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Vertical Sleeve Gastrectomy With Duodenal Switch

Often referred to as simply a ‘duodenal switch’ procedure, this particular form of bariatric surgery is in fact a vertical sleeve gastrectomy to which a duodenal switch is added. This procedure is also sometimes referred to as a biliopancreatic diversion with duodenal switch.

Of all of the different forms of weight loss surgery available today this is perhaps the most controversial and, though widely performed, there are many surgeons who will not carry out the procedure because of concerns about its long-term effects on a patient’s health.

The first part of the procedure is a vertical sleeve gastrectomy in which the stomach is divided vertically and approximately eighty-five percent is removed. The small remaining ‘sleeve shaped’ stomach, which retains the original outlet to the intestines, functions very much as a normal stomach and this part of the surgery is designed purely to restrict the quantity of food which can be consumed. This part of the operation is a form of ‘restrictive’ surgery and cannot be reversed.

The second phase of the operation is to create a duodenal switch and this is a form of ‘malabsorption’ surgery which is largely reversible. Whereas restrictive surgery creates weight loss by physically preventing the patient from eating too much food, malabsorption surgery is designed to restrict the body’s ability to absorb calories from a meal as it passes through the digestive tract.

During the procedure the intestine is divided and a small section (usually about 150 cm in length) is used to create a bypass from the duodenum, which is close to the stomach outlet, to a point near the end of the intestinal tract, thus bypassing the bulk of the digestive tract (typically about 500 cm will be bypassed). The result of this bypass (or duodenal switch) is that food passing through the intestine will only mix with the body’s digestive juices in the short final section of the intestine below the switch, giving the digestive juices very little time to digest the food and absorb calories from it into the body.

While duodenal switch weight loss surgery has the advantage of providing the patient with weight loss through both restriction and malabsorption, it is the degree to which the malabsorption element predominates in the duodenal switch which gives rise to much of the controversy surrounding this form of surgery. By comparison, the traditional Roux-en-Y operation has a much shorter bypass and the distance over which food mixes with the digestive juices in the intestine is in the region of five times greater.

The argument which many surgeons use against the duodenal switch is simply that so little absorption takes place that there is too great a risk of anemia, protein deficiency and metabolic bone disease. The vertical sleeve gastrectomy with duodenal switch is also arguably the most complex form of weight loss surgery and many believe that it carries an unacceptably high risk of complications.

Despite the risks however, the duodenal switch remains a surgical option and can be very effective, especially in patients with a very high body mass index (BMI).

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How to manage Bland Diet

What is a bland diet? It is a diet specially set to treat certain gastrointestinal or stomach problems such as heartburns, ulcers and gas.

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An answer to a question, what is a bland diet, is that it is a simple treatment for people suffering from any one or more gastrointestinal disorders such as chronic gastritis, ulcer, esophagitis and dyspepsia.

Bland diet is a dietary regimen for people suffering from stomach disorders. Hence, it is quite understood that ingredients of a bland diet are soft food items, which are easy to digest with a capacity to keep the acidity to low levels. Questions about diet may be asked to your physicians and he/she can suggest the diet or recommend a dietician to do it.

Diet medical questions may include the queries about the food stuffs to eat and food stuffs to avoid during the time while a person experien ces any gastrointestinal disorders. However, before a dietician could decide the bland diet for a person, he/she needs to seek answers to several medical questions related to the person such as any food allergies or irritations associated with any food items and emotions medical questions of people.

Bland Diet:

The diet prescribed as a bland diet will include food items that are easy to digest and low in fiber and acid contents. Even giving up alcohol and smoking is advised while patient is on bland diet. Also a patient is advised to have 4 to 6 light meals after regular interval to avoid heavy and large meals.

Chewing food properly and eating slowly helps in the digestion of the food. Adequate sleep, avoiding smoking and controlling anxiety are supportive treatments for the standard treatment of the problem.

Allowed Food Items:

• Dairy Products
Milk, cheese, yogurt with low-fats and other dairy products are easily digested and hence, can be included as a part of bland diet. However, there is no restriction on ice-creams and one may consume even ice creams during bland diet, but it should not have any product such as nuts that are not allowed in bland diet.

• Fresh Fruits and Vegetables
Fresh vegetables and fruits are allowed to a bland dieter. However, while carrot, squash, green peas are good to eat in a bland diet, broccoli, onions and green peeper should be avoided as it forms gas. In fruits, oranges, grapefruits, and bananas are allowed.

• Proteins
Protein requirement of the body, while on a bland diet should be met with soy products and meat. Fried chicken and greasy hamburgers are not allowed to be consumed, while grilled and baked chicken is allowed.
Low-fat peanut butter and eggs are also efficient to meet the body’s protein requirement in a bland diet.

• Carbohydrates
Carbohydrates are contained in whole grain breads, pasta, oatmeal, corn flakes, white rice and sweet potatoes. All these food items are allowed.

Bland diet is designed for treating certain medical circumstances such as gastrointestinal problems. Hence, to answer what is a bland diet, we can say that this is a diet that aims at improving the digestion with the help of a timed-routine diet and soft to digest food items. Once the problem is controlled patients can return to their normal diet.

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A Quick Look at Some of Today’s Most Effective Diets

The idiot-proof diet is all about calorie shifting. That is, in this diet, you shift your food intake throughout the day instead of eating just 3 meals a day. The diet is popular because it’s actually very easy to follow and there are hardly any restrictions when it comes to the types of food you can eat.

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The Idiot-Proof Diet

The idiot-proof diet is all about calorie shifting. That is, in this diet, you shift your food intake throughout the day instead of eating just 3 meals a day. The diet is popular because it’s actually very easy to follow and there are hardly any restrictions when it comes to the types of food you can eat.

The ‘calorie shifting’ model takes place because you eat every two and half hours. The theory is that because your body is consuming calories (energy) constantly throughout the day, it’s always in ‘burning calories’ mode instead of the ‘saving calories’ mode.

When you sign up for the diet, you get access to a diet handbook, an 11-day diet-plan and a diet calculator. You get to pick what foods you like to eat so don’t think that you’ll be tarving in this diet!

NutriSystem

The NutriSystem way of dieting is all about proper meal planning. People love this diet because it takes away the burden of trying to figure out what to eat during their dieting phase. You see, a lot of people actually get confused as to what they can eat when they want to lose weight. That’s not really surprising because there’s so much information out there and for every yay sayer, there is a nay sayer so it’s really tough to know what to eat.

However, with NurtiSystem, they do all the meal planning and portion controlling for you. You just need to sign up to any of their diet programs (e.g., Women’s Program, Men’s Program, Vegetarian Program, etc.) and order a multi-day (usually for 28 days) diet program.

After you choose your diet program, a menu is presented to you and you simply choose what you want to eat. The meals are then delivered to your doorstep at various intervals during your diet program.

The South Beach Diet

The South Beach Diet is popular because the name alone conjures bikini-clad bodies! Add to that the fact that it was founded by a cardiologist, Dr. Arthur Agatston, then you have a sort of ‘doctor recommended, doctor approved’ seal on the diet as well.

At first glance, the South Beach Diet looks a lot like the Atkins Diet in the sense that it restricts carbohydrates during the initial phase of the program (there are 3 phases). The first phase (14 days) encourages ‘normal eating’ in the sense that you can pretty much eat whatever you want but you must NOT eat bread, rice, potatoes, pasta, or baked goods. Fruit is also not allowed. No sugar. No alcohol.

The second phase allows you to SLOWLY introduce these items back into your diet but at lesser levels that you consumed them before of course. The third phase is more about general maintenance.

Weight Watchers

Probably one of the longest running diet programs out there is Weight Watchers. It believes in the overall approach where food, exercise, behavior and support are addressed.

Weight Watchers is known for advocating a point system for foods. Using this system, one calculates the calorie intake of the foods he or she eats. The number of points you can have in a day varies depending on your weight. The beauty of the program is that there are no gut-wrenching food restrictions so you never feel deprived of anything. However, the point system teaches you how to balance your meals so that even if you indulge on one food item, you don’t go overboard and consume too much in a day.

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