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GASTRIC BYPASS SURGERY – WHAT CAN IT DO FOR YOU?

Some people have gastric bypass surgery and shed 100 pounds or more. What can this surgery do for you?

To answer this question, you will first need to know what gastric bypass surgery is and how it helps you lose weight.

A gastric bypass surgery also known as Roux en-Y surgery is a medical procedure that reduces the size of your stomach causing you to feel full when you have eaten only a small portion. What your surgeon will essentially do is divide your stomach into two sections – a small upper one and a much larger remnant one using surgical staples (which is why this procedure is also known as stomach stapling). The small top pouch is the one that will hold your food. Your surgeon will also re-arrange your small intestine such that both the stomach pouches remain connected to the intestines.

The reduction in the functional volume of your stomach reduces your food intake. Not only that, the re-arrangement of the small intestine causes food to by-pass the first part of the small intestine resulting in reduced calorie absorption. Both these factors help you lose weight.

But is gastric bypass surgery for everyone who needs to lose weight?

That’s a personal choice or your doctor may prescribe it for you. Generally, it is considered in only those individuals who have tried hard but failed to achieve weight loss through exercise and diet.

Obesity, which is a complex disease, leads to other diseases. Morbid obesity or the accumulation of too much body fat increases a person’s risk for developing other health problems or co-morbidities such as heart diseases, diabetes, etc.

But how much fat is too much fat?

That’s calculated by your body mass index or BMI which is a measure of your weight in relation to your height. In simple words, it tells you how much you should normally weigh for your height and if you exceed that normal weight then you are medically considered overweight. Reducing your weight and therefore, your BMI, helps you control the risk of developing obesity related health problems. (Use the BMI calculator to calculate your BMI.)

Like any other surgery there are risks associated with gastric bypass surgery as well. Some of the risks include gastritis (which is an inflammation of the stomach lining), development of gallstones (caused by significant weight loss in a short time), nausea, vomiting, bleeding, infections, and nutritional deficiency (which can be avoided through nutritional supplements). So, when deciding to have the surgery you should carefully weigh the risks associated with it and the problems that it can solve for you.

Variations of gastric bypass surgery are gastric bypass, Roux en-Y proximal; gastric bypass, Roux en-Y distal; and loop gastric bypass or mini-gastric bypass. Gastric bypass surgery is not the only bariatric surgery available for treating morbid obesity. Some people also consider gastric lap-band as an option.

The cost can be a major deciding factor when considering the surgery. Depending upon your specific medical conditions and insurance terms, your health insurance carrier may or may not cover the costs.

The high cost of healthcare has led some Americans to seek treatment in countries like India, Thailand, Singapore, Mexico and Turkey. This practice of going abroad, which is termed as medical tourism or medical travel or health tourism, is a way of getting low cost high quality medical care. But before you decide to outsource your health care it’s extremely important that you do your homework properly – research the facilities, the surgeons, compare the cost and quality offered by different hospitals, talk to people who have had their surgery overseas, etc.

You can learn more about the growing trend of medical tourism, gastric bypass surgery and other medical and dental procedures by logging on to http://www.healthbase.com.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.Healthbase LogoHow Digestive System WorksProvided by: National Institute of Diabetes and Digestive and Kidney Diseases

 

The digestive system is a series of hollow organs joined in a long, twisting tube from the mouth to the anus (see figure). Inside this tube is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food.

Two solid organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes. In addition, parts of other organ systems (for instance, nerves and blood) play a major role in the digestive system.

Why Is Digestion Important?

When we eat such things as bread, meat, and vegetables, they are not in a form that the body can use as nourishment. Our food and drink must be changed into smaller molecules of nutrients before they can be absorbed into the blood and carried to cells throughout the body. Digestion is the process by which food and drink are broken down into their smallest parts so that the body can use them to build and nourish cells and to provide energy.

How Is Food Digested?

Digestion involves the mixing of food, its movement through the digestive tract, and chemical breakdown of the large molecules of food into smaller molecules. Digestion begins in the mouth, when we chew and swallow, and is completed in the small intestine. The chemical process varies somewhat for different kinds of food.

Movement of Food Through the System

The large, hollow organs of the digestive system contain muscle that enables their walls to move. The movement of organ walls can propel food and liquid and also can mix the contents within each organ. Typical movement of the esophagus, stomach, and intestine is called peristalsis. The action of peristalsis looks like an ocean wave moving through the muscle. The muscle of the organ produces a narrowing and then propels the narrowed portion slowly down the length of the organ. These waves of narrowing push the food and fluid in front of them through each hollow organ.

The first major muscle movement occurs when food or liquid is swallowed. Although we are able to start swallowing by choice, once the swallow begins, it becomes involuntary and proceeds under the control of the nerves.

The esophagus is the organ into which the swallowed food is pushed. It connects the throat above with the stomach below. At the junction of the esophagus and stomach, there is a ringlike valve closing the passage between the two organs. However, as the food approaches the closed ring, the surrounding muscles relax and allow the food to pass.

The food then enters the stomach, which has three mechanical tasks to do. First, the stomach must store the swallowed food and liquid. This requires the muscle of the upper part of the stomach to relax and accept large volumes of swallowed material. The second job is to mix up the food, liquid, and digestive juice produced by the stomach. The lower part of the stomach mixes these materials by its muscle action. The third task of the stomach is to empty its contents slowly into the small intestine.

Several factors affect emptying of the stomach, including the nature of the food (mainly its fat and protein content) and the degree of muscle action of the emptying stomach and the next organ to receive the contents (the small intestine). As the food is digested in the small intestine and dissolved into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion.

Finally, all of the digested nutrients are absorbed through the intestinal walls. The waste products of this process include undigested parts of the food, known as fiber, and older cells that have been shed from the mucosa. These materials are propelled into the colon, where they remain, usually for a day or two, until the feces are expelled by a bowel movement.

Production of Digestive Juices

The glands that act first are in the mouth–the salivary glands. Saliva produced by these glands contains an enzyme that begins to digest the starch from food into smaller molecules. The next set of digestive glands is in the stomach lining. They produce stomach acid and an enzyme that digests protein. One of the unsolved puzzles of the digestive system is why the acid juice of the stomach does not dissolve the tissue of the stomach itself. In most people, the stomach mucosa is able to resist the juice, although food and other tissues of the body cannot.

After the stomach empties the food and juice mixture into the small intestine, the juices of two other digestive organs mix with the food to continue the process of digestion. One of these organs is the pancreas. It produces a juice that contains a wide array of enzymes to break down the carbohydrate, fat, and protein in food. Other enzymes that are active in the process come from glands in the wall of the intestine or even a part of that wall.

The liver produces yet another digestive juice–bile. The bile is stored between meals in the gallbladder. At mealtime, it is squeezed out of the gallbladder into the bile ducts to reach the intestine and mix with the fat in food. The bile acids dissolve the fat into the watery contents of the intestine, much like detergents that dissolve grease from a frying pan. After the fat is dissolved, it is digested by enzymes from the pancreas and the lining of the intestine.

Absorption and Transport of Nutrients

Carbohydrates: Based on a 2,000-calorie diet, it is recommended that 55 to 60 percent of total daily calories be from carbohydrates. Some of our most common foods contain mostly carbohydrates. Examples are bread, potatoes, legumes, rice, spaghetti, fruits, and vegetables. Many of these foods contain both starch and fiber.

The digestible carbohydrates are broken into simpler molecules by enzymes in the saliva, in juice produced by the pancreas, and in the lining of the small intestine. Starch is digested in two steps: First, an enzyme in the saliva and pancreatic juice breaks the starch into molecules called maltose; then an enzyme in the lining of the small intestine (maltase) splits the maltose into glucose molecules that can be absorbed into the blood. Glucose is carried through the bloodstream to the liver, where it is stored or used to provide energy for the work of the body.

Table sugar is another carbohydrate that must be digested to be useful. An enzyme in the lining of the small intestine digests table sugar into glucose and fructose, each of which can be absorbed from the intestinal cavity into the blood. Milk contains yet another type of sugar, lactose, which is changed into absorbable molecules by an enzyme called lactase, also found in the intestinal lining.

Protein: Foods such as meat, eggs, and beans consist of giant molecules of protein that must be digested by enzymes before they can be used to build and repair body tissues. An enzyme in the juice of the stomach starts the digestion of swallowed protein. Further digestion of the protein is completed in the small intestine. Here, several enzymes from the pancreatic juice and the lining of the intestine carry out the breakdown of huge protein molecules into small molecules called amino acids. These small molecules can be absorbed from the hollow of the small intestine into the blood and then be carried to all parts of the body to build the walls and other parts of cells.

Fats: Fat molecules are a rich source of energy for the body. The first step in digestion of a fat such as butter is to dissolve it into the watery content of the intestinal cavity. The bile acids produced by the liver act as natural detergents to dissolve fat in water and allow the enzymes to break the large fat molecules into smaller molecules, some of which are fatty acids and cholesterol. The bile acids combine with the fatty acids and cholesterol and help these molecules to move into the cells of the mucosa. In these cells the small molecules are formed back into large molecules, most of which pass into vessels (called lymphatics) near the intestine. These small vessels carry the reformed fat to the veins of the chest, and the blood carries the fat to storage depots in different parts of the body.

Vitamins: Another vital part of our food that is absorbed from the small intestine is the class of chemicals called vitamins. The two different types of vitamins are classified by the fluid in which they can be dissolved: water-soluble vitamins (all the B vitamins and vitamin C) and fat-soluble vitamins (vitamins A, D, and K).

Water and salt: Most of the material absorbed from the cavity of the small intestine is water in which salt is dissolved. The salt and water come from the food and liquid we swallow and the juices secreted by the many digestive glands.

How Is the Digestive Process Controlled?

Hormone Regulators

A fascinating feature of the digestive system is that it contains its own regulators. The major hormones that control the functions of the digestive system are produced and released by cells in the mucosa of the stomach and small intestine. These hormones are released into the blood of the digestive tract, travel back to the heart and through the arteries, and return to the digestive system, where they stimulate digestive juices and cause organ movement. The hormones that control digestion are gastrin, secretin, and cholecystokinin (CCK).

  • Gastrin causes the stomach to produce an acid for dissolving and digesting some foods. It is also necessary for the normal growth of the lining of the stomach, small intestine, and colon.
  • Secretin causes the pancreas to send out a digestive juice that is rich in bicarbonate. It stimulates the stomach to produce pepsin, an enzyme that digests protein, and it also stimulates the liver to produce bile.
  • CCK causes the pancreas to grow and to produce the enzymes of pancreatic juice, and it causes the gallbladder to empty.

Nerve Regulators

Two types of nerves help to control the action of the digestive system. Extrinsic (outside) nerves come to the digestive organs from the unconscious part of the brain or from the spinal cord. They release a chemical called acetylcholine and another called adrenaline. Acetylcholine causes the muscle of the digestive organs to squeeze with more force and increase the “push” of food and juice through the digestive tract. Acetylcholine also causes the stomach and pancreas to produce more digestive juice. Adrenaline relaxes the muscle of the stomach and intestine and decreases the flow of blood to these organs.

Even more important, though, are the intrinsic (inside) nerves, which make up a very dense network embedded in the walls of the esophagus, stomach, small intestine, and colon. The intrinsic nerves are triggered to act when the walls of the hollow organs are stretched by food. They release many different substances that speed up or delay the movement of food and the production of juices by the digestive organs.

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Preventing a Heart Attack

(Source: Raffles Hospital)

Heart attacks come without warning and strike with deadly force. Whilst the spectrum of treatment modalities has improved over the years, they can sometimes be available too late. Prevention is the greatest cure for heart attacks and you should start today.

 

  1. Be mindful of your diet and your weight
  2. Watch what you eat. You should cut down on the fatty, cholesterol enriched foods and sugar. Eat balanced meals with lots of fruit and vegetables. Drink water instead of sugared drinks. Start on an exercise routine that is easy to maintain. Control your weight through proper nutrition and exercise. Spare your heart the extra load.

  3. Don’t smoke.
  4. If you are a non-smoker, don’t start. If you are a smoker, try to kick this habit. You will do better without it.

  5. Be more active
  6. Put more zest into your life and more spring into your steps. Walk more. Use the stairs instead of taking the lifts. Try going to work on public transport and walking instead of driving once in a while.

  7. Manage your stress; don’t let stress manage you
  8. There are many ways to cope with stress in your life. Learn to manage your time more efficiently and take control of stress instead of letting stress take control of you.

  9. Keep blood pressure, blood cholesterol and diabetes under control
  10. If you are already suffering from hypertension, high cholesterol or diabetes, follow the advice of your doctors and take your medications as prescribed. Go for your regular check-ups and follow your doctor’s recommendations faithfully.

  11. Check Early to Save Your Life
    • Don’t put yourself at unnecessary risks. The following tests are conditions that are risk factors for coronary heart disease. You should consider doing these tests on a regular basis. They are simple to do and may save your life.
    • Have your blood pressure checked by your doctor at least once a year.
    • Do a blood cholesterol test at least once in every 5 years, or more frequently if you have a high cholesterol level. Review the results with your doctor and listen to his advice.
    • Have your blood glucose checked at least once a year for diabetes. Diabetes can also be screened for by doing a simple urine dipstick test.
    • If you are particularly at risk of coronary heart disease, you should follow-up with your doctor regularly. Your doctor may advise you to do an ECG (electro-cardiogram) to assess the status of your heart. In some instances, you may need to do an exercise treadmill test to determine the fitness of your cardio-respiratory system.

Remember, early detection of heart disease allows for early treatment, and early treatment could well prolong your life.


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The contents or materials provided in this website are for general information only and are not intended as medical advice.

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Coronary artery bypass graft surgery (CABG)

Provided by Escorts Heart Institute
Brought to you by Healthbase

Coronary artery bypass graft surgery (CABG) involves sewing one end an artery or vein above a blocked coronary artery and the other end below the blockage, thereby allowing blood an alternative means to get to the heart. The arteries or veins used for the bypass (which are known as “grafts”) are usually obtained from the leg or the chest wall. Bypass surgery may not be possible if the coronary artery is heavily calcified or if the disease is very widespread. CABG can be done with or without connecting the patient to heart-lung machine, depending on the kind of blockages and surgeon’s decision.

Several new surgical approaches are being developed, which can potentially reduce the discomfort and complications associated with traditional bypass surgery. These are collectively referred to as being “minimally invasive.” In general, these approaches focus on performing bypass surgery though a very small chest incision and performing bypass surgery while the heart is still beating (ie, without the need for a heart/lung bypass machine).

OPCAB (Off Pump Coronary Artery Bypass)
The bypass surgery done without connecting the patient to of heart-lung machine or pump is called OPCAB.

MIDCAB (Minimally Invasive Direct Coronary Artery Bypass)
is bypass surgery done through a small cut (incision) in the lower part of the sternum (chest bone) only, rather than full cut across it. This type of surgery, which is possible in selected cases only, is associated with a small scar, lesser pain and faster recovery. Alternatively, this surgery can also be done through a small cut on the left side of the chest.

The location and degree of coronary artery blockages are determined before surgery by using a procedure called heart catheterization, or coronary angiogram. This procedure provides an outline, like a road map, of the arteries of the heart.

Factors favoring bypass surgery
Bypass surgery is often recommended over angioplasty when the left main coronary artery is narrowed by more than 50 percent, when angioplasty does not relieve angina, when many arteries are narrowed, or when the heart’s left ventricular pumping function is substantially impaired. Bypass surgery is also preferred over angioplasty in diabetic patients who have two or three vessels involved.

Benefits
Bypass surgery can very effectively relieve angina and can even prolong life in people with severe coronary heart disease, such as those with three-vessel involvement associated with impaired left ventricular pumping function. However, the success of bypass surgery on symptoms and on survival depends upon several factors, including the pattern and extent of arterial narrowing, the general progression of coronary heart disease over time, and the blood vessels used for bypass. In general, bypass surgery is more likely than angioplasty to provide complete revascularisation.

About 95 percent of people who have narrowing of several arteries have improvement or complete relief of their angina immediately after surgery. About 85 to 90 percent of people remain angina-free at one to three years after surgery, and about 75 percent of people remain angina-free or free of major coronary events at five years after surgery. By 10 years, about one-half of all grafted vessels become narrowed or occluded, and by 15 years, about 85 percent of grafted vessels become narrowed or occluded. These late events usually require a second surgery

Recovery from bypass surgery
It usually takes a while to recover from even routine bypass surgery. However, about 70 to 80 percent of people who have this surgery are eventually able to return to work; this is about the same as the percentage of people who are treated medically and are able to return to work. Factors that appear to have a role in a person’s ability to return to work are the presence or absence of angina after surgery, employment status before surgery and income, the function of the heart’s left ventricle, and age.


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Aortic Aneurysms & Dissections

Provided by Escorts Heart Institute
Brought to you by Healthbase

An aneurysm is an abnormal swelling in a weakened blood vessel while dissection is said to have occurred when blood enters through a lengthwise tear between layers of the wall of aorta or an artery (a blood vessel carrying blood from the heart to the body). These layers then separate and swell, making a thin walled balloon-like formation that causes severe pain. This condition can be a birth defect, a complication of disease like atherosclerosis or injury. High blood pressure also contributes to this disease.The patient may experience pain in chest, abdomen, or back, and may affect the hips and legs, coughing up blood, shortness of breath, nausea, vomiting, blood in stools, fainting, difficulty in swallowing, or just headache.

The diagnosis can usually be arrived at following review of history, chest x-ray, electrocardiogram (ECG), CT scan (computerized x-rays), Angiogram (x-rays after a dye has been injected into an artery), Echocardiogram, and blood tests.

How is it done?
The preferred treatment is immediate surgery. The doctor will replace the weakened part of the artery with a graft made of artificial material, and is carried out with the help of heart lung machine on many occasions. Depending on the location of the aneurysm/dissection, aortic valve may have to be replaced in some situations. The coronary arteries may also have to be implanted on the new graft for continued blood supply to heart. After surgery, blood pressure and other vital signs will be monitored in the recovery room set up.

After Care
It is important to strictly follow certain guidelines as listed:

  • Stop smoking.

  • Maintain your ideal weight.

  • Eat a healthy diet that includes:

    • Low salt food.

    • Avoiding foods high in fat and cholesterol.

    • Increasing fiber in your diet.

    • Adequate precautions against constipation.

  • Exercise daily; walking is recommended.

  • Get enough rest and learn to use relaxation techniques to help reduce stress.

  • Keep blood pressure under control.


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©2006 Healthbase Online Inc. All rights reserved.  |  About us
The contents or materials provided in this website are for general information only and are not intended as medical advice.