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Gastric Strips: Do They Really Work?

“Do they really work?”

This post is dedicated to everyone who is about to have their weight loss surgery or is currently recovering from the procedure since many of you wonder about the best way to get prepared for bariatric surgery and what medications to bring with you. Gastric strips gained popularity among bariatric patients claiming to provide relief from gas that often causes so much discomfort after the surgery.

Some patients start using gastric strips a few days before surgery and right after it, hoping it will help them get rid of the gas faster. The truth is… it won`t happen! Although some of you who did take gastric strips might say they did work, but this is rather a so-called placebo effect¹. Of course when you are suffering from gas pain you think: whatever works… as long as it doesn`t hurt me. Well, we cannot deny that. But let`s look at the root of the problem.

During bariatric surgery doctors pump a certain amount of CO2 into your abdomen, particularly between the internal organs and the abdominal wall. The doctor puts you in a specific position called Reverse Trendelenburg Position², which allows the gas move to the upper part of your abdomen. The purpose of this is to help to create space around your stomach, so the surgeon can manipulate the stomach, cut the attachments to the adjacent organs, and perform the sleeve/bypass procedure. The CO2 never enters into your intestinal lumen, i.e. inner space of the intestine, where the gastric strips “work”. Thus the strips cannot help you get rid of the gas faster simply because they affect the “wrong” area. Nevertheless some patients reported they felt better after taking gastric strips. As it was mentioned above this is a mere placebo effect¹.

So what is the solution? Towards the end of surgery, the doctor will remove a major amount of gas from the abdominal cavity, but some of it stays. This gas is further removed by using an oxygen mask during the first 3 – 4 hours after surgery, and later by walking. Gas will be removed naturally by being absorbed into the bloodstream and simply exhaled just like we normally exhale CO2 after every breath we take. To accelerate this process walking helps a lot. This is one of the reasons why patients need to get up and start walking shortly after the surgery (another reason is maintaining good blood circulation and avoiding blood clot formation). But keep in mind that the surgery itself also causes certain abdominal pain due to cutting the internal tissues, and sometimes it is hard for a patient to distinguish between the sources of pain.

Abdominal pain can be related to the irritation of the nerves of the abdominal wall. That pain often “travels” from your stomach to the shoulders. And in order to understand why we feel pain in such “remote” places we have to go back in time. During our development at the stage of embryos our shoulders and the diaphragm were innervated by the same nerve. This is why a heart attack, for example, can be felt in the jaw or shoulder even if pain originates in the heart. And this is the reason why bariatric patients often feel pain in their shoulders. Usually, it takes from 2 – 3 days to 2 – 3 weeks to get free from the abdominal pain, whether it is caused by gas or by the surgery itself.

Having said that, we do not recommend our patients take gastric strips, but neither do we deny your right to enjoy the placebo effect they might have on you. Our recommendation is to be active! The more you move the faster you will feel better.

Always wishing good health and fast recovery to all our patients,

Dr. Cynthia Hernandez

¹Placebo effect – A beneficial effect in a patient following a particular treatment that arises from the patient’s expectations concerning the treatment rather than from the treatment itself.

²The reverse Trendelenburg, also called the anti-Trendelenburg, is a common surgical position in which the lower extremities are leveled lower than the head and neck. It is the opposite of the Trendelenburg position, in which the head and the neck are below the lower extremities. The reverse Trendelenburg is widely used in bariatric surgery.

Written by Go Light Bariatrics

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