Blood pressure is required for blood to flow and carry oxygen to vital organs of the human body. But it is when; this Blood pressure gets too high results into Hypertension. This may harm the arteries and cause the heart to work harder. More of adult medical conditions, but nowadays youth falling prey to it.

Risk Factors that lead to developing hypertension in adolescents include

• Family history has been linked to a higher risk
• Racial predilection has been seen, the African-American population is at higher risk
• Increasing body mass index
• Low birth weight and intra-uterine growth retardation
• Increased sodium consumption

Diagnosis of Hypertension in teenager emphasizes on

1. Going through Patient History: A thorough history is essential in guiding the evaluation and management of a hypertensive adolescent
2. Physical Examination: A comprehensive physical examination could give hint about the underlying cause of hypertension in children and the presence of target organ damage.
3. Blood Pressure Measurement: The American Academy of Pediatrics, the European Society of Hypertension and the European Society of Cardiology recommend regular blood pressure screening in children above the age of 3 years at routine health visits.
4. Ambulatory blood pressure monitoring uses a device that can be worn for 24 hours. It takes multiple blood pressure readings and can help get a more accurate reading of overall blood pressure.

Management of Hypertension in Youth can be achieved by

1. Therapeutic Lifestyle Modification: Enhances on dietary management, increased physical activity, stress reduction and avoidance of drug and tobacco use. Dietary management should include age appropriate, a salt-restricted diet with an emphasis on weight loss in overweight or obese children.
2. Pharmacological Therapy: Children who are symptomatic, who have diabetes or end organ damage such as left ventricular hypertrophy should all be prescribed antihypertensive medication. In addition, children with persistent hypertension after 6–12 months of instituting a heart-healthy lifestyle should also be prescribed a medication to lower their BP.
3. Antihypertensive medications: Combination of drugs recommended if BP control is not achieved with a single drug.

Reports show the reversal of target organ damage following the institution of antihypertensive therapy in children. Seeman et al reported a regression in Left Ventricular Hypertension in a small pediatric cohort treated with ramipril (Antihypertensive medication) monotherapy over a 6-month period.

Other forms of therapy

The emerging trend of utilizing bariatric surgery for reversing morbid obesity in adolescents is gaining awareness. Teen-LABS consortium published the largest series of prospectively collected data on 242 adolescent patients with a mean age of 17.1 (+/−1.6) and BMI of 53. Here in the patient’s Mean weight decreased by 28% with gastric bypass and 26% with sleeve gastrectomy, which was sustained at 3 years. Weight loss, the first line treatment with obesity-related hypertension leads to a decrease in Symptomatic hyperactivity, thereby lowering BP, providing experimental evidence for effective treatment of obesity-related hypertension.

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Bariatric Surgery: The solution of Obesity surgery for Diabetes type 2

Diabetes is one of the most common medical conditions which affect more than 150 million people worldwide. Owing to the dynamic lifestyles of people nowadays, at least 90% of the people have Diabetes type 2 which is related to Obesity, overweight, family history, insufficient physical activity or old age.

Obesity is a medical condition that is related to diabetes and occurs when a person carries excess weight or body fat, so as affecting the person’s health. A medical expert would say a person with high Body Mass Index is Obese.

Types of Diabetes:

1. Diabetes Type 1- it is believed to be an autoimmune condition.
2. Diabetes Type 2- your body can’t use insulin efficiently.
3. Gestational- occurs only during pregnancy

Generally, metformin is the medication prescribed for type 2 diabetes. It works by improving the sensitivity of your body tissues to insulin so that your body uses insulin more effectively.

The most common amongst all is diabetes type 2. Risk factors for type 2 diabetes include:

• having a sedentary lifestyle
• being overweight
• having had gestational diabetes or prediabetes

Although diabetes is traditionally viewed as a chronic, relentless disease in which delay of end-organ complications is the major treatment goal, bariatric surgery offers a novel endpoint: major improvement or even complete disease remission. For obesity, it is one of the most popular and safe methods. Evidence suggests that bariatric or metabolic surgery for obesity may lower death rates for severely obese patients, especially when coupled with healthy eating and lifestyle changes after surgery.

Though bariatric surgery for obesity or weight loss surgery includes a variety of procedures performed on people who are obese, the basic principle of weight loss is achieved by the following methods:

1. Sleeve Gastrectomy: Reducing the size of the stomach through removal of a portion of the stomach. This approach resulted in reduced surgical morbidity and mortality compared with the traditional one-stage approach highly obese patients. Unexpectedly, patients achieved remarkable weight loss after the first stage and SG.
2. RYGBP: This is the most common amongst all. By resecting and re-routing the small intestines to a small stomach pouch. After RYGBP, ingested food bypasses most of the stomach and the first part of the small intestine. (gastric bypass surgery)
3. Restricting food intake and decreasing the absorption of food in the stomach and intestines.

Results:

• Average 77 % of excess body weight is lost in one year after surgery
• A study shows that after 10 to 14 years, patients have maintained 60 % of excess body weight loss. A study of 500 patients showed that 96 % of physical problems were improved and resolved in some cases which mainly includes back pain, sleep apnea, high blood pressure, type 2 diabetes and depression.
• In most cases, patients report an early sense of fullness even by taking little food so that there will be no desire to take more food

Bariatric surgery can help in prevention of diabetes and helps weight loss through gastric bypass in obese patients. Also, non-diabetic patients can decrease their likelihood of developing diabetes by 60 percent.

One long-term study tracked 400 people with type 2 diabetes. Six years after bariatric surgery, 62% showed no signs of diabetes. They also had better blood pressure, cholesterol, and triglyceride levels.

In a recent study, over 20,000 patients were examined. It revealed that 84% who underwent obesity surgery for diabetes experienced complete reversal of their type 2 diabetes.

Rapid improvement in blood sugars and reduction or elimination of diabetic medications is often seen within the immediate period following bariatric surgery for diabetes type 2.

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How To Avoid Weight Gain After Bariatric Surgery (Weight loss surgery)

Endoscopic sleeve gastroplasty is a newer type of weight-loss procedure. Endoscopic sleeve gastroplasty reduces the size of your stomach using an endoscopic suturing device without the need for surgery. This procedure may be an option if you’re significantly overweight — a body mass index of 30 or more — and diet and exercise haven’t worked for you.

Endoscopic sleeve gastroplasty leads to significant weight loss. It helps you lose weight by limiting how much you can eat And the procedure is minimally invasive, reducing the risk of operative complications.

Like other weight-loss procedures, endoscopic sleeve gastroplasty requires the commitment to a healthier lifestyle. You need to make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of endoscopic sleeve gastroplasty.

Why it’s done

Endoscopic sleeve gastroplasty is performed to help you lose weight and potentially lower your risk of serious weight-related health problems, including:

• Gastroesophageal reflux disease
• Heart disease and stroke
• High blood pressure
• Sleep apnea
• Type 2 diabetes

Endoscopic sleeve gastroplasty and other weight-loss procedures or surgeries are typically done only after you’ve tried to lose weight by improving your diet and exercise habits. Endoscopic sleeve gastroplasty is less invasive than other forms of bariatric surgery.

Who it’s for

Endoscopic sleeve gastroplasty is often an option for people who aren’t candidates for other bariatric surgeries. The procedure is available to people whose body mass index (BMI) is above 29 who haven’t been successful maintaining weight loss with other methods.

Results

Endoscopic sleeve gastroplasty can lead to significant weight loss. The amount of weight you lose also depends on how much you can change your lifestyle habits.

When weight-loss surgery doesn’t work

It’s possible to not lose enough weight or to regain weight after any type of weight-loss procedure, even if the procedure itself works correctly. This weight gain can happen if you don’t follow the recommended lifestyle changes. To help avoid regaining weight, you must make permanent healthy changes in your diet and get regular physical activity and exercise.

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The Diverse Categories of Bariatric Surgery

Overeating is a kind of addiction which is similar to smoking or alcoholism being a thorny psychological habit to shatter. The weight loss accomplishment after Bariatric Surgery may appeal the patients to gradually pamper in overeating, making them consider that a small further portion of an ice cream or a bar of chocolate is not going to effect after the surgery. However, it does matter in both longer and shorter run.

So, patients even themselves have to play a vital role in getting better on their eating and food habits after the surgery to keep hold of their preliminary success for a lifetime after the surgery.

Here are some of the top tips when followed on a daily basis, will lend a hand to you for avoiding weight regain even after a long time of surgery.

      1. Take smaller food bites

After your operation, when your stomach space has been surgically made compact to put a ceiling on overeating, a few bites of the healthy part of food will fill you up. So take bites as smaller as possible.

      2. Eat gradually

You need to take time to chew and get pleasure from food. This is applicable to each and every person being operated or not.

      3. Don’t drink while you are eating

It is better not to take drinks with food no matter which meals you take. Having a glass of water previous to an hour of your meal is good for health. You can take another glass after an hour of your food.

      4. Use a smaller food plate

You need to use plates that hold less amount of food which is a good way to avoid subliminal overeating routine from taking over devoid of your sense.

     5. Order less food in restaurants

You should order a lesser amount of food when you go to restaurants, order little portions or from the children menu as the fewer food you order, the fewer food you are liable to eat.

    6. Stop eating when you feel occupied

While eating food even if you have just one bite left out in your plate, don’t eat it as your body is not a waste bin. It is like a temple that you require to take care of else you would need to face the consequences. So admire contentment signals from your stomach and not give in to the childhood sessions of “clean your entire plate” as advised from the elders.

Conclusion

At Radiance Hospital, we have operated and cured thousands of patients with Bariatric Surgery and we make possible India’s prevalent active post surgery support groups. A big percentage of our patients fruitfully maintain weight-loss even subsequent to years of surgery following suggested healthy lifestyle and diet plans from our medical experts. Also, our lifetime follows up programs are open to all our patients and those treated by other doctors or surgeons.

For more information about our post bariatric surgery diet, you can any time contact us and set up a swift appointment with our trained dieticians or be present at one of our support group discussions or meetings.

The types of bariatric surgery that may be best to assist a person to lose weight. You should converse with your doctor what type of surgery might be precise for you.

Open approach and Laparoscopic Surgery

Open surgery is a good option for people having a higher level of obesity. In open bariatric surgery, surgeons make a sole, big cut in the abdomen. More frequently, surgeons now use laparoscopic surgery, in which they make numerous small cuts and slot in thin surgical tools through the cuts. Surgeons also pop in a small scope attached to a camera that captures as well as projects required images onto a video monitor.

Laparoscopic surgery has less risk than open surgery causing fewer pains and scarring as compared to open surgery. Laparoscopic surgery even leads to a swift recovery.

What are the Surgical Alternatives?

There are four kinds of operations which are described below. Let’s discuss the types of bariatric surgery.

•       Laparoscopic adjustable gastric band
•       Gastric bypass
•       Gastric sleeve surgery
•       Biliopancreatic diversion with duodenal switch

1. Laparoscopic Adjustable Gastric Band

In this sort of surgery, the surgeon places a ring with an inner inflatable band across the top of your stomach to generate a small pouch. This makes you feel complete after eating a smaller quantity of food. The band has a circular balloon within that is being packed with a salt solution. It is considered as the best bariatric surgery type.

The surgeon can fine-tune the size of the opening from the pouch to the stomach by putting or removing the solution by using a small device known as a port placed under your skin.

Subsequent to surgery, you will require follow-up visits to regulate the size of the band opening. If the band leads to troubles or is not enabling you to lose adequate weight, the surgeon may get rid of it.

2. Gastric Bypass

Gastric bypass surgery has two parts foremost the surgeon staples your stomach having a small pouch in the top section. The staples make your stomach small, so you eat fewer and feel packed sooner. It is one of the safest weight loss surgery.

Subsequently, the surgeon cuts your small intestine and links the lowermost part of it straight to the small stomach pouch. Food then bypasses the stomach and the high part of your small intestine so your body soaks up fewer calories.

The surgeon joins the bypassed fraction farther down to the lower part of the small intestine. This bypassed part is still linked to the major part of your stomach so that the digestive juices can move from the stomach and the foremost section into the lower section of small intestine. The bypass even alters gut hormones and gut bacteria that may affect the overall appetite and metabolism. Gastric bypass is tough to reverse, although a doctor may do it if medically crucial.

3. Gastric Sleeve

In gastric sleeve surgery, a surgeon takes out most of your stomach, leaving back a banana-shaped section that is closed with staples. It reduces food intake making you feel full sooner. Taking out a section of your stomach may even affect the gut hormones and gut bacteria that may affect body appetite and metabolism. The surgery cannot be reversed as some of the stomach is lastingly removed.

4. Duodenal Switch

This surgery is much more complicated than the others. The duodenal switch incorporates two breaks up surgeries. The foremost is similar to gastric sleeve surgery and the second one directs food to bypass the small intestine. The surgeon even attaches the bypassed part again to the last section of the small intestine, enabling digestive juices to blend with food.

This sort of surgery enables you to lose a larger amount of weight than the other three mentioned. But, this surgery is even the most likely to lead to surgery-related issues and lack of vitamins, minerals as well as the proteins in the body.

Moving Forward

Before the above surgeries, you need to meet with numerous health care providers, such as a bariatric surgeon, a dietitian, a psychiatrist, and a psychologist. These medical care providers will recommend you to turn out to be more active and have a healthy eating diet both before and after the surgery.