Tonya Luiz survived a bowel obstruction in January 2007

Once bariatric post-ops reach goal, it's easy to become complacent. Even the most compliant person can look in the mirror and seeing a "normal" body staring back, forget how it took major surgery to get to that point.

However, the digestive track of a gastric-bypass patient will never be normal, and post-ops need to be aware of complications that can arise. The most common complication for Roux-En-Y patients is a bowel obstruction.

Causes of Bowel Obstruction

A number of things can cause a bowel obstruction: a too-large piece of food stuck in the intestines, severe constipation, scar tissue, or tangled intestines.

The first two causes are the usual culprits behind bowel obstructions occurring within the first year after bariatric surgery. The latter two typically arise two to four years after surgery.

Though all bypass patients are at risk of a bowel obstruction, a 2006 study out of Hackensack University in New Jersey found that those who had laparoscopic Roux-En-Y have the highest incidence. The study, published in "The Journal of the American College of Surgeons" in September of that year, found 10 percent of lap Roux-En-Y patients suffer from bowel obstructions.

The researchers behind the study believe lap RNY leaves behind minimal adhesions --- scar tissue -- allowing the intestines to float and move around freely. Open RNY tends to produce "thin, diffused upper abdominal adhesions that may then stabilize the bowel and prevent internal hernias and bowel obstruction," according to the study.

Bowel Obstruction Symptoms

Regardless of cause, bowel obstructions are serious health threats for bariatric patients and require immediate medical attention. Symptoms include:

• Abdominal pain or cramping
• Abdominal distension
• Gassiness but inability to pass it other than by belching
• Pain when eating or drinking
• Vomiting
• Diarrhea
• Constipation

The symptoms of a bowel obstruction are similar to that of appendicitis and gall bladder attacks. The best way to diagnose a bowel obstruction is with a CT scan or upper GI with a small bowel series.

However, doctors unfamiliar with bariatric surgery may disregard a bowel obstruction as a naturally occurring kink in the intestines. Because surgery is almost always required, it's best that anyone suspecting a bowel obstruction seeks treatment from an experienced bariatric surgeon.

Tonya Luiz is a journalist and a surgical weight loss consultant and educator who had emergency surgery for a bowel obstruction January 2007. Her blog, Inside Out, is at http://insideout-tonya.blogspot.com. To read about her bowel obstruction experience, click on the March 3 posting, "No immunity from complications." To reach her, e-mail tonya@bariatricnetworkassociates.com.