Comparison of Gastric Banding and Gastric Bypass Surgeries

	Gastric Banding	Gastric Bypass
Graphical Representation
Anatomy	A band made of adjustable silicon, has been inserted around the stomach as to form a small stomach pouch of approximately 15-20 ml.	The stomach is divided into two parts as to form a pouch of approximately 20-30 ml and this small stomach is connected to the intestine.
Weight Loss Mechanism	Food intake decreases due to restruction of the stomach volume and it can be well decreased by adjusting of the staple.	Food intake decreases due to restruction of the stomach volume and also digestion of the foods decreases because of the foods have taken directly pass down from small stomach to the intestine.
Weiht Loss Rates	50-60% of the excess weight is lost at 18-24 months period.	70-80% of the excess weight is lost at 18-24 months period.
Diet and Required Life Style Changes	High calorie diet (chocolate, icecream, desert etc) should be avoided. Regular exercises should be done in the forward periods.	High protein foods must be taken in the beginning, sugar foods should be avoided (dumping syndrome) and regular additional vitamins must be taken against to lack of vitamin and minerals. Regular exercises should be done in the forward periods.
Nutritional and Vitamin Requirements	Multivitamin, Calcium (rarely)	Multivitamin, Calcium, Vitamin B12, Iron
Surgery risks	Surgery risk rate of early and late period %0-8	Surgery risk rate of early and late period %0.2-10
Eating Adaptation	May be difficult, frequently nausea and vomittings may be experienced	There is usually more qualitied and easier eating adaptation.
Technical Difficulties	No	Yes (a difficult application, more training and surgery practises are required)
Prosthetics (Foreign) Material	Yes (there is silicon material but it’s adaptation is quite good, the reservoir sometimes may create problems)	No
Reversing of the surgery	Yes	Yes (but quite difficult)

Vitamin and Mineral Using After Gastric Bypass Surgery

Vitamin and mineral deficiency is a situation that frequently encountered but easily can taken precautions at the patients those have underwent Gastric Bypass surgery.

Iron, Folic acid, Vitamin B 12, Calcium and Zinc deficiencies are encountered more frequently. The list of necessary vitamins and minerals and their daily doses have been given following. You can find all of these drugs from the local pharmacies or vitamin support products selling stores.

If you have trouble to find, then we definitely suggest you to contact with your doctor.

COMPULSORY	DOSAGE/DAY
Multi-Vitamin and Mineral	1-2*
Vitamin B12	500 mcg**
Iron	27-28 mg
Vitamin C	500 mg
Calcium Citrate by Vitamin D	1200-1500 mg
OPTIONAL
Zinc	10-20 mg
Laxatives (Stool Softeners)	Constipation depending on iron intake

* Multi-vitamins and minerals should be taken as 1-2 tablets a day with meals.

** 500 microgram tablets or monthly applicable 1000 microgram injectable (injection) forms are available for Vitamin B12 intake.

More than one equivalents of drugs mentioned above belongs to the various companies are available. Your doctor will prescribe you a suitable one among them.

Assoc. Prof. Halil Coskun M.D.