Gastric bypass complications have drastically decreased in the last decade, with the development of the minimally invasive surgical techniques. Still, we may consider several serious complications. Many different factors, including the type of procedure that is performed, determine the incidence and likelihood of complications. Some complications can occur with both laparoscopic (minimally invasive) and open procedures, while others are more likely if an open procedure is performed. As much as 1% of people can have life-threatening complications from gastric bypass surgery, including heart attacks, blood clots, leaks, bleeding, and infection, reports the Mayo Clinic. About 5% of people who undergo the surgery have minor complications such as wound infections, ulcers, and digestive problems.
Incisional hernias, organ injuries during the surgery, and wound infections are gastric bypass complications that commonly occur following open surgery. Bowel obstruction, hemorrhage or bleeding, and stomal stenosis or narrowing are gastric bypass complications that have a higher incidence following laparoscopic surgery. About 1% of patients undergoing the procedure develop early complications and about 5% of patients develop late gastric bypass complications.
Bleeding
One of the potential complications of gastric bypass surgery is a hemorrhage or bleeding which results from an excessive discharge of blood from blood vessels. Depending on the severity of the bleeding, it may stop on its own or may require interventions such as replenishing body fluids, stopping blood thinning or anticoagulant medications, a blood transfusion to replace lost blood, and rarely even a repeat procedure to identify and control the point of bleeding.
Blood Clots
Another possible gastric bypass complication is a thrombus or blood clot, which is the presence of a semi-solid clump of blood cells inside the veins or arteries. A blood clot is harmless if it remains attached to the wall of a blood vessel, but if it breaks free and finds its way into a small vein or artery and blocks it, the clot can prevent that part of the body from getting an adequate supply of blood and oxygen. When this occurs in the leg, for example, it causes redness, swelling, and pain and is termed deep vein thrombosis. If a clot finds its way to the lungs, it can cause a condition called pulmonary embolism, which presents with chest pain, shortness of breath, dizziness, and coughing up blood, among other symptoms. Blood clots can occur after any type of surgery, including gastric bypass surgery.
Digestive Problems
Digestive problems are possible gastric bypass complications. These include diarrhea or loose stools, constipation, foul smelling stools, excessive flatulence, difficulty swallowing, and gurgling sounds from the abdomen due to excess air. It may be possible to treat diarrhea and constipation with increased fluid intake and fiber in the diet. People who have undergone gastric bypass may find it difficult to eat too quickly or too much at any one time.
Bowel Obstruction
One of the most serious gastric bypass complications that patients are at risk for lifelong after the procedure is bowel obstruction resulting from a twisting of the intestine that prevents food from passing through and restricts the flow of blood. This condition is diagnosed with a CAT scan and often requires surgery to correct.
Dumping Syndrome
A collection of symptoms including nausea, diarrhea, and fainting is referred to as dumping syndrome, which is one of the gastric bypass complications that results from surgery on the stomach. When food is dumped from the stomach to the intestine too quickly, the body is not equipped to handle this and responds by introducing large amounts of water to the intestine, which in turn leads to the symptoms associated with dumping syndrome. A change in diet and medical treatment can help with distressing symptoms which can also include palpitations, sweating, flushing, bloating, and vomiting.
Dehydration
Following gastric bypass, it becomes necessary to stay well hydrated. Dehydration is a common gastric bypass complication, and untreated, it can lead to vomiting and nausea. Severe dehydration can require admission to the hospital for intravenous fluid replenishment.
Dyspepsia
People who have undergone gastric bypass surgery can suffer from an uncomfortable burning sensation in the chest called dyspepsia or heartburn due to incomplete digestion of food and backflow into the food pipe. To avoid this gastric bypass complication, patients may need to modify their diet and exclude alcohol, caffeine, spicy and greasy food, and some drugs like aspirin.
Hypoglycemia or Low Blood Sugar
Excessive dumping can result in hypoglycemia or low blood sugar after a gastric bypass procedure. This complication can be controlled with medications when it is mild, but if severe, surgery may be needed to remove a portion of the pancreas to reduce the production of insulin, so that dangerously low levels of blood sugar do not occur.
Incisional Hernia
The protrusion of an internal body part or organ through an incision or cut that was made to perform a surgery is called a hernia, and this is one of the gastric bypass complications that is seen after an open procedure. If it occurs, a hernia needs to be repaired with by means of a surgical procedure.
Nutritional Deficiencies
Following gastric bypass or bariatric surgery, it becomes necessary to take nutritional supplements to augment vitamins and minerals that are not sufficiently available from food. If recommended guidelines are not followed and routine blood tests are not performed, one of the common gastric bypass complications encountered is a deficiency of essential nutrients. This can have serious effects on many organ systems of the body. Nutrients that need to be supplemented included calcium, iron, vitamins, proteins, and minerals such as zinc.
One of the most feared gastric bypass complications: Leak
Will be discussed in a future article. You can also refer the to Gastric Sleeve Complications in Lebanon for more info.
