Sclerotherapy for Weight Loss
Sclerotherapy, a medical procedure originally only treating unsightly veins, is increasing in popularity among surgeons performing weight-loss surgery. Doctors inject the same type of solution in the stomach area as a follow-up treatment to rectify failed gastric bypass surgery. The procedure, more commonly described as "endoscopic sclerotherapy," has proven successful.
Background
During the first year following gastric bypass surgery, patients generally experience significant weight loss. The weight loss eventually slows down, and a couple of years later certain patients find themselves having regained their initial weight loss.
According to a University of Connecticut study published in the July-August 2008 issue of the medical journal Surgery for Obesity and Related Diseases, "a 10 to 15 percent weight regain can occur in these patients." The primary causes involve inappropriate diet, insufficient exercise or genetic predisposition. The secondary cause, known as stoma--stomach opening, is due to a stretched-out anastomosis (the part that bridges the stomach pouch with the small intestine).
Other treatments besides sclerotherapy are available to rectify failed gastric bypass surgery, but they are not deemed as effective. These treatments include surgical revision and medical or dietary therapy. Unfortunately, the former is complicated and so risky it can be deadly, while the latter, which is much safer, is not often successful. Endoscopic sclerotherapy, on the other hand, is considered not only safe but highly effective so far. "Most patients (74%) begin to lose weight or stop gaining weight [after undergoing sclerotherapy]," according to Muhammad A. Jawad, M.D., bariatric surgeon at the Bariatric and Laparoscopy Center of Odala.
Procedure
Sclerotherapy is an outpatient procedure that only takes 30 minutes to perform. The doctor injects the chemical sodium morrhuate into the area of the stoma--opening--of the stomach. The chemical induces scarring, which is supposed to shrink the stoma. Scar tissue continues to form in the subsequent two months, resulting in the diameter of the stoma to shrink. The goal is a 10-mm reduction. More injections may be needed to reach this goal; however, not often.
For example, Laurie Spaulding, M.D. and author of the "Treatment of Dilated Gastrojejunostomy with Sclerotherapy" in the medical journal Obesity Surgery, reports that she only needed to use an average of 1.3 injections in a sample of 20 patients in her initial 2003 report.
Most people will experience weight loss or at least maintain their weight with this method, as shown in a weight-loss group of 71 patients undergoing endoscopic sclerotherapy of the stoma in the University of Connecticut study. Conducted by Mark Loewen, M.D. and Carlos Barba, M.D., the study lasted from July 2004 to August 2006. "During the 12-month follow-up period, 72 percent of patients maintained or lost weight," according to the study.
Considerations
Endoscopic sclerotherapy involves relatively minor side effects and complications. Complications include nausea and post-injection pain.
