Gastric Bypass and Dumping Syndrome

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Gastric Bypass and Dumping Syndrome

• Malia Burgess, Eric Spickler, and Jessica Pogachar

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Gastric Bypass

• the stomach is made smaller by a double row of
  staples near the top of the stomach, making a
  small pouch.
• The small pouch is then directly connected to the
  middle section of the jejunum.
• The two parts of the small intestine are then
  connected forming a Y shape to allow for the
  unused portion of the stomach to drain.

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Contribution to Weight Loss

• Restriction of stomach size allows for only a
  small amount of food at any given time
• Opening of jejunum that attaches to the stomach
  is smaller allowing for a slower flow of food out
  of the stomach giving a feeling of being full for
  a longer period of time.
• Bypassing the upper portion of the small
  intestine leads to a smaller amount of ingestion
  of the food into the body.

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Dumping Syndrome

• Dumping Syndrome is caused by the intake of
  sugars and fats and results in palpitations of
  the heart, sweating, queasiness, nausea, and
  diarrhea.
• The patient also feels weak and has to lie down
  for 30-60 minutes due to the symptoms.
• Why and how are the digestive and cardiovascular
  symptoms of Dumping Syndrome are related?

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Relevance to Lecture

• Functions of the stomach and small intestine in
  digestion
• Blood plasma volume
• Compensation of heart rate due to decreased
  volume of blood

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Hyperosmolar Load Theory

• Osmotically active substances pass through the
  stomach rapidly causing the flow of water into
  intestinal lumen.
• This is a result of the shortening of the stomach
  resulting in a smaller reservoir to store and
  digest food.
• Digestion of food also decreases due to decreased
  secretion of gastric juices as well as the
  absence of duodenal feedback to signal release of
  contents when ready.
• Diarrhea may result

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Cont.

• The increase of water into the intestinal lumen
  causes a decrease in blood plasma volume
  resulting in low blood pressure.
• The SNS stimulates
• increased heart rate to compensate for the
  decrease in blood pressure, resulting in an
  increase in blood flood and increased blood
  pressure to maintain homeostasis.
• vasoconstriction
• sweating
• Patient may complain of weakness
• Queasiness and nausea are caused by the
  overstretching of the stomach by a large quantity
  of food and the excess water within the
  intestinal tract.

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Dietary Changes

• Intake of 6 small meals
• Liquid intake 30 minutes after a meal, not with
  the meal
• Milk products should be avoided
• Intake of only simple sugars
• Increase of protein and fat intake to make up for
  loss of carbohydrates.

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Analogy

• Gastric bypass is analogous to a short cut
  through the city instead of the long drive around
  through the county. Its shorter and wastes less
  time but you miss out on the nice scenery
  (nutrients).
• Dumping is analogous to trying to get all your
  tasks done too quickly and catching a cold from
  not taking care of yourself.

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References

• E-Medicine
• http//www.emedicine.com/med/topic589.htm
• Web MD
• http//my.webmd.com/hw/weight_control/hw252819.asp

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Questions?