Development of gout after gastric bypass

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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Gastric bypass is a radical form of weight control.

Complications caused by the surgery may be as high as 10% or more.

Complications requiring a hospital stay of seven or more days were reported in 1.35% of patients from the International Bariatric Surgery Registry (IBSR) database. Some of the complications involve the heart or liver, rupture of blood vessels in the lungs, infection surrounding the diaphragm area, leaking and bleeding of the stomach and intestines, blood clotting of veins and blockage of the small intestine.

Complications requiring a hospital stay of less than seven days were reported in 5.28% of patients the IBSR database. These complications include breathing difficulties, wound infections, and injury to the spleen.

Gallstones develop in more than one-third of patients as a result of losing a large amount of weight or from losing weight quickly.

Anemia, osteoporosis and other bone diseases are nutritional deficiencies that develop after the surgery due to long-term absorptive function.

Within 30 days of surgery, death occurred in less than a quarter of one percent (0.17%) of patients in the IBSR database. Pulmonary embolism was the most frequent cause of death.

After any type of surgical procedure, there is the chance that an acute attack of gout may occur. This is related to the stress of surgery as well as rapid fluid shifts accompanying the procedure. Diagnosis is established by needle aspiration of fluid from the affected joint and looking at the fluid under a polarizing microscope. Identification of monosodium urate crystals makes the diagnosis.

Gout attacks after this type of surgery is treated as it is with any type of surgical procedure.

Careful evaluation to exclude pseudogout is also warranted.

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