GASTRIC BYPASS SURGERY

Brya Bradley

3/20/13

PATHOPHYSIOLOGY OVERVIEW Gastric bypass is a surgical procedure

that decreases the size of the gastric pouch. This procedure is performed on obese patients who have a very hard time losing weight. The greatest weight lose is usually achieved during the first year after surgery. However weight tends to stabilize after 18 months. Complications of this procedure include dumping syndrome in which gastric contents empty too rapidly into the small intestine overwhelming its ability to digest nutrients.

VARIATIONS OF GASTRIC BYPASS

Stabling the stomach without transaction to create a small, 30-45ml gastric pouch.

Creating an upper and lower gastric pouch and totally disconnecting the pouches.

Creating an upper gastric pouch and completely removing the lower pouch.

NUTRITIONAL REQUIREMENTS With in the first 24 hours

patient will be placed on IV solutions containing 5% to 10% dextrose, electrolytes, vitamins and medications needed

Clear liquids first 2-3 meals.

Pureed food after tolerance of clear liquids

Regular food 2-3 weeks after surgery. Food has to be (no fried or sweet foods)

Bread, Cereal, Pasta, and Rice 1-2 serving/d 1= ¼ cup

Hot cereal (make with milk) – unsweetened oatmeal, cream of wheat, and grits.

Fruit 1-2 serving/d 1 = ¼ cup

Unsweetened applesauce, pureed canned / jarred peaches and pears in their own juice (not syrup), any fruit pureed without the skin, mashed ripe banana.

Vegetable 1-2 serving/d 1 = ¼ cup

Any vegetable (except corn) cooked soft and blended or mashed with the back of a fork. Make sure broccoli and cauliflower are cooked very well.

Meat, Poultry, Fish, Nuts, Beans and Eggs 2-3 serving/d 1 = ¼ cup

Chopped up soft poached eggs or scrambled eggs (egg whites might be “too light”). Blenderized meat and poultry and flaked fish cooked very soft and moist, blenderized tuna salad without vegetables. Very soft/moist meatloaf (after one week), gefilte fish, and silken tofu.

Food Groups Food Choices

EXAMPLE OF BREAKFAST, LUNCH AND DINNER TRAY

Breakfast

¼-1/2 cup cooked cereal ¼- ½ cup skim plus or fat free Lactaid milk

Lunch

¼ - ½ cup sugar free yogurt ¼ cup pureed fruit

Dinner

1-2 oz flaked fish ¼ cup puree vegetable

REFERENCES Dirksen Heitkemper, L. (2004). Medical surgical

nursing. (6th ed., pp. 1345-1355). St Louis Missouri: Mosby Inc.

Goldenberg, L. MPH, RD, CDN., Kinsella T. MS, RD., Sherry J. MS, RD, CDN (2011). The cornell weight loss surgery program:. Dietary Guidelines for Roux-en-Y Gastric Bypass,

Ignatavicius Workman. (2013). Medical Surgical Nursing Patient-Centered Collaborative care. (7th ed., pp. 995-997). St. Louis Missouri: Elsevier Inc.

Roth, R. (2011). Nutrition & diet therapy. (10th ed., pp. 411-413). Clifton Park, NY: Delmar Cengage Learning.