Surgeon General Iván Dominguez Sánchez answers readers’ questions

Surgeon General Iván Dominguez Sánchez answers readers’ questions this week with this segment Your expert responds.After his training Hospital general and digestive system surgeon October 12 (Madrid) Dr. Domínguez completed his training in laparoscopic surgery between 2016 and 2019 as part of the bariatric surgery team of the Pontevedra University Hospital, one of the most recognized hospitals in our country.

In 2019 he decided to move to Oviedo (Medical Center of Asturias) to obtain a degree that would allow him to perform robotic surgeries during stays in different international centers.

Once he gained the required experience and qualifications, he decided to return to his home country to practice the best surgery in the place where he grew up.He is currently the country’s leading bariatric surgery expert san rafael hospital From A Coruña.

Here are answers to readers’ questions:

What is the most important thing after gallbladder surgery? Can I eat it normally?

Gallbladder surgery is performed laparoscopically through 3-4 incisions between 0.5 and 1 cm, so postoperative pain is minimal and can be controlled with basic analgesia. The most important thing is to avoid strenuous exercise, such as lifting weights or performing high-stress activities. Walking is possible from day one.

When your gallbladder is removed, your diet should be low in fat for the first 3-4 weeks until your body adjusts. If we don’t diet, the consequences are not serious and include indigestion or diarrhea.

What impact does spicy food have on ulcers and other diseases?

Spicy foods by themselves are not harmful if the ulcer did not previously exist. It does not cause ulcers, but it can make symptoms worse if we already have them. We must not forget that the digestive tract has an entrance and an exit, and their discomfort is exacerbated if we suffer from hemorrhoids.

When can you suspect a hiatal hernia?

These symptoms are associated with reflux disease. If you notice a burning sensation in your chest when you lie down (a symptom called heartburn), food moving to your mouth after eating, if you notice that you cough more when you sleep or wake up with a hoarse voice and bad breath, you You may have a hiatal hernia. The most important thing is to contact us if you are experiencing these symptoms.

I have recurring gastritis, will it lead to ulcers?

Chronic inflammation of the gastric mucosa can lead to the breakdown of the barrier that protects the stomach from acid, leading to the formation of ulcers. We must study the causes of chronic gastritis (Helicobacter pylori, autoimmune gastritis…) to prevent it from evolving into ulcer disease.

How to tell if you have hemorrhoids?

Hemorrhoids are nothing more than enlarged veins or varicose veins in the anal area. You may experience itching, painful bowel movements, a lump sensation in the anal area, and even bleeding. If in doubt, consulting your surgeon should be the first option before starting any treatment.

Can I safely resume exercise after having my gallbladder removed?

Not having a gallbladder does not affect your physical abilities, all we have to do is avoid straining for the first few weeks of surgery to prevent herniation of the area into the abdominal cavity. So, walking is possible from the start, but we avoid heavy lifting or exercises that increase intra-abdominal pressure, such as doing sit-ups.

At what weight should I consider bariatric surgery?

It depends less on weight than on its effect on metabolism. As an indirect measure we will measure body mass index (weight/height2) and look at associated diseases.

With a BMI of 35, surgery may be the most appropriate option. If your BMI is between 30-35, you will be assessed for limitations caused by obesity, or if you have associated diabetes, you may be suitable for so-called metabolic surgery.

The goals of bariatric surgery are to change body weight, help balance metabolism, resolve existing conditions such as high blood pressure, high cholesterol, changes in blood sugar levels, and even prevent their progression.

What are the long-term benefits of bariatric surgery in terms of weight loss and improved health?

The goal of the surgery is to achieve a weight that helps the body return to metabolic balance. In the long term, blood sugar levels may return to normal, blood pressure may return to normal values, and excess cholesterol and triglycerides in the blood may return to normal. Diseases such as type 2 diabetes can improve or even disappear. By losing weight, if a patient has sleep apnea, they can correct it and stop using devices like CPAP to fall asleep.

By restoring better mobility, joint damage will improve and you will be able to perform exercises and even activities of daily living that were previously impossible.

Another consequence that should not be ignored is that by improving quality of life, patients may change their daily routines, thereby affecting their mood. At the work level, you will notice that actions that were previously more difficult for you will be simplified.

What are the treatments for ulcers? Are there diets that can help control or prevent ulcers?

The first thing to do is to research the cause of the ulcer. For them, analytical studies and digestive endoscopy will be performed to observe and biopsy ulcers. If the ulcer is caused by Helicobacter pylori infection (which is very common), it must be eradicated with antibiotic treatment.

In any case, the most common measure is to take gastroprotective agents, mainly proton pump inhibitors, such as omeprazole.

Of course, a diet that does not contain gastric irritants such as alcohol, spicy foods, or tobacco is necessary.

What are the warning signs of complications after gallbladder surgery?

The risk of complications after laparoscopic cholecystectomy is small. Observe patients closely immediately after surgery and study their vital signs regularly.

After discharge, the most common and easily diagnosed complication is wound infection, which requires treatment with a dressing. If the intra-abdominal infection is severe, the patient will have abdominal pain, fever and other symptoms and need to go to the emergency room.