Dangerous Detour

Dangerous Detour

Gastric bypass is serious business.

The most common type of bariatric surgery is gastric bypass, the procedure that dramatically decreases the size of the stomach and reroutes digestion to the small intestine.

Even though this radical alteration to the digestive tract may produce very challenging complications, the general public seems to be put at ease when celebrities such as Al Roker and Randy Jackson undergo gastric bypass with impressive results. Between 1998 and 2002, gastric bypass surgeries in the U.S. jumped from 14,000 to 82,000 per year.

But as more surgeries are conducted, the dangers linked to them become more evident.

Beyond digestion

Two years ago, a government report showed that about four out of every 10 gastric bypass surgery patients experience complications. Abdominal hernias, infections, and digestive problems such as acid reflux, vomiting, and diarrhea are typical setbacks.

A new study from the University of Arkansas shows that neurological difficulties may also arise after gastric bypass.

Researchers examined 150 patients with neurological problems and found that 26 were potentially linked to bariatric surgery. The most frequent and disabling condition was myelopathy, a spinal column disorder that causes loss of sensation and even mobility.

• Symptoms of myelopathy generally began about 10 years after surgery.
• Other neurological conditions the UA team linked to bariatric surgery:
• Encephalopathy – progressive cognitive decline, memory loss, inability to concentrate, and loss of consciousness
• Optic neuropathy – progressive vision loss

Polyneuropathy – movement loss due to inflammation

In the May 22, 2007, issue of the journal Neurology, the authors note that the common denominator among the 26 patients was multiple nutritional deficiencies. Correction of these deficiencies usually did not correct the problems. Copper and vitamin B-12 deficiencies were linked to myelopathy, but specific deficiencies could not be pinpointed for the other complications.

On the periphery

The Arkansas study is not the first to recognize that gastric bypass can prompt health challenges beyond the digestive tract.

A 2004 study, which also appeared in Neurology, found that 16 percent of 435 bariatric surgery patients experienced peripheral neuropathy, characterized by numbness or prickly, burning sensations in the feet, legs, hands, and arms. Extended peripheral neuropathy often results in impaired coordination, urinary urgency, erectile dysfunction, and lightheadedness.

Most sobering of all, however, is a study I told you about in the e-Alert “A Refreshing Blink” (11/2/05). As reported in the Journal of the American Medical Association, researchers from the University of Washington examined medical records for more than 16,000 gastric bypass patients.

Results showed that in the 35-44 age group, five percent of men and three percent of women died within one year of surgery. These rates were slightly higher in the 45-54 age group, and in patients aged 65 to 74, about six percent of the women died within one year, and almost 13 percent of the men.

There’s no doubt that patients who are morbidly obese can avoid a wide range of health problems if gastric bypass surgery is successful. But before signing on for this procedure (which is irreversible), those patients should weigh the considerable risks of an extreme solution.

You can find more information about the pros and cons of bariatric surgery at the web site for Bariatric Edge: bariatricedge.com. Although this site essentially promotes this type of surgery, other gastric bypass complications are discussed, including the possibility of increased bone calcium loss and metabolic bone disease.
Sources:
“Neurologic Complications of Gastric Bypass Surgery for Morbid Obesity” Neurology, Vol. 68, No. 21, 5/22/07, neurology.org
“A Controlled Study of Peripheral Neuropathy After Bariatric Surgery” Neurology, Vol. 63, No. 8, 10/26/07, neurology.org