Jejuno-ileal bypass (JIB) surgery is a procedure developed in the 1950’s for weight loss by reducing the length of the small intestine. JIB differs from gastric bypass which reduces the size of the stomach so that the patient feels ‘fuller’ with smaller meals and therefore eats less. These procedures are known as bariatric surgery or commonly as weight loss surgery. Jejuno-ileal bypass surgery has been shown to be effective in the treatment and management of obesity however the complications associated with this procedure has led to it being banned in many developed countries.
The small intestine is an essential component of the gastrointestinal tract, responsible for the breakdown and absorption of food and water. The average human small intestine is between 6 to 7 metres long but in procedures like jejuno-ileal bypass surgery, the small intestine length is reduced to less than one metre. As with any bowel surgery, complications like adhesions may occur but with JIB, the complications can be severe and even life threatening. In a research study conducted at the Shahid Beheshti University of Medical Sciences in Tehran, Iran in 2007, recent developments in the JIB procedure has shown to be effective in reducing the risk of liver disease. However the research thus far has been limited since most developed countries have banned the procedure.
Jejuno-Ileal Bypass (JIB) Surgical Procedure
In jejuno-ileal bypass surgery, the small intestine is bypassed and set aside within the abdomen so that food travels through a short portion of the small intestine and empties into the colon. Since the small intestine plays the most significant role in food absorption, bypass surgery involving the small bowel prevents nutrient absorption. This inevitably reduces the calories absorbed by the body preventing fat metabolism and storage. Inevitably, the body has to utilise its fat stores to continue to nourish the body. While the procedure may seem like the ideal option for obese patients who are unable to control their food intake, the procedure can significantly affect the health and well being of the patient.
Complications of Jejuno-Ileal Bypass (JIB) Weight Loss Surgery
There are a number of complications associated with a jejuno-ileal bypass and this led to the procedure being banned in the 1970s. However JIB is still considered a legitimate surgical procedure for weight loss. Some of the complications include :
- Nutritional deficiencies especially protein, calcium, vitamin D and electrolyte deficiencies.
- Gastrointestinal symptoms like diarrhea, small intestine bacterial overgrowth (SIBO), abdominal bloating, intestinal inflammation.
- Liver and gallbladder complications including gallstones, liver failure.
- Kidney disorders and possible renal failure.
A host of other complications may arise including hair loss, generalised body swelling (oedema) and arthritis. Long term complications may involve the heart and lungs which could eventually be fatal.
Weight Loss Surgery Options
Before considering weight loss surgery, it is important to understand the complications associated with any procedure. Always discuss your options with your general practitioner and surgeon as well as the prognosis and complications. Weight loss surgery should only be considered when other tried and tested methods of weight loss have failed. Gastric bypass surgery has become more popular globally and while there are complications associated with this procedure, it is seen as the safer option for weight management. Up until recently, this procedure was allowed in South Africa but has now been banned by the medical council.