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Category: gastric emptying pylorus

Bile Reflux Gastritis

August 02, 2024 10:53 am

Bile Reflux

Bile Reflux is primarily a diagnosis of exclusion. All other possible causes must be ruled out, and bile reflux gastritis is made with the pertinent symptoms. The reason for this is that there is no primary test that can prove the diagnosis. When it comes to treatment, the surgical option requires preventing the bile from coming back to the stomach. The procedure we have performed routinely for bile reflux gastritis is the duodenal switch (without a reduction in the stomach size). This allows the food to go through an intact stomach and pyloric valve with normal stomach physiology (to prevent dumping syndrome). The bile is diverted through 100 cm of the small bowel as the biliary and alimentary limbs to prevent backflow of bile to the stomach (if it’s made too short). The procedure referenced  (https://www.americanjournalofsurgery.com/article/S0002-9610(03)00213-7/abstract) is nearly 20 years old. It is rarely, if at all, performed due to its very complex and relatively high-risk nature. Its primary role for a surgeon is to reconstruct the biliary track flow. This operation involved transecting the common bile duct and creating a biliary tree to small bowel anastomosis. This is, at times, done when there is injury, obstruction, or tumor of the bile duct. This anastomosis has its complications, including stricture and sump syndrome. Therefore, hepaticojejunostomy or hepato-duodenostomy anastomosis are reserved for cases with no alternatives. A-Normal Anatomy B-Duodenal switch for bile Reflux C-Hepatojejunostomy for bile relaxation was proposed in a 2003 study.  

Carbonated Drinks and Weight Loss Surgery

August 11, 2012 3:56 pm

The consumption of carbonated drinks is discouraged after weight loss surgery. In fact, there is a wealth of information that documents the detrimental health effects of carbonated drinks for each individual. These include osteoporosis, obesity, and premature dental decay, just to name a few.  Indirectly, carbonated drinks have been found to increase risk of stroke and Cardiac events. There are studies that show a 48% increase in heart attack and stroke rates for individuals who drink diet sodas vs. those who drink it rarely or not at all.

There is also no health benefit to diet carbonated drinks.  In fact, there are animal studies that show that rats who consume no-calorie sweeteners found in diet sodas experience an increased appetite (Susan Swithers, PhD- 2004).

There are also other factors to consider. The carbonation comes from a mixture of dissolved gasses that are released when the container is opened.  The Carbon Dioxide gas dissolved in the drinks, amongst others, can distend the stomach. Potentially, stretching your stomach. There is also acidity that needs to be corrected by the body. This has been shown to result in changes in the bacterial population in the GI track, resulting in significant bloating and reduced absorption of nutrients.

Calcium loss is caused by the leaching of the calcium from the bones with carbonated drinks, which can cause osteoporosis.

Gastric Emptying after the Duodenal Switch and the Sleeve Gastrectomy

January 19, 2012 1:10 am

 
I am frequently asked what the transit time is from when the food is ingested to when the stomach empties. The emptying of the stomach depends on a number of complex factors, including the function of the pylorus, the type of food ingested, and a number of known and possibly unknown regulatory hormones.
In a previously published newsletter, we already discussed a number of hormones that play a role in the regulatory function of the GI track. The detailed information is posted in the newsletter section of our website.