Food intolerances two years after gastric bypass (PS – No, really?)

Apparently this concern with gastric bypass patients hasn't been "well-studied."

Hey researchers – PLEASE SEEK OUT PATIENTS WHOM COMPLAIN OF EXACTLY THESE ISSUES FROM DAY ONE.  

Because, uh, *putting on my Dr. Google Hat* they're totally normal and expected, or so we thought?  Or am I living under a rock where it's that we're not supposed to live with digestive distress most of the time?I suppose this is my bias because I live as a distressed patient, with a distressed patient, and know mostly only distressed patients?  And WHAT IS GOING ON WITH THE FOODS LISTED IN THIS STUDY!?

I am using a lot of question marks lately.  I need to stop that.

Discuss.

Study blurb via Reuters –

(Reuters Health) – A common weight loss surgery is associated with long-term gastrointestinal problems and food intolerance, a recent study suggests.

Researchers examined data on 249 extremely obese patients who had what’s known as laparoscopic Roux-en-Y gastric bypass, which reduces the stomach to a small pouch about the size of an egg.

Two years after surgery, these patients had lost about 31 percent of their total body weight on average. But compared to the control group of 295 obese people who didn’t have operations, the gastric bypass patients were far more likely to experience indigestion and an inability to tolerate multiple foods.

“It was already known from previous studies that the Roux-en-Y gastric bypass might aggravate gastrointestinal symptoms after surgery,” said lead study author Dr. Thomas Boerlage of MC Slotervaart in Amsterdam.

 

 

Study – Weight-Loss Surgery Linked To Increased Suicide Risk

Another OBVIOUS. 

Reuters –

“These findings suggest that more effort may be needed to improve access to mental health care services in these patients should they need them, and perhaps some screening in the second year and onwards,” Bhatti said. 

During the first three years after surgery, 111 patients received emergency care for self-inflicted injuries, or roughly 1 percent of people in the study. While small, the risk of these emergencies was 54 percent higher after surgery than it was before.

Study – JAMA

Importance  Self-harm behaviors, including suicidal ideation and past suicide attempts, are frequent in bariatric surgery candidates. It is unclear, however, whether these behaviors are mitigated or aggravated by surgery.

Objective  To compare the risk of self-harm behaviors before and after bariatric surgery.

Design, Setting, and Participants  In this population-based, self-matched, longitudinal cohort analysis, we studied 8815 adults from Ontario, Canada, who underwent bariatric surgery between April 1, 2006, and March 31, 2011. Follow-up for each patient was 3 years prior to surgery and 3 years after surgery.

Main Outcomes and Measures  Self-harm emergencies 3 years before and after surgery.

Results  The cohort included 8815 patients of whom 7176 (81.4%) were women, 7063 (80.1%) were 35 years or older, and 8681 (98.5%) were treated with gastric bypass. A total of 111 patients had 158 self-harm emergencies during follow-up. Overall, self-harm emergencies significantly increased after surgery (3.63 per 1000 patient-years) compared with before surgery (2.33 per 1000 patient-years), equaling a rate ratio (RR) of 1.54 (95% CI, 1.03-2.30; P = .007). Self-harm emergencies after surgery were higher than before surgery among patients older than 35 years (RR, 1.76; 95% CI, 1.05-2.94; P = .03), those with a low-income status (RR, 2.09; 95% CI, 1.20-3.65; P = .01), and those living in rural areas (RR, 6.49; 95% CI, 1.42-29.63; P= .02). The most common self-harm mechanism was an intentional overdose (115 [72.8%]). A total of 147 events (93.0%) occurred in patients diagnosed as having a mental health disorder during the 5 years before the surgery.

Conclusions and Relevance  In this study, the risk of self-harm emergencies increased after bariatric surgery, underscoring the need for screening for suicide risk during follow-up.




Link – http://archsurg.jamanetwork.com/article.aspx?articleid=2448916

PAC MAN

FAAAAAHTS or Gastrointestinal colonization with methanogens increases difficulty of losing weight after bariatric surgery

Gastrointestinal colonization with methanogens increases difficulty of losing weight after bariatric surgery.

PAC MAN

This is totally my gut.
 
I feel like we knew this – have you lived with a gastric bypass or duodenal switch patient for a period of time?  I'm just saying, those of us with altered bariatric intestines  LIVE with "MARSH ASS."   Welcome to the world of pre-biotics, probiotics, fart-smell-better products and I kid you not, LINED UNDERWEAR.  

 
Hey, I never said I was a professional.  Read the studies.
 
What is a methanogen?  Wisegeek says —

"Methanogens are a type of microorganism that produces methane as a byproduct of metabolismin conditions of very low oxygen. They are often present in bogs, swamps, and other wetlands, where the methane they produce is known as "marsh gas." Methanogens also exist in the guts of some animals, including cows and humans, where they contribute to the methane content of flatulence. Though they were once classified as Archaebacteria, methanogens are now classified as Archaea, distinct from Bacteria.

Some types of methanogen, including those of the Methanopyrus genus, are extremophiles, organisms that thrive in conditions most living things could not survive in, such as hot springs, hydrothermal vents, hot desert soil, and deep subterranean environments. Others, such as those of the Methanocaldococcus genus, are mesophiles, meaning they thrive best in moderate temperatures.  Methanobrevibacter smithii is the prominent methanogen in the human gut, where it helps digest polysaccharides, or complex sugars."

Gut bacteria may decrease weight loss from bariatric surgery March 6, 2015
 

The benefits of weight loss surgery, along with a treatment plan that includes exercise and dietary changes, are well documented. In addition to a significant decrease in body mass, many patients find their risk factors for heart disease are drastically lowered and blood sugar regulation is improved for those with Type 2 diabetes.

Some patients, however, do not experience the optimal weight loss from bariatric surgery. The presence of a specific methane gas-producing organism in the gastrointestinal tract may account for a decrease in optimal weight loss, according to new research by Ruchi Mathur, MD, director of the Diabetes Outpatient Treatment and Education Center at Cedars-Sinai.

"We looked at 156 obese adults who either had Roux-en-Y bypass surgery or received a gastric sleeve. Four months after surgery we gave them a breath test, which provides a way of measuring gases produced by microbes in the gut," said Mathur. "We found that those whose breath test revealed higher concentrations of both methane and hydrogen were the ones who had the lowest percentage of weight loss and lowest reduction in BMI (body mass index) when compared to others in the study."

The methane-producing microorganism methanobrevibacter smithii is the biggest maker of methane in the gut, says Mathur, and may be the culprit thwarting significant weight loss in bariatric patient. Mathur and her colleagues are conducting further studies to explore the role this organism plays in human metabolism.

While that research continues, bariatric patients may still have options to improve weight loss after surgery.

"Identifying individuals with this pattern of intestinal gas production may allow for interventions through diet. In the future there may be therapeutic drugs that can improve a patient's post-surgical course and help them achieve optimal weight loss," said Mathur.

The study, "Intestinal Methane Production is Associated with Decreased Weight Loss Following Bariatric Surgery" was done in collaboration with the Mayo Clinic. The paper is being presented by Mathur Thursday, March 5, at the 97th annual meeting of the Endocrine Society in San Diego.

 

angry lego head

The Biggest Loser Meltdown Moment

Did you watch this last night?

"I don't want you to go through what your dad has gone through." -Dr.

So — you KNOW I am thinking it — I probably yelled AT THE TV.

angry lego head

I would like to know what happened to Rob's dad after all this crying and freaking out with the shaming of the wheel-chair.  I hate when information about weight loss surgery is thrown out there to the general public like "this" without any context.

Biggest Loser, please explain.  I understand that the producers like to create 'breakthrough' moments with the contestants to get them motivated and moving forward and to tear off all excuses, but why create a stigma around weight loss surgery? 

New

#itfits

It, fits?  OH COME ON.  

The NEW AND IMPROVED LAPBAND!  

You can do better!

New

Apollo Endosurgery, Inc., the leader in minimally invasive endoscopic surgical products for bariatric and gastrointestinal procedures, today announced the launch of the “It Fits” campaign, aimed at rejuvenating the LAP-BAND® System and educating a broad range of patients about the benefits of the minimally-invasive weight loss procedure.

“It Fits” supports the company’s decision to place greater emphasis on the unique advantage of the LAP-BAND® System – the only FDA approved device for weight reduction for people with at least one weight-related health problem, and having a BMI of 30 or greater.

Read more: http://www.digitaljournal.com/pr/1989812#ixzz34taKYjn9

The new ad spot – from Apollo – tugs right there at your heart, don't it?  I might be tearing up over all of the completely stereotypical situations right here in this here commercial!  OMG I CAN FIT IN THE AEROPLANE SEATBELT WITHOUT AN EXTENDER COULD YOU PLEASE PUT ME IN A COMMERCIAL ALTHOUGH I WAS NEVER SUPER MORBIDLY OBESE I AM JUST AN ACTOR!

Until this and my tears dry up!

Screen Shot 2014-06-17 at 7.33.40 AM

Because of course we will ignore the patient histories of thousands — to have a procedure to lose how much weight?  

Just as a frame of reference, that makes me qualify in a few BMI points.  Confession:  when I reached my high weight about the same time the new BMI-qualifications for the Allergan-owned lap-band came around, I decided THAT WAS IT.  I could not possibly do it again, my butt was not revising band-over-bypass for that much weight, not after watching this weight loss community for 12 years.  Nope.

Jawdrop

Carnie Wilson Speaks At WLSFA 2013 Las Vegas Luncheon

Carnie Wilson Speaks At WLSFA 2013 Las Vegas Luncheon