Dying to be Thin;The Unexpected Crisis d/t Gastric Bypass Long-term effects

11/19/2025

Roux-en-Y gastric bypass is a significant weight-loss surgery that involves creating a small stomach pouch and rerouting the small intestine to reduce calorie and nutrient absorption. This procedure leads to substantial weight loss and can improve obesity-related conditions, such as type 2 diabetes, but necessitates lifelong vitamin supplementation, adherence to a strict diet, and lifestyle modifications to achieve success. Potential risks associated with this surgery include leaks, dumping syndrome, and other surgical complications, while recovery entails a phased diet and lifelong follow-up care.

How it works
A small pouch is created by stapling or dividing the upper portion of the stomach.
The small intestine is then divided, and the lower part is connected to the new stomach pouch.
The upper part of the divided small intestine is reconnected further down.
This process restricts food consumption and limits nutrient absorption.

Recovery and aftercare
Diet: Patients will initiate a clear liquid diet, progressing to full liquids, soft foods, and eventually a regular diet over several weeks.
Supplements: Lifelong vitamin supplementation is necessary to prevent deficiencies.
Follow-up: Regular follow-up appointments with the medical team are essential, particularly during the first year.
Lifestyle: Combining the surgery with a healthy diet and regular exercise is crucial for optimal long-term weight loss.

Potential risks and side effects
Dumping syndrome: Consuming high-sugar or high-fat foods can cause symptoms like nausea, vomiting, or diarrhea.
Surgical risks: Leaks from staple lines, blood clots, infection, and breathing problems are possible complications.
Other complications: Ulcers or stomal stenosis (narrowing of the connection between the stomach and intestine) are also potential risks.

11/07/2025

11/27/2023

11/27/2023

06/10/2023

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12/18/2021

A Case series of candy cane limb syndrome after laparoscopic Roux-en-Y gastric bypass
Khuram Khan, Ricardo Rodriguez, [...], and Leaque Ahmed

Additional article information

Abstract
Candy cane syndrome is a rare complication reported in bariatric patients following Roux-en-Y gastric bypass. It occurs when there is an excessive length of roux limb proximal to gastrojejunostomy, creating the possibility for food particles to lodge and remain in the blind redundant limb. Patients present with non-specific symptoms such as abdominal pain associated with nausea and vomiting. Most remain undiagnosed as the disease process is poorly described. We report three cases of candy cane syndrome treated successfully at our institution.

BACKGROUND
Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is the most common surgery performed in USA for weight loss. Even though, it is considered one of the safest surgical procedure, rare complication such as candy cane syndrome can occur, leading to debilitating symptoms which are difficult to diagnose and manage [1]. Pathophysiology in candy cane syndrome is related to redundant roux length at the time of creation of gastrojejunosotmy which serves as a blind pouch for the food to stay. Treatment is centered on minimizing the redundancy and shorting the excessive length of roux limb proximal to gastrojejunosotmy.

05/14/2020

Risks
As with any major procedure, bariatric surgery poses potential health risks, both in the short term and long term.

Risks associated with the surgical procedure can include:

Excessive bleeding
Infection
Adverse reactions to anesthesia
Blood clots
Lung or breathing problems
Leaks in your gastrointestinal system
Death (rare)
Longer term risks and complications of weight-loss surgery vary depending on the type of surgery. They can include:

Bowel obstruction
Dumping syndrome, which leads to diarrhea, flushing, lightheadedness, nausea or vomiting
Gallstones
Hernias
Low blood sugar (hypoglycemia)
Malnutrition
Ulcers
Vomiting
Acid reflux
The need for a second, or revision, surgery or procedure
Death (rare)

12/31/2019

Handling Complications

What Are Possible Bariatric Surgery Complications?

Some potential bariatric surgery complications that can occur after any abdominal operation (including but not unique to bariatric surgery) may include:

Incisional pain
Infections
Bleeding
Incisional hernias
Blood clots in the legs (DVTs)
Heart attacks
Pneumonia
Obstructions (difficulty with food moving through due to scar tissue)
At the BMCC we have specifically designed effective protocols and clinical pathways to prevent these complications*.

Other possible complications and considerations that are more specific to bariatric surgery may include:

Leaks at surgical sites
Ulcers (to combat this, avoid ulcer-causing substances: ni****ne, caffeine, alcohol, drugs, and NSAIDS)
Vitamin or protein malnutrition (you’ll need a lifelong commitment to vitamin/protein intake as directed)
Excess skin
Internal hernias
Dumping syndrome (usually only with the bypass)

Gallstones:
Gallstones can form after bariatric surgery. However, recent studies have shown that the risk of developing this problem after bariatric surgery is no higher than in the general population. Because of this, in most bariatric practices (including the BMCC) healthy gallbladders are not routinely removed at the time of bariatric surgery.

Finally, weight regain is always a possibility with any surgery, so maintaining a strong commitment to the post-surgical pathway is critical.

07/12/2019

Bariatric Services
Bariatric Surgery Risks, Complications and Side Effects
All surgical procedures carry risks. Your surgeon will explain all potential bariatric surgery complications, both short and long term, and answer any questions.

What Are the Most Common Post-Op Risks and Side Effects Associated with Bariatric Surgery?
Some bariatric surgery risks include:

Acid reflux
Anesthesia-related risks
Chronic nausea and vomiting
Dilation of esophagus
Inability to eat certain foods
Infection
Obstruction of stomach
Weight gain or failure to lose weight
Bariatric Surgery Long-Term Risks
Bariatric surgery carries some long-term risks for patients, including:

Dumping syndrome, a condition that can lead to symptoms like nausea and dizziness
Low blood sugar
Malnutrition
Vomiting
Ulcers
Bowel obstruction
Hernias
Overview of Bariatric Surgery Risks and Complications by Procedure
Risks and side effects vary by bariatric procedure. The following list is not all-inclusive, but briefly outlines risks of gastric bypass and gastric sleeve.

Your bariatric surgeon will make sure you understand the risks and complications of your specific procedure.

Risks of Gastric Bypass:

Breakage
Dumping syndrome
Gallstones (risk increases with rapid or
substantial weight loss)
Hernia
Internal bleeding or profuse bleeding of the
surgical wound
Leakage
Perforation of stomach or intestines
Pouch/anastomotic obstruction or bowel obstruction
Protein or calorie malnutrition
Pulmonary and/or cardiac problems
Skin separation
Spleen or other organ injury
Stomach or intestine ulceration
Stricture
Vitamin or iron deficiency
Risks of Gastric Sleeve:

Blood clots
Gallstones (risk increases with rapid or
substantial weight loss)
Hernia
Internal bleeding or profuse bleeding of the
surgical wound
Leakage
Perforation of stomach or intestines
Skin separation
Stricture
Vitamin or iron deficiency
Reducing Your Bariatric Surgery Risks
You can help lower some of the risks and possible side effects by:

Decreasing your Body Mass Index (BMI)
Increasing your amount of exercise
Stopping smoking