An ulcer is a common disease that does not appear suddenly. Sometimes people, in pursuit of success and building a career, overlook the first alarm bells, preferring not to notice problems in the body.
Often, with pain in the intestines, the appearance of spasms - the first symptoms of the disease, few turn to a doctor for advice, preferring to self-medicate at home. The symptoms are similar to the first signs of gastritis. If you do not take timely measures for examination and further treatment, the likelihood of an ulcer increases daily.
The “gold standard” of obesity surgery
Gastric bypass surgery (GBS) or gastric bypass surgery has been used to treat severe forms of obesity since 1966. The operation has been improved over the years and in this embodiment represents a highly effective and relatively safe method of reducing body weight in persons suffering from severe forms of obesity. The operation is performed both openly and laparoscopically, i.e. without extensive skin incisions, through separate punctures on the abdominal wall. In this case, it may be technically more difficult, take more time, but it is better tolerated by patients, promotes earlier restoration of ability to work, and a return to a normal lifestyle. GS refers to complex combined operations and combines a restrictive component, i.e. reduction of stomach volume and reconstruction of the small intestine aimed at limiting the absorption of food components. Reducing the amount of food consumed is achieved by creating a “small ventricle” in the upper part of the stomach with a volume of up to 20-30 ml, which connects directly to the small intestine. The remaining, larger part of the stomach is not removed, but is completely excluded from the passage of food. Thus, after this operation, food from the esophagus immediately passes into a small part of the stomach and from there directly into the small intestine, bypassing most of the stomach and duodenum. The juice produced by the stomach, as well as bile and pancreatic juice, enter through another loop of the intestine and are mixed with food in the small intestine. As a result of the operation, the amount of food consumed is reduced several times. At the same time, the early entry of food into the small intestine causes a pronounced and stable feeling of satiety, a lack of desire to continue eating, and the appearance of indifference to food.
Cholecystectomy
- Cost: 100,000 - 160,000 rubles.
- Duration: 25-30 minutes
- Hospitalization: 3 days in hospital
More details
Removal of the gallbladder during HS may be required due to the increased likelihood of stone formation in it as body weight decreases and is a measure to prevent exacerbation of cholecystitis and pancreatitis in the long term after surgery. HS surgery is very common in the United States and is considered by many to be the “gold standard” in obesity surgery. This is the most popular operation in America and has proven itself for several decades. The advantages of this operation are: 1. Significant and sustainable reduction in body weight, which averages 65-75% of the initial excess body weight. In many patients, this figure exceeds the indicated figures, and often the final body weight approaches ideal characteristics. 2. Effective therapeutic effect for type II diabetes mellitus. Most likely, soon after HS, a patient suffering from type II diabetes will not need any glucose-lowering drugs. 3. Positive effect on blood lipid composition. A significant reduction in hypercholesterolemia and hypertriglyceridemia, along with normalization of blood glucose, is an important measure to prevent the development of cardiovascular diseases. 4. Advantageous effect, compared to simple operations, on the course of other diseases that depend on excess body weight (arterial hypertension, respiratory failure, bronchial asthma, reflux esophagitis, diseases of the musculoskeletal system, peripheral veins, ovarian dysfunction, etc.) . Eating in the long term after HS is quite comfortable, however, during the first week after surgery, food taken should only be in liquid form (water, juices, broths, kefir, jelly, etc.). The daily amount of liquid allowed for consumption is agreed with the attending physician. During the second week, food intake in the form of liquid puree (mashed fruit, soups, liquid porridge, baby food, etc.) is allowed. You need to eat slowly, spreading out your meals over 30-40 minutes. When you feel a feeling of a full stomach, you need to stop. Starting from the third week after surgery, a gradual transition to normal nutrition is possible, provided that you eat food at a fairly slow pace and chew it thoroughly. It is necessary to make 20-30 chewing movements before the food is swallowed. The period of weight loss after HS ranges on average from 16 to 24 months. Some weight gain may occur after this, but it is usually not significant. The operation is almost completely reversible, although the reconstructive operation is quite complex and is usually not necessary.
Is smoking electronic cigarettes harmful?
The question of the harmlessness or danger of electronic cigarettes to the body is only being studied. All the moments of their harmful influence have not yet been named.
But people with stomach ulcers should absolutely avoid vaping , despite the fact that nicotine-free liquid is used to refill them.
A mixture of flavoring additives is inhaled with the steam, which stimulates the taste buds. A signal is given about the arrival of food that is not there, and the stomach is already producing juice. This leads to excess acid in the stomach. The same goes for another popular alternative – hookah.
Possible side effects and complications
The vast majority of patients tolerate the operation well, however, as with any other operation, side effects and complications are possible during treatment. These are, first of all, inflammatory complications directly in the operation area, as well as bleeding, the formation of blood clots in the vessels, and the development of pulmonary complications (pneumonia, atelectasis). We take all measures necessary to prevent these complications. In this case, early activation of patients and active breathing exercises are very important. The patient must first purchase or make a tight bandage that matches the perimeter of the abdomen. During the operation itself, bleeding from the splenic capsule may occur, and if it cannot be stopped by other means, in this situation it may be necessary to remove the spleen. Since during the gash surgery the organs of the digestive tract are sutured, there is some likelihood of complications from the internal sutures (suture failure), as well as the sutures of the abdominal wall. In some situations, the occurrence of such complications may require surgical exploration under general anesthesia.
The mechanism of formation of nicotine addiction
After developing a stable attachment, a person can no longer do without cigarettes. When you try to quit a destructive hobby, withdrawal occurs - unpleasant and painful manifestations. The body, accustomed to constant psychostimulation , requires new portions of tobacco and refuses to function normally.
During the process of inhaling smoke, about a quarter of the nicotine enters the circulatory system and reaches the brain within a few seconds. Thanks to this, the intoxicating effect occurs quickly and the person feels satisfaction, improved mood, and activation of mental processes. This happens because nicotine stimulates areas of the brain responsible for the production of pleasure hormones: dopamine, norepinephrine, endorphin. The positive psychostimulating effect of cigarettes forces a person to again resort to tobacco products in order to maintain their emotions and physical condition at the desired level.
Over time, the smoker will need to increase the dosage or frequency of cigarette consumption. Addiction to nicotine occurs very quickly and takes control of a person’s life. Now not a single important conversation, lunch break, walk or outdoor recreation can do without a cigarette. And all attempts to give up tobacco are met with unpleasant symptoms of withdrawal.
Side effects and long-term complications
In the long term after GSH, the following side effects and complications are possible: 1. Development of an ulcer in the area of the anastomosis between the stomach and small intestine. The probability of ulcer formation is 3-5%, and it is higher in patients who smoke. If you quit smoking, ulcers respond well to treatment. 2. Insufficient consumption of protein foods in the first months after surgery can cause general weakness and short-term hair loss. In some situations, repeated hospitalization for parenteral (intravenous) nutrition is possible. The protein intake rate after this operation is about 80 g per day. 3. Side effects caused by insufficient intake of minerals and vitamins. The likelihood of such consequences increases significantly if the patient does not take the necessary nutritional supplements (see below). 4. The so-called dumping syndrome, manifested by sudden weakness, sweating, rapid heartbeat, nausea, and trembling after eating. This is usually observed when taking high-calorie foods, particularly sweet and dairy products. Prevention of a pronounced dumping reaction is possible by refusing to consume these high-calorie foods. During such attacks, a decrease in blood glucose levels may occur. 5. Metabolic complications (see below). 6. Postoperative abdominal wall hernias. Possible for any type of surgery in obese patients. Treatment of postoperative hernias is surgical. Hernia surgery can be performed after weight loss is completed at the same time as abdominoplasty.
The main task of a smoker
When trouble comes in the form of a rather serious illness, people try to save their health and life. If a person has a desire to change his lifestyle, then he is on the right path. Even a heavy smoker has the right to consult a doctor for advice and help.
Often people suffering from peptic ulcers turn out to be long-term smokers. A person is not always able to cope with addiction on his own. Your doctor can help. As an option, prescribe a drug that initially reduces nicotine dependence. In the future, such a technique will serve as an impetus for a person to give up a bad habit.
If addiction manifests itself on a psychological level, the help of a psychologist is necessary. A specialist of the mentioned profile will, in a few steps, help overcome the barrier and free a person from the desire to smoke. The main thing is to focus on the results of the smoker himself.
Additional treatment
To prevent complications associated with insufficient consumption of food components, after HS surgery it is necessary to systematically take mineral and vitamin supplements throughout life: 1. Multivitamins, which also include macro- and microelements. Preferred drugs: Centrum, or Unicap, or Vitrum, 1 tablet or capsule per day. Other combinations of vitamins may be used. 2. Vitamin B 12 in the form of injections 2 times a month. Necessary for maintaining normal hemoglobin levels in the blood. 3. Calcium preparations in a daily dose of 1000 mg (recommended drug Calcium-D3 Nycomed 2 tablets per day). Failure to use calcium-containing medications increases the likelihood of developing osteoporosis, i.e. decrease in bone strength. 4. For women with preserved menstrual function, it is necessary to take iron supplements in the form of ferrous sulfate in a daily dose of 325 mg. This is a measure to prevent iron deficiency anemia, which is possible due to repeated blood loss. 5. According to the surgeon’s recommendation, for 1-3 months after HS, it may be necessary to take omeprazole (Omez) 1 capsule per day to prevent the development of peptic ulcers. Vomiting can occur when a small part of the stomach quickly overflows during a meal, as well as when eating insufficiently chewed or coarse-fiber food. If vomiting continues for several hours and there is a complete inability to take liquids and food, you must urgently contact your doctor by phone. Diarrhea (frequency of stool 3-4 times, and sometimes more than once a day) is not typical for this operation, but can sometimes be observed during the first month. For excessively frequent diarrhea, taking 1 capsule of Imodium is effective. During the period of intensive weight loss (within 18-24 months after surgery), pregnancy is contraindicated. Subsequent pregnancy is possible, but consultation with a specialist and regular monitoring are necessary. In women who suffered from infertility before surgery, pregnancy may occur already in the process of losing body weight. From the very beginning of pregnancy, a daily intake of the vitamin folic acid is necessary. As with any other operation aimed at reducing body weight, regular monitoring by a specialist surgeon is necessary after HS surgery. Observation is carried out: 1 time every 3 months during the first year, 1 time every six months during the second year. In the future, monitoring is carried out annually in accordance with the date of the operation. At the same time, laboratory tests are required: general blood test, blood test for glucose, urea, creatinine, bilirubin, total protein, albumin, calcium, iron, AST, ALT, alkaline phosphatase, lipid composition.
How to prevent ulcers?
Whether it is to prevent an ulcer or a recurrence, there are some precautions to take. These include limiting the aggravating factors of peptic ulcer disease:
- Quit smoking;
- Learn to deal with stress, find time to relax;
- Take a varied and balanced diet;
- Avoid very sour or spicy foods;
- Don't drink too much coffee or tea;
- Practice regular physical activity;
- Avoid excessive consumption of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), which are said to be gastrotoxic and weaken the natural defense mechanisms of the stomach lining.
Literature:
- Bogoslovsky, Vladimir Alekseevich. About the dangers of smoking / V. A. Bogoslovsky. – 2nd ed., rev. and additional – Moscow: Center. scientific research Institute of San. education Ministry of Health of the USSR, 1998. – 37 p.; 22 cm. – (To help the lecturer).
- Ulanov, Vladimir Ivanovich. The harm of smoking / Vladimir Ulanov. – [Velsk]: Povazhye, [2012]. – 239 p. : ill.; 21 cm.
- Barabash, Pavel Ivanovich. How to quit smoking: (Practical guide to quitting smoking) / Pavel Barabash. – Khabarovsk: Publishing house DVAGP, B. – 56 p.; 20 cm. – (Modern psychotechnologies).
