Medical loans for Bariatric surgery
Exercise and diet alone often fails to effectively treat people with extreme and excessive obesity. Bariatric surgery is an operation that is performed in order to help such individuals lose weight. Evidence suggests that bariatric surgery may lower death rates for patients with severe obesity, especially when coupled with healthy eating and lifestyle changes after surgery.
Principles of bariatric surgery
The basic principle of bariatric surgery is to restrict food intake and decrease the absorption of food in the stomach and intestines.
The digestion process begins in the mouth where food is chewed and mixed with saliva and other enzyme-containing secretions. The food then reaches the stomach where it is mixed with digestive juices and broken down so that nutrients and calories can be absorbed. Digestion then becomes faster as food moves into the duodenum (first part of the small intestine) where it is mixed with bile and pancreatic juice.
Bariatric surgery is designed to alter or interrupt this digestion process so that food is not broken down and absorbed in the usual way. A reduction in the amount of nutrients and calories absorbed enables patients to lose weight and decrease their risk for obesity-related health risks or disorders.
Body mass index (BMI)
Body mass index (BMI), a measure of height in relation to weight, is used to define levels of obesity and help determine whether bariatric intervention is required. Clinically severe obesity describes a BMI of over 40 kg/m2 or a BMI of over 35 kg/m2 in combination with severe health problems.
Health problems associated with obesity include type 2 diabetes, arthritis, heart disease, and severe obstructive sleep apnea. The Food and Drug Administration (FDA) approves the use of adjustable gastric banding for patients with a BMI of 30 kg/m2 or more who also have at least one of these conditions.
Types of Bariatric Surgery
There are various types of bariatric surgeries that can be performed. Surgery may be performed using an “open” approach, which involves cutting open the abdomen or by means of laparoscopy, during which surgical instruments are guided into the abdomen through small half-inch incisions. Today, most bariatric surgery is laparoscopic because compared with open surgery, it requires less extensive cuts, causes relatively minimal tissue damage, leads to fewer post-operative complications and allows for earlier hospital discharge.
There are four types of operations that are offered:
- Adjustable gastric banding (AGB)
- Roux-en-Y gastric bypass (RYGB)
- Biliopancreatic diversion with a duodenal switch (BPD-DS)
- Vertical sleeve gastrectomy (VSG)
Each of the surgery types has advantages and disadvantages and various patient factors affect which procedure is chosen including BMI, eating habits, health problems related to obesity, and number of previous stomach surgeries. The patient and provider should discuss the most suitable option by considering the benefits and risks of each type of surgery.
Factors that are considered when choosing the surgery include:
- Benefits and risks associated with surgery type
- Patient preference and willingness to adhere to the post-surgery dietary recommendations
- Body mass index
- Eating habits
- Health conditions related to obesity
- Previous stomach surgeries
- Adjustable Gastric Banding (AGB)
The basic principle of this type of surgery is to decrease food intake with the use of a small bracelet-like band placed around the top of the stomach. The band restricts the size of the opening from the throat to the stomach, limiting the amount of food a patient can ingest. The size of the opening can be modified using a balloon inside the band that can be inflated or deflated with saline solution according to the needs of the patient.
- Roux-en-Y Gastric Bypass (RYGB)
This method is also used to decrease food intake and involves creating a small pouch that is similar in size to the pouch created with AGB. The food bypasses the rest of the stomach and reaches the small intestine, where it is absorbed to a much lesser degree than if it had passed through the stomach, duodenum, and upper intestine.
- Vertical Sleeve Gastrectomy (VSG)
This procedure involves removal of most of the stomach, which not only restricts food intake and absorption, but lowers levels of the hormone ghrelin that is responsible for appetite.
- Biliopancreatic Diversion with a Duodenal Switch (BPD-DS)
Also called the duodenal switch, this three-stage procedure involves the removal of a large part of the stomach which makes the patient feel full after eating only a small meal, followed by re-routing of the small intestines to prevent food absorption. The third step involves changing how bile and other digestive juices affect the process of digesting and absorbing calories.
Surgical and post-operative risks
People who have had bariatric surgery need to adhere to a rigorous and lifelong diet and exercise plan to prevent complications and to avoid putting on weight after surgery. In addition, patients may develop excess loose and folded skin that requires further surgery to remove and tighten.
As with all types of surgery, bariatric surgery is associated with risks including internal bleeding, deep vein thrombosis, infections, and pulmonary embolism (blood clot in the lungs). It is estimated that the risk of dying shortly after bariatric surgery is around 1 in 200.
Weight loss surgery involves reducing the capacity of the stomach to hold food, and therefore the amount of calories and nutrients that can be absorbed in the intestines. A patient’s diet needs to be modified accordingly after surgery to ensure maximum nutrition while reducing calorie intake.
A typical diet plan for a patient who has undergone bariatric surgery involves:
- The stage 1 diet that is provided at hospital immediately after surgery. This initial diet comprises mainly liquids that the patient can slowly sip until the new stomach or stomach pouch is full.
- The stage 2 diet is made up of low-sugar, liquid or semi-liquid foods such as warmed cereal with milk.
- The stage 3 diet is designed for when a patient is discharged from hospital and includes semi-solid, pureed, and finally soft foods. The progress to soft food is slow to allow time for post-operative wounds in the stomach and intestines to heal.
Diet progression
Initial requirements include enough liquid to prevent dehydration and sufficient protein. Later, the diet needs to be adjusted to accommodate nutritional needs. The size of the stomach pouch is about one ounce and initially, as little as two to three teaspoons of food may make the patient feel full. Over time, the pouch stretches bit-by-bit to allow more food intake.
The diet’s composition
About three quarters of the patient’s calorie intake should come from protein sources such as eggs, fish and meat, while carbohydrates such as potatoes, rice and wheat should provide 10 to 20 % of the calorie intake, and fats between 5 to 15 %.
For the first six months, the diet should provide the patient with 800 to 1,000 calories and 75 grams of protein a day.
Foods to avoid
Foods containing sugars should be avoided, firstly because they may hamper weight loss and, secondly, because eating sugary food may lead to a condition called dumping syndrome, which describes when sugar moves directly from the stomach pouch into the small intestine where it can cause palpitations, nausea, abdominal pain and diarrhea.
Liquids should be avoided for a period of 30 minutes before and after eating solid food. When taken together with solids, liquids may cause nausea, as well as pushing food through the stomach pouch at a faster rate, leading to more eating than advised to satisfy appetite.
Overeating should be avoided at all costs. Overeating by even an ounce may induce nausea, vomiting, or lead to stretching of the pouch.
Hydration
Patients must maintain good levels of hydration, with 1 ½ to 2 liters of water consumed every 24 hours. This amount is to be increased by 20% if the patient is sweating. Carbonated beverages, soft fizzy drinks, sweetened drinks, and caffeine-containing drinks need to be avoided.
Maintaining nutrition
Due to the decreased food intake post-surgery, patients are at risk of vitamin and mineral deficiency and diet must be supplemented with multivitamins and minerals for the rest of the patient’s life.
Arogya Finance, a social healthcare venture based in Mumbai’s tying-up with various doctors and hospitals for various medical treatments. Arogya Finance facilitates easy Equated Monthly Instalments to patients to pay for the treatments provided by the doctors and hospitals.
“Unexpected healthcare expenses have led to over 40 million people falling into poverty every year due to heavy expenses incurred for numerous treatments. Arogya Finance has partnerships with various doctors and hospitals to make medical loans available to patients at the right time and place in different parts of India. We are already in talks with many hospitals, pharma companies and major doctors across India to provide a one-stop financial solution for people in need whenever and wherever there is an unforeseen medical emergency.” said Mr. Jose Peter, Co-Founder and CEO of Arogya Finance.
Arogya Finance is here to help the people throughout the country to borrow easily and quickly in times of medical emergencies and how you can secure a loan for your healthcare finance needs where you need no collateral, minimum documentation. Get in touch with us for more details.
SOURCE: https://www.news-medical.net/health/What-is-Bariatric-Surgery.aspx
https://www.news-medical.net/health/Diet-After-Bariatric-Surgery.aspx
https://www.news-medical.net/health/Weight-Loss-After-Bariatric-Surgery.aspx
https://www.news-medical.net/health/Bariatric-Surgery-Types.aspx
https://www.news-medical.net/health/Bariatric-Surgery-Side-Effects.aspx
