Gastric bypass surgery is essentially a two-step process.(1) First, a surgeon uses staples to divide a patient’s stomach into a small upper section and a larger bottom section. That top section is only about the size of a walnut, and following surgery, is where food eaten by the patient will go. This new, smaller section can hold only about one ounce of food.
Once the stomach has been sectioned, the “bypass” is then performed. The surgeon connects the small part of the intestine, or “jejunum”, to a small hole in the new upper pouch. Food eaten will now bypass the lower part of the stomach and first part of the small intestine. In some cases, this new passageway can become constricted because of scar tissue and other factors.(2) In cases where the connection stops being able to pass food, it is called an anastomotic stricture.
Although some scientific sources rate the incidence of stricture as low as five percent, it can be higher—up to 20%–depending on the technique used.(3) Stricture is typically detected from several weeks to several months after the gastric bypass surgery and is treated by a procedure known as endoscopic dilation.
Local anesthetic is usually sufficient, as the doctor will pass an endoscope through the patient’s mouth and into the esophagus, small new stomach, and bridge to the small intestine.(4) Throughout the procedure, a patient is able to breathe normally.
Once the doctor confirms the stricture, they typically use either a dilating (inflatable) balloon or plastic dilators. During the corrective process, patients often experience a mild pressure in the back of their throat or chest. X-rays are also sometimes taken during the performance of an endoscopic dilation to confirm procedure details and final success.
After the outpatient procedure is completed, patients may experience a sore throat for the rest of the day. But within 24 hours, they are usually able to resume eating and drinking. There are very rarely any complications, but in a few isolated instances, a perforation in the esophagus or intestine may occur and require separate, corrective surgery.
(1) National Institutes of Health – Gastric Bypass Surgery, Retrieved August 28, 2011 from http://www.nlm.nih.gov/medlineplus/ency/article/007199.htm
(2) Temple University – Possible Risks Associated with Bariatric Surgery, Retrieved August 28, 2011 from http://bariatric.templehealth.org/content/RisksSurgery.htm
(3) RealSelf.com – Stricture Symptons: How Do I Know If I Have a Stricture?, Retrieved August 28, 2011 from http://www.realself.com/question/stricture
(4) American Society for Gastrointestinal Endoscopy – Understanding Esophegeal Dilation, Retrieved August 29, 2011 from http://www.asge.org/PatientInfoIndex.aspx?id=392