Side effects of Bariatric Surgery are often not informed properly. Weight-loss surgery is often marketed as a magic pill for issues ranging from morbid obesity to diabetes. Basically, bariatric surgery involves stapling a portion of the stomach to reduce appetite. Proper Precaution needs to be taken assess the condition of the liver prior to the surgery or else bariatric weight loss surgery may cause severe side effects.

Doctors at Institute of Liver and Biliary Sciences (ILBS), a prominent state-run hospital for gastrointestinal illnesses in India, said they have received at least three patients over the past one-and-a-half years with liver failure caused due to weight loss surgery.

In one of the case, a 35-year-old patient was admitted with severe jaundice, abdominal pain and extreme weakness. The doctors managed to stabilize the patient by nutritional enhancement and other medical interventions but still the patient may require to undergo a liver transplant for long-term survival. As per doctors, any surgery in a cirrhotic patient (a person whose liver is damaged due to long-term scarring) is risky. In case of weight-loss surgery, which involves reducing the size of the stomach, the bacteria or toxins excessively go into liver and cause further injury leading to failure.

Another doctor said liver failure in case of a patient who has undergone bariatric weight loss surgery is as bad as an alcoholic’s. In most cases, the liver is so damaged that living donor transplant is not possible. Only a full-sized liver harvested from cadaver donor can match the graft size required. The doctor suggested that any patient going for a weight loss surgery must consider complete assessment of liver condition. Liver function test (LFT), may not give the real picture. Doctors should ideally use a fibro scan with extra lobe or MR spectroscopy to rule out cirrhotic liver.

He added that if the liver is found to be cirrhotic, then surgery should be considered carefully and with respect to the health risks involved. Ideally, such patients should not starve themselves to lose weight rapidly. More than one-third of U.S. adults are obese, according to the Centers for Disease Control and Prevention . Worldwide, an estimated 300 million people suffer from weight-related issues. Close to 2,00,000 persons undergo weight-loss surgery every year.

The guidelines state that patients who have a bone mass index (BMI) of more than or equal to 40 kgm2 should be allowed to undergo the bariatric surgery. If the person has obesity-related co-morbidities then surgery can be considered even if the BMI is more than or equal to 35 kgm2. The BMI of a healthy individual is anywhere between 18 and 23 kgm2.

Bariatric surgery also appears to raise the risk for acute liver failure (ALF) from acetaminophen poisoning. Acetaminophen overdose is the leading cause of ALF in the United States and that about half of ALF cases caused by acetaminophen resulted from unintentional overdose, often from the use of combination analgesics containing acetaminophen. Bariatric surgeons conducting gastric bypass operation need to warn their patients to cut back on acetaminophen, certainly to below the maximum daily dose stated on the product label.

Bariatric Surgery Side Effects

Bariatric Surgery is a procedure to restrict food intake and decrease absorption of food in stomach and intestines.

Doctors remove a portion of stomach and remaining portions are joined together using staples.

The Problem

Most obese and diabetic patients who undergo the procedure have fatty liver. If proper assessment is not made to rule out liver diseases, like cirrhosis for example, the condition tends to aggravate post-surgery due to nutrition deficiency and medicines. In few cases, it even leads to liver failure which necessitates Liver transplant.

Solution

Never rush into a weight loss surgery, rule out any serious liver disease before undergoing the procedure.

Liver function test (LFT) often fails to give the real picture. High risk patients should be put through MR spectroscopy and fibro scan.

Nutritional restrictions should be put on hold in case of jaundice and other symptoms reflective of liver health issues.

Prevention & precaution is always better than cure. Before undergoing any weight loss surgery, discuss in detail with your doctor and be protected from Bariatric surgery side effects .