Overcoming Genetics with Bariatric Surgery

Many of us have struggled with our weight. Whether it’s those 30 pounds of baby weight that have stubbornly hung around long after the baby was born or the 50 pounds gained after a back injury, weight gain is for many a constant struggle and a sensitive subject.

However, inactivity and poor diet are not the only causes of obesity. Research estimates that genetics determines at least 40 to 50 percent of our weight. Unfortunately, the specific genes are not well understood.

How can one overcome genetics? If everyone in your family is heavy, isn’t it a foregone conclusion that you will be heavy also? Not necessarily. Fortunately, we can level the genetics playing field with weight-loss surgery.

The most popular weight loss procedure in the United States is the laparoscopic sleeve gastrectomy. The surgery is minimally invasive, takes about an hour and requires an overnight stay in the hospital for most patients. The stomach, which regularly can hold about the volume of a football, is stapled and divided so that it is the shape and size of a banana.

Weight loss is achieved because the patient can no longer eat a large volume of food, and calories are proportionately decreased. The pylorus, the muscular valve at the outlet of the stomach, is left intact in this surgery. This also helps patients who have this procedure stay full.

Besides the effects of the procedure on restricting food volume, there is increasing evidence that the mechanisms in the brain that cause hunger are permanently modified by the sleeve gastrectomy. People state that they no longer feel hungry and no longer crave some of the high-calorie foods they used to.

Weight-loss surgery is a powerful tool in the hands of the patient, but it is not an “easyfix.” Sleeve gastrectomy requires commitment to healthy food choices and exercise on the part of the patient. The exciting news is that those struggling with obesity are not doomed to a life of aches and pains, poor health, and a miserable quality of life. There is help, and there is hope.

If you are in the Las Vegas area and are considering bariatric surgery, schedule an appointment with VIP Surg. Dr. Tsuda, Dr. Ryan, and their expert team can help find the right treatment for you.

Overweight Woman is Overjoyed

 

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LINX: Treating GERD with Innovation

A hiatal hernia occurs when part of the stomach pushes through the diaphragm. The diaphragm normally has a small opening for the esophagus. This opening can become the place where part of the stomach pushes through. Small hiatal hernias often cause no symptoms, while larger ones can cause pain and heartburn, leading to gastroesophageal reflux disease, or GERD. In 2012, the Food and Drug Administration approved a new treatment device called the LINX Reflux Management System to offer a new approach to treating GERD, a disease that is increasing at a rate of 30 percent every decade.

Think of the stomach as a mixing bowl that allows food and digestive juices to combine to begin the digestive process. The stomach has a protective lining that prevents acid in the digestive juices from eating away at the stomach muscle and causing inflammation. Unfortunately, the esophagus does not have a similar protective lining. Instead it relies on the lower esophageal sphincter (LES) to act as a valve to prevent acid from refluxing from the stomach into the esophagus. In the situation of a hiatal hernia, part of the stomach pushes up through the opening allowing acid to pass into the esophagus causing symptoms may include the following:

  • heartburn
  • nausea, vomiting, or retching (dry heaves)
  • burping
  • water brash, the rapid appearance of a large amount of saliva in the mouth that is stimulated by the refluxing acid

Symptoms usually are worse after meals. These symptoms may be made worse when lying flat and may resolve with sitting up or walking.

In some patients, reflux into the lower esophagus sets off nervous reflexes that can cause a cough or even spasm of the small airways within the lungs (asthma). A few patientsanatomy-archers may reflux acid droplets into the back of their throat. This acid can be inhaled or aspirated into the lung causing coughing spasms, asthma, or repeated infections of the lung including pneumonia and bronchitis. This may occur in individuals of all ages, from infants to the elderly.

Fortunately, the innovative LINX procedure is helping with this significant health problem. This device is a series of magnets in the form of ring that is implanted around the bottom of the esophagus during a short, 40-minute laparoscopic procedure.

The ring of magnets is designed to stay closed and prevent the reflux valve from opening thereby preventing acid from the stomach move up into the esophagus. The magnets will open up the ring when people are eating to let food in much like a person’s native reflux valve.

 

Here are some things you need to know about the LINX procedure.

  • It is focused on the underlying cause of reflux disease not the side effect. Reflux disease is a result of a damaged lower esophageal sphincter (LES).
  • It is safer than the long-term use of proton pump inhibitors (PPIs). Studies have proven that reflux disease can progress even when PPI therapy has effectively eliminated GERD symptoms. LINX is effective at reducing symptoms and improving quality of life.
  • A recent study published in the New England Journal of Medicine tracked 100 patients for three years after their LINX surgery. That study found an overall decrease in stomach contents reaching the esophagus, fewer reflux symptoms, and a substantial reduction in PPI usage.
  • The side effects disappear over time in most cases. Initially, most patients experience some discomfort, but it typically dissipates over several weeks. In addition, the most commonly reported side effect is mild difficulty swallowing, which usually subsides over time.
  • The cost can be much less than a lifetime of PPI use: a 2010 study by Consumer Reports found once-a-day PPI use can range from $2,000 to $4,500 per year for brand name prescription PPIs.
  • This is minimally invasive and is performed as an out-patient procedure.
  • LINX is reversible and can be replaced.
  • Since the LINX band is placed around the LES, the device can be removed or replaced, if necessary.
  • This procedure is recommended for those with continued GERD symptoms under maximum therapy prescribed by a specialist.
  • LINX is not for everyone with advanced GERD. Today LINX is not approved for those with Barrett’s Esophagus or anyone suffering from esophageal cancer. It is important for everyone suffering from advanced stages of reflux disease to explore all available options before their disease progresses to the point where options are limited.

It is important to take your heartburn symptoms seriously because they are signals from your body that something is wrong. Since reflux disease is a progressive chronic condition, treating it early could prevent you from having to consider surgery later on.

As the first LINX trained surgeons in Las Vegas, Dr. Shawn Tsuda and Dr. Heidi Ryan at VIP SURG are ready to help you fight back against gastroesophageal reflux disease. Schedule a consultation to learn more.

 

 

The Link Between Seasonal Allergies and Reflux

While many may think of seasonal allergies happening in the spring along with blooming flowers, fall can also be a difficult time for those who are allergic. Ragweed, dust, mold, mildew, and the removal of fall crops are just some of the possible fall triggers for allergy sufferers. What many people don’t know is that allergies can be a big issue for people dealing with acid reflux disease. Separate from food allergies, seasonal allergies can also play a role in exacerbating the symptoms of acid reflux.

The link between seasonal allergies and acid reflux disease is that as allergic response becomes more active, one has more nasal drip, and more nasal drip leads to more acid, and that acid can then reflux up into the nasal passages and make the whole cycle even worse. In addition, one of the ways that seasonal allergies can aggravate acid reflux disease is the pressure from coughing or sneezing. This pressure can temporarily weaken the lower esophageal sphincter (LES) and allow stomach contents to splash into the esophagus. In order to get the added acid reflux pain under control, suffers also need to get the drainage, sneezing and coughing under control.

The first line of defense in the seasonal allergy arsenal is generally the use of antihistamines. Medications provide a way to lessen the reaction the body has to the histamines produced by allergies. These medications can help many people deal with their allergies without any further treatments.

Senior man with reflux

If you do need antihistamines in the pollen season, remember that they can dehydrate and cause constipation. The latter is also a huge reflux trigger. Be sure to drink plenty of water and gradually increase your fiber intake to counteract any unpleasant side effects. You don’t want to trade one reflux trigger for another.

There are a few things that you can do this time of year to help lessen your increased acid reflux symptoms due to allergies:

  • Even though the weather this time of year can be gorgeous, keep the windows closed in at least one room of your house. Spending time in this room throughout the day will give your entire bodily system a break from the environmental stress being placed on it.
  • Shower and change clothes after working or being outside. Most aller
    gens cannot be seen. Especially on a windy day, just assume that if you have been outside, you are wearing allergens when you come inside.
  • Be proactive with your reflux medication and your allergy medication this time of year. Reflux comes in waves. One of the best ways to manage reflux is to understand ahead of time when your reflux may be troublesome and manage accordingly. An antihistamine can be helpful. It works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. This medication can also slow down your runny nose and nasal drip whichin turn can help your reflux symptoms.
  • Do not experiment with new foods. Keep your eating very simple and reflux friendly until at least the first frost in your area.
  • Avoid raw fruits and vegetables. Allergens can be found in our environment and also in raw fruits and some vegetables. These same foods can often be better tolerated cooked. When foods are heated, the proteins are distorted and the immune system no longer recognizes the food as a problem.

If you live in the Las Vegas area and are suffering from acid reflux. Schedule a consultation at VIP Surg. We can help find the right treatment for you.

 

Normal Heartburn or GERD?

Acid reflux is a serious disorder that can and must be treated to prevent symptoms and stave off potentially life-threatening consequences. Known medically and commercially as GERD, the acronym for gastroesophageal reflux disease, repeated bathing of the soft tissues of the esophagus with corrosive stomach acid can seriously damage them and even cause esophageal cancer, which is often fatal.

Acid reflux is more than just a nuisance. It involves the backward flow of stomach acid into the tissues above it. It results when the lower esophageal sphincter, a ring of muscle between the esophagus and the stomach, fails to close tightly enough to prevent the contents of the stomach from moving up instead of down. Sometimes the upper sphincter, between the esophagus and the throat, malfunctions as well.

Contrary to what many believe, heartburn is but one of the many symptoms of GERD, and failure to recognize the others when heartburn is not among them can result in harmful untreated reflux. In addition to indigestion, GERD can cause:

  • persistent dry cough
  • sore throat
  • frequent throat clearing
  • hoarseness
  • burping or hiccups
  • bloating
  • difficulty swallowing
  • a sensation of a lump in the throat

If, when faced with such an otherwise unexplainable symptom, your doctor fails to thinkhand holding stethoscope with GERD word. medical concept of GERD as a possible reason, you might suggest it yourself. An examination of the esophagus may be the only way to find out if someone without obvious heartburn has acid reflux but doesn’t know it.

One characteristic often associated with acid reflux — being overweight, especially with abdominal obesity — largely explains why the condition has become so common in Western countries. Someone with a body mass index in the overweight range is almost twice as likely to have GERD as a person of normal weight. Losing weight is one of the best ways to find relief without having to rely on medication. Other ways to relieve GERD symptoms include:

  • quitting smoking
  • limiting alcohol
  • avoiding carbonated drinks
  • eating five or six small meals a day rather than one or two big ones
  • avoiding eating within three hours of bedtime
  • Raising the head of the bed by six inches or more

If you suffer from GERD and are looking for treatment, schedule an appointment with Dr. Shawn Tsuda. Among other procedures, Dr. Tsuda specializes in a revolutionary treatment for GERD called LINX. Find out if it’s right for you.

 

Heartburn or GERD – It makes a Difference

Acid reflux occurs when stomach contents moves backward into the esophagus. It’s also called acid regurgitation or gastroesophageal reflux (GERD). Acid reflux is a common digestive condition. According to the American College of Gastroenterology, more than 60 million Americans experience acid reflux at least once a month. More than 15 million Americans experience it every day.

Acid reflux usually causes a burning sensation in the chest. The sensation radiates up from the stomach to the mid-chest or throat. This is also known as heartburn. When symptoms that seem like heartburn persist, it could be a disease with more serious consequences. Chronic reflux can sometimes lead to difficulty swallowing and in some cases it can even cause breathing problems like asthma.

Acid reflux is caused when the muscle at the end of the esophagus, the lower esophageal sphincter (LES) is faulty or weak. The LES is a one-way valve that normally opens for limited amounts of time when you swallow. Acid reflux occurs when the LES doesn’t close properly or tightly enough. A faulty or weakened LES allows digestive juices and stomach contents to rise back up into the esophagus.

Large meals that cause the stomach to stretch a lot can temporarily loosen the LES. Other factors associated with reflux include:

  • obesity
  • stress
  • hiatal hernia (when part of the stomach pushes up through the diaphragm)
  • consuming particular foods (particularly carbonated beverages, coffee, and chocolate)

Most people experience occasional acid reflux or GERD. However, in some cases the digestive condition is chronic.

Acid reflux can affect infants and children as well as adults. Children under 12 usually don’t experience heartburn. Instead they have alternative symptoms like:

  • trouble swallowing
  • dry cough
  • asthma
  • laryngitis (loss of voice)

These alternative symptoms can also appear in adults.

Gastroesophageal Reflux Disease (GERD) is a chronic digestive disease. It’s the more serious form of GERD and can eventually cause more serious health problems if left untreated. Acid reflux that occurs more than twice a week and causes inflammation of the esophagus is considered to be GERD.

Most people with GERD experience symptoms such as:

  • heartburn
  • regurgitation
  • trouble swallowing
  • a feeling of excessive fullness

Living with acid reflux is inconvenient. Fortunately, symptoms can generally be controlled through:

  • stopping smoking
  • reducing alcohol consumption
  • eating less fat
  • avoiding foods that set off attacks
  • losing weight
  • sleeping in different positions
  • antacids
  • anti-reflux medication
  • surgery

Most people with reflux will not have long-term health problems. However, GERD can increase the risk of Barrett’s esophagus. This is a permanent change in the lining of the esophagus which increases the risk of esophageal cancer.

If you suffer from GERD that isn’t responding to treatment, schedule an appointment with Dr. Shawn Tsuda to learn about LINX http://www.linxforlife.com/. This could be the answer you’ve been searching for.

Stethoscope on notebook and pencil with GERD (Gastroesophageal R

 

Gastric Bypass for a Longer Life

According to research by the Geisinger Health System, one of the largest health service organizations in the U.S., patients with severe obesity who have gastric bypass surgery reduce their risk of dying from obesity and other diseases by 48% up to 10 years after surgery, compared to similar patients who do not undergo the procedure. This is significant considering that the American Society for Metabolic and Bariatric Surgery estimates about 24 million Americans have severe obesity, which would mean a BMI of 35 or more with an obesity-related condition like diabetes or a BMI of 40.

Researchers from the Geisinger Health System followed nearly 2,700 patients who had gastric bypass at the system’s nationally accredited bariatric surgery center between 2004 and 2014. Mortality benefits began to emerge within two years after surgery and were significant within four years. The biggest reduction in risk occurred in patients 60 years or older at the time of surgery and in patients who had diabetes before surgery.

“The long-term survival benefits these older patients and those with diabetes experience likely relate to improvements in long-term metabolic and cardiovascular health, among other risk factors,” said Michelle R. Lent, Ph.D., a Geisinger Obesity Institute researcher. “While this study did not evaluate specific-cause mortality, as expected, we did find significant improvements or remission in diabetes and high blood pressure.”

In the study, more than 60 percent of patients with diabetes before surgery experienced diabetes remission about five years after surgery. Previous studies have shown death from heart disease and even certain cancers are lower in gastric bypass patients than patients with severe obesity who do not have the operation.

People with obesity and severe obesity have higher rates of heart disease, diabetes, some cancers, arthritis, sleep apnea, high blood pressure and dozens of other diseases and conditions. Studies have shown individuals with a BMI greater than 30 have a 50 to 100 percent greater risk of premature death compared to healthy weight individuals.Live Longer

If you live in the Las Vegas area and are interested in learning what bariatric surgery can do for you, schedule an appointment with Dr. Shawn Tsuda. He and his team of experts can help you choose the best treatment for your unique situation.

 

Tips for Choosing the Right Surgeon for You

Whether you need a complicated, invasive surgery or a simple out-patient operation, choosing the right surgeon can seem overwhelming. Even what should be relatively straightforward procedures such as gallbladder removal or hernia repair can sometimes result in serious complications, so you always want to be in good surgical hands. Here are some tips on finding the surgeon and hospital that are best for your situation.

Once you have narrowed down your list of potential surgeons, schedule a consultation. If you have a fairly urgent need for surgery, you may have to cross surgeons off of your list purely because of the wait for a visit. Otherwise, plan to meet with at least two surgeons and discuss your potential surgery.

Things to ask:

  • Is surgery necessary? The best way to avoid surgical errors is to avoid surgery entirely, so ask about the effectiveness and safety of alternatives. Compare those with the risks of surgery and the chance that it will help you.
  • Is your board certification up-to-date? Look for a surgeon who has undergone the necessary training, even after being in clinical practice, to maintain board certification in his or her specialty.
  • What’s your experience? Ask how many operations the surgeon has performed in the past year and how that compares with his or her peers.
  • What are your success, failure, and complication rates? Not all will be able or willing to tell you, but the good ones should.
  • What’s the hospital’s infection rate?
  • Does the hospital follow best practices? The federal Centers for Medicare and Medicaid Services tracks how frequently hospitals give antibiotics on schedule, control blood sugar in heart-surgery patients, prepare skin properly before incisions and take other steps proven to help prevent surgical complications.Make the right choice.

You may be expected to schedule a surgery at the end of the consultation. If you are not confident that you have found your ideal surgeon, do not schedule the surgery. Either way, it’s fine to ask for a day to consider everything the doctor has said before making the surgery official.

If the surgeon you consulted with is not your ideal surgeon, schedule a consultation with a different surgeon. Even if you think the first surgeon is your best choice, a second opinion from another surgeon can be valuable. Most types of insurance will allow for two or three consultations. If you believe you have found your ideal surgeon you can schedule your surgery, confident in your decision.

If you’re looking for an experienced general surgeon in the Las Vegas area, Dr. Shawn Tsuda specializes in minimally invasive surgical techniques including the laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric band, sleeve gastrectomy, foregut surgery, ventral and inguinal hernia repairs, endoscopy, and basic laparoscopy. Schedule a consultation to learn what he can do for you.