Dr. Terry Dubrow, the star of ‘Botched,’ is a board-certified plastic surgeon who discussed bariatric surgery and possible difficulties.
Lisa Marie Presley’s cause of death was announced earlier this week. According to an autopsy report, the 54-year-old singer-songwriter died in January from a “sequelae of a small bowel obstruction,” which developed after she underwent bariatric surgery some years ago.
According to the report, the obstruction was a strangulated small bowel caused by adhesions that formed following her weight-loss surgery. “This is a known long-term complication of this type of surgery,” said Dr. Juan Carrillo, Deputy Medical Examiner.
Bariatric surgery, which includes gastric bypass and other weight loss procedures, involves surgically changing the digestive system, mainly the stomach and small intestine, to limit the quantity of food an individual can eat and absorb.
Dr. Terry Dubrow, the show’s star and board-certified plastic and reconstructive surgeon, discusses the operation and some potential problems.
“The thing about bariatric surgery is that there are several types,” he says. “They range from completely disconnecting parts of the intestines, so you don’t absorb as much, to reducing the size of the stomach, which limits how much food you eat.”
Patients must have a body mass index (BMI) of greater than 40 and an associated medical condition for which obesity is one of the major risk factors to undergo bariatric surgery, according to Dubrow, who assumes Presley’s surgeon would have ensured she met those weight requirements.
Bariatric surgery, like any major procedure, has possible health hazards that might result in short-term, long-term, and catastrophic problems.
According to Dubrow, who is also board certified in general surgery, the most common consequences of bariatric surgery are malabsorption syndromes, which occur when patients do not absorb the expected levels of vitamins that would be absorbed with a regular diet.
“You’re not absorbing enough vitamin B12, which causes anemia, and you’re not absorbing enough nutrients, which causes skin conditions.” “It’s mostly mechanical,” he adds, emphasizing the significance of checking patients’ blood levels before and after surgery.
A tiny bowel obstruction, which caused Presley’s death, is another complication of bariatric surgery.
“The issue is that when you go inside the abdomen and either disconnect part of the intestines to limit absorption or operate on the stomach itself to limit the volume you can eat, you induce scarring in and around the intestines.”
“Those are known as adhesions,” he explains.
“The most common complication of that kind of surgery is that when that scarring is in there, it sometimes can catch pieces of the bowel, or it can impair intestinal motility — the movement of food — and that causes what’s called a small bowel obstruction,” Dubrow says. “That happens in about 6% of all bariatric type surgery.”
Minor intestinal obstruction symptoms begin with an “uncomfortable kind of bloating,” according to Dubrow. This causes intense nausea and vomiting.
However, many people who experience this blockage are unaware of the source because symptoms can mimic the illness or stomach discomfort.
“And this is not necessarily something that happens immediately after the surgery,” Dubrow says. “This could happen in two, five, or ten years.” You’re always in danger of having an intermittent minor bowel obstruction.”
A minor bowel obstruction can often dissolve on its own. However, if it continues to the point where it prevents food from passing through the body, edema might ensue, cutting off blood flow.
“When the blood supply to the intestines is cut off, it can cause small bowel necrosis, which means your intestines die,” Dubrow explains. “You can be walking around with a tummy ache, a small bowel obstruction, and your intestines are dying inside your abdomen, unbeknownst to you.” It is life-threatening if your intestines perish enough.”
Furthermore, the toxicology results from Presley’s autopsy revealed that oxycodone levels remained in her blood at the time of death. She had another cosmetic operation months before and was given pain medication.
Dubrow, who emphasizes that he was not Presley’s doctor, feels that the combination of bariatric surgery and pain medication could have created a “perfect storm” of risk factors for small intestinal obstruction.
“When you have plastic surgery, you often take pain relievers and narcotics. “They discovered oxycodone in Lisa Marie, which is commonly used after plastic surgery,” he explains. “However, taking opioids slows down the intestinal tract.”
“So if you have a combination of previous gastric bypass surgery with scarring and you take opioids from recent plastic surgery, that can predispose you to a small bowel obstruction,” he continues.
Dubrow advises bariatric surgery patients to be more cautious about any symptoms that occur and to seek medical assistance.
“Don’t just dismiss it as a stomachache. Don’t assume you’ve got the flu. “If you have nausea, vomiting, bloating, or abdominal pain, you should be very concerned that you are developing or have developed a small bowel obstruction,” he advises.
“You need to have a higher index of suspicion that this could be a problem,” Dubrow says. “Don’t let it linger all day, all night, and into the next day.” You should go to an urgent care center and have a simple x-ray of your belly to see if you have a tiny intestinal obstruction.”