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BSS-team: ''Our consultation and aftercare clinics are situated all
over the UK, Ireland, The Netherlands and Belgium.''

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gastric band DUBLIN

Due to the number of weightloss surgery patients we've have in Ireland we will now organize 3 times a moth aftercare clinics in Dublin.

Price for gastric band fill or defill will be 120€.

Price for initial consultattion will be 30€.

All previos patienst from the hospital group and patients who didn't have the surgerty done with oruselves are more the welcome for follow up and advice.

Kind regards, BSS team



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Post-op dumping syndromes

Acarbose, a glucosidase inhibitor that slows carbohydrate digestion, has been found to result in complete remission of dumping syndrome (DS) in most subjects and substantially decreased the frequency and intensity of both early and late DS events. The study researchers from Brazil, stated that previous studies have been reported an associated acarbose with the remission of late dumping, although not early dumping. Therefore, they wanted to evaluate the role of acarbose in dumping syndrome prevention and treatment and in resistive exercises resistance in bariatric subjects.

The paper, ‘Acarbose promotes remission of both early and late dumping syndromes in post-bariatric patients’, published by Dovepress, included patients who had previously undergone Roux-en-Y gastric bypass surgery and had achieved body weight goal (BMI<27  for men and <25 for women), had a confirmed diagnosis of DS and were refractory to diet recommendations. Inclusion criteria were the complete adherence to an isocaloric (calculated by indirect calorimetry) and high protein (1.5–1.8 g/kg/day) diet plan, proposed resistive exercises (frequency, intensity, and exercise prescription varied among individuals), and age between 18 and 80 years. Patients who lacked regular follow-up were excluded.

Fifty milligrams of acarbose was orally administered 4–5 times a day before meals for 6 months. For those patients who presented with severe flatulence, 120mg simethicone (b.i.d.) was additionally prescribed. The dose of 50mg before meals has been extensively studied and standardised,14–16 whereas the addition of simethicone was thought to attenuate the most important adverse effects of acarbose use (abdominal cramps, bloating, and flatulence).

A total of 25 subjects (13 men and 12 women; mean age, 37.2 years) were regularly followed up. None of the patients withdrew or missed doses. Among these, seven presented with severe flatulence and one patient showed persistent flatulence despite simethicone prescription. None of the subjects stopped acarbose use owing to side effects. Significant improvements (Table 1) were seen in all analysed parameters: 1) mean number of early DS episodes per week (2.18–0.31; 85.8% reduction; p<0.001), 2) mean number of late DS episodes per week (2.79–0.12; 95.7% reduction; p<0.001), 3) self-referred intensity of each episode (6.1–1.65; 73.0% reduction; p<0.001), 4) Sigstad’s score (2.36–0.32; 86.4% reduction; p<0.001), and 5) ability to perform resistive exercises (3.03–7.12; 135.0% improvement; p<0.001). Improvements were observed from the beginning of the use of acarbose and persisted throughout the six months of therapy.

Table 1: Summary of the results

Complete remission of DS (except during exercises) was observed in 21 patients (84% of analyzed subjects), which persisted throughout the 6 months of acarbose use in all 21 subjects.

The authors acknowledge that a limitation of the study is that they did not include a control group to study the possible placebo effect of acarbose, although it is unlikely that the observed improvements are due to placebo effect.

“Further prospective randomised placebo-controlled double-blind clinical trials with monitoring of vital signs and glucose should be performed in order to confirm our findings,” the authors conclude. “Until then, acarbose may be treated as an option for refractory DS subjects.”

The article was edited from the original article, under the Creative Commons license.



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Bariatric Surgery Can Help People Keep Weight Off Long Term

It really hit Terry White eight years ago when he was at the mall with his wife. He was out of breath every few minutes and had to sit down. "My wife told me I had to get to the gym and lose weight," he says.

He had dieted most of his life. "I've probably lost 1,000 pounds over the years," says White, a realtor in North Myrtle Beach, N.C. But he put most of it back on.

By age 59, he knew he was headed for disaster; he weighed 387 pounds at just 5 foot 6. With encouragement from a friend, he headed to Duke University Medical Center in Durham where he had gastric bypass surgery. It reduced his stomach to about the size of an egg so his body absorbed fewer calories and fat from food.

The weight just fell off, he says. He didn't feel deprived. He just didn't want to eat that much. In seven months he'd lost 200 pounds. That was eight years ago. He's gained back a bit, but not much. It turns out his success isn't unique.

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Researchers with the Durham Veterans Affairs Medical Center in North Carolina recently tracked the progress of 1,787 veterans who underwent gastric bypass surgery. They found that one year after surgery patients lost 98 pounds on average. Ten years later they gained back only about 7 pounds.

Earlier studies have tracked gastric bypass patients for relatively short periods of time, about 1 to 3 years. That has led to the assumption that most people who have gastric bypass surgery will eventually regain the weight.

This study, published online on August 31 in JAMA Surgery, is one of the largest and longest to evaluate the surgery's effects on weight loss. It also did a better job than many studies at follow-up, with 82 percent of participants staying in the study for 10 years.

Researcher Matthew Maciejewski at the Duke University School of Medicine collaborated with Dr. David Arterburn, a senior investigator at Group Health Research Institute in Seattle, in analyzing the data. They expected to see gradual weight gain over 10 years, with some patients gaining back everything they lost.

But they were pleasantly surprised. Patients regained a small amount of weight in the first few years after surgery, but then they "actually plateaued and maintained their weight loss and even lost a little more weight over the next few years," says Arterburn. Just 3 percent of the study participants gained most or all of the weight back in 10 years.

He says the surgery likely interferes with the body's natural defense to less food: a slowdown in metabolism. This is what dooms so many dieters. The study compared the 1,787 veterans who had the surgery to 5,305 equally obese patients who did not have surgery. For the nonsurgical patients, their weight after 10 years essentially stayed the same.

Arterburn says bariatric surgery seems to change how the brain perceives hunger. "Even though they're taking in a whole lot less calories than they were before, they don't feel a constant urge to eat, and it's not just a reduction in the size of the stomach. They don't feel hungry in between meals."

This is exactly what happened to Terry White, who is now 67. He no longer falls asleep all the time. He walks and jogs about 5 miles daily. He and his wife Wanda are planning to charter a boat in the West Indies to celebrate their upcoming 50th anniversary. He says it's been an "unreal" and extraordinary change in his quality of life.

Researcher Maciejewski says the findings of the study provide evidence that bariatric surgery can be highly effective for severely obese patients. He says further research is needed to look at postsurgical complications and how the experience affects long term mental health.



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Clinic dates

Dublin Meridian Clinic Clarehall

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London

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Manchester Calderbank Medical Chambers

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Belfast Bloomingfield Surgery

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Glasgow Central Chiropratic & Health Clinic

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Bristol Clifton Physiotherapy

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Birmingham Chiro Relief

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Killarney

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Gastricband aftercare clinics in the UK and
Ireland 2017 available for all patients