you do about a vitamin deficiency?

If a vitamin deficiency occurs after gastric bypass surgery, steps can be taken to counteract it. First of all, care should be taken to ensure a sufficient intake of vitamins, trace elements and minerals with food. If this is not enough, vitamins can be taken with additional supplements. Multivitamin preparations that cover several complexes are ideal here.

Some vitamins, such as primarily vitamin B12, which is important for blood formation, can also be given at regular intervals via the vein or into the muscle.

Further information on the topic can be found here: What to do if you have a vitamin deficiency

How should one eat immediately after the operation?

Immediately after the gastric bypass operation, there is usually a slow increase in diet during the remaining inpatient stay, i.e. the resumption of nutrition is slowly determined and individually adjusted by the treating physicians according to a fixed schedule.

While they are still in the hospital, the patients receive precise instructions on nutrition, mostly from specially trained nutritionists, so that they are discharged home with clear nutritional recommendations.

The question of how exactly one can eat immediately after the operation does not apply, as this is still part of the treatment in the hospital. Only at home, after discharge from the ward, is it necessary to act independently in accordance with the clear dietary recommendations in order to avoid symptoms and deficiencies caused by malnutrition.