Dr Niruben Rajasagaram is a bariatric consultant, oesophagogastric and general surgeon with an impressive track record in advanced laparoscopic surgery. Having trained extensively in both national and international institutions, Dr Niruben has completed several sub-speciality fellowships, solidifying his reputation as a leading expert in his field. His journey includes earning a medical degree from the prestigious Royal College of Surgeons in Ireland, achieving membership in the Royal College of Surgeons Ireland (MRCS) in 2004, and receiving the Fellowship of the Royal Australasian College of Surgeons (FRACS) in 2011. He has done a further 4 years of advanced fellowship in Bariatric and Upper GI surgery.

With over 14 years of surgical experience, including four years specialising in bariatric, upper gastrointestinal, and advanced biliary surgery, Dr. Niruben brings unparalleled expertise to every patient case. His certifications from the Australian New Zealand Gastro-Oesophageal Surgery Association (ANZGOSA) and the Gastroenterological Society of Australia further underscore his commitment to excellence. Working at esteemed institutions like Western Hospital, Alfred Hospital, and St. Vincent's Melbourne, Dr. Niruben focuses on understanding the unique health needs of individuals.

Let’s understand Gastric Bypass surgery from the expert.

What Is Gastric Bypass Surgery?

Gastric bypass is a type of weight loss surgery (bariatric surgery) designed to help people with obesity lose weight and improve their health. The surgery makes your stomach smaller and connects it directly to your small intestine, skipping part of your digestive system.

There are two types:

• Roux-en-Y gastric bypass: The digestive tract is joined in two places.
• Mini gastric bypass: A simpler version where it’s joined in one place.

The smaller stomach helps you feel full with less food, and bypassing part of the intestine reduces nutrient absorption. Together, these changes support weight loss.

Benefits of Gastric Bypass Surgery and When to Consider It

Gastric bypass surgery often leads to greater and longer-lasting weight loss compared to other bariatric procedures. Losing weight through this surgery can help:

• Manage type 2 diabetes.
• Reduce reflux disease (roux En Y Gastric Bypass)
• Lower blood pressure.
• Improve heart health.
• Enhance your overall quality of life.

You might consider gastric bypass surgery if diet and exercise haven’t helped you achieve a healthy weight. It is typically recommended for those with:

• A body mass index (BMI) over 40.
• A BMI over 35, along with obesity-related health issues like diabetes or heart disease.

While gastric bypass is highly effective, it’s not suitable for everyone. Discuss your options with your doctor to determine if it’s the right choice for you and what to expect.

Common Side Effects and Changes During Recovery After Gastric Bypass Surgery

After gastric bypass surgery, your body undergoes significant changes. It's common to experience:

• Fatigue: Feeling unusually tired or lacking energy- as per Better Health Victoria.
• Mood Changes: Fluctuations in mood, including irritability or feelings of sadness.
• Digestive Changes: Altered bowel movements, such as diarrhoea or constipation.

In the initial months, rapid weight loss and dietary adjustments can lead to:

• Feeling Cold: Increased sensitivity to cold temperatures.
• Body Aches: Muscle soreness or discomfort.
• Hair Thinning: Noticeable hair loss or thinning.

These symptoms are typically temporary. Maintaining a balanced diet, staying hydrated, and following your healthcare provider's advice can help manage these changes. If symptoms persist or worsen, consult a doctor for further guidance.

Possible Long-Term Complications of Gastric Bypass Surgery

While gastric bypass surgery can help with weight loss, it may cause some digestive complications over time:

• Dumping Syndrome: This happens when food moves too quickly into your small intestine, causing nausea, diarrhea, cramps, and low blood sugar. It can be managed with diet changes and often improves over time.
• Malabsorption and Malnutrition: The surgery reduces calorie absorption, which can lead to nutritional deficiencies. Your doctor will recommend supplements to prevent this.
• Bile Reflux: If the pyloric valve doesn’t work properly, bile can flow back into your stomach, leading to irritation, gastritis, or ulcers.
• Gallstones: Rapid weight loss can cause extra cholesterol to build up in your gallbladder, forming gallstones. While they don’t always cause problems, they can block bile ducts and be dangerous.
• Marginal Ulcers: Gastric bypass surgery increases the risk of ulcers. Avoiding smoking and non-steroidal anti-inflammatory drugs (NSAIDs) can help prevent them.
• Weight Regain: If you don't maintain healthy eating habits, your stomach pouch may stretch over time, leading to weight regain. In such cases, a revision surgery may be needed.

What to Expect During and After Gastric Bypass Surgery

Before and During the Procedure:

• Gastric bypass surgery is done in a hospital under general anesthesia to keep you asleep and comfortable.
• Most procedures are performed laparoscopically, using small incisions, though some may involve larger open incisions.
• The surgeon creates a small stomach pouch about the size of a walnut, which can hold only about an ounce of food. The rest of the stomach is bypassed.
• Part of the small intestine is connected to this pouch, allowing food to bypass most of the stomach and the first section of the small intestine.
• Surgery usually takes a few hours, followed by monitoring in the recovery room.

After the Procedure:

• Initially, you’ll only have liquids to allow healing, gradually moving to pureed foods, soft foods, and eventually firmer foods.
• You’ll need to follow strict eating and drinking limits and take supplements like multivitamins with iron, calcium, and vitamin B-12.
• Regular checkups, bloodwork, and tests will monitor your progress in the first months.
• You will usually be in hospital for 2 nights after the procedure.

Common Changes After Surgery:

Rapid weight loss in the first 3-6 months may cause:

• Body aches.
• Fatigue (like flu symptoms).
• Feeling cold.
• Dry skin.
• Hair thinning or loss.
• Mood changes.

How long does gastric bypass surgery take?

The surgery usually takes 2 to 4 hours. However, you will have to stay in the hospital for a minimum of 2 days and more based on your health. You will have dietary restrictions and won't be allowed to eat solid food yet.

How painful is gastric bypass surgery?

You may feel moderate pain for a few days, but pain medication through a vein will help manage it. You'll be discharged once you can move around comfortably without needing IV pain relief.

At home, prescription pain meds can help, but most people stop needing them within a week. Laparoscopic incisions heal quickly, though you may still feel some discomfort as they heal.

What Diet Will You Follow After Gastric Bypass Surgery?

After gastric bypass surgery, you’ll need to follow strict dietary guidelines to help your body heal and ensure you get proper nutrition with a smaller food intake.

Post-Surgery Diet Stages:

• Liquid Diet: For the first few weeks, you’ll start with liquids.
• Soft Foods: Gradually move to soft foods over the next few weeks.
• Solid Foods: Return to solid foods after 2–3 months, choosing them carefully.

General Dietary Guidelines:

• Hydration: Drink at least 64 ounces of fluids daily, but not during meals, as your reduced stomach size makes this challenging. Staying hydrated prevents nausea and constipation.
• Protein: Aim for at least 100 grams of protein a day to maintain muscle and strength. Protein should be the focus of your meals.
• Supplements: Take daily vitamins and minerals for life, as your digestive system won’t absorb enough nutrients from food alone.
• Limit Sugars and Starches: Avoid foods high in sugar and starch to prevent side effects like indigestion, rapid blood sugar changes, or discomfort.

Transform Your Health through Gastric Bypass Surgery with Dr. Niruben

Gastric bypass surgery is a highly effective option for patients seeking life-changing weight-loss solutions. Under the care of Dr. Niruben, patients not only receive expert surgical intervention but also benefit from a comprehensive support system. Our multidisciplinary team, including dieticians, exercise physiologists, habits coaches, and counsellors, ensures an all-around weight loss and health management approach.

Dr. Niruben's expertise, combined with ongoing patient support and collaborative care with GPs and specialists, offers an unparalleled path to achieving lasting health and weight-loss goals. If you're considering gastric bypass surgery, trust in the care and expertise of a surgeon who truly prioritises your well-being.

To schedule an appointment with Dr Niruben Rajasagarm, call us on 03 8548 0318.