Dr Ben Dodd

Understanding Gastric Bypass And Type 2 Diabetes

Mon, 25 May 2026 04:24:12 GMT

Managing Type 2 diabetes often involves a combination of lifestyle changes (diet, exercise, weight loss), medication, and monitoring for signs of end organ injury. Some people living with Type 2 diabetes wish to consider the option of bariatric surgery, particularly gastric bypass, to optimize the treatment of their diabetes. Gastric bypass surgery, which alters how food travels through the digestive system, and how the brain and gut interact with food, has been thoroughly investigated in patients with diabetes.

While it may not suit everyone, decades of research have shown major lasting benefits of gastric bypass in Type 2 diabetes patients, including very high rates of resolution of the disease that persist long term. Furthermore, patients with fatty liver disease (aka impaired glucose tolerance or prediabetes) will also respond very well to metabolic surgery, especially gastric bypass.

This blog outlines the relationship between gastric bypass and Type 2 diabetes, highlighting current research, possible mechanisms, and important considerations for those seeking personalised care under medical guidance.

What Gastric Bypass Involves

Gastric bypass, including both Roux-en-Y Gastric Bypass (RYGB) and One Anastamosis Gastric Bypass (OAGB, aka ‘mini’ gastric bypass, or ‘single loop’ gastric bypass) is a surgical procedure that changes the structure of the stomach and small intestine. It involves creating a small stomach pouch and rerouting part of the small intestine onto this stomach pouch, thereby ‘bypassing’ the usual food pathway through the upper gut.

Key aspects of the procedure:

A portion of the stomach is bypassed, leaving a smaller area to receive food from the swallowing pipe.
Part of the upper small intestine is also bypassed, which alters how calories and nutrients are absorbed.
These structural changes alter hormonal responses between the gut and brain, appetite regulation, digestion and calorie absorption. The result is changed food relationships, eating behaviours, weight loss and dramatic improvements in glucose control in diabetic patients.

Exploring the Link Between Obesity & Type 2 Diabetes

Type 2 diabetes is a complex condition influenced by genetics, lifestyle, environement and metabolic factors. Excess body weight, particularly around the abdomen and its organs (‘visceral fat’), is directly associated with insulin resistance and diabetes. This usually correlates with low muscle mass, low activity levels and chronic overnutrition (excess calories, particularly from ultra-processed foods, UPFs).

Factors commonly observed in people with Type 2 diabetes & obesity:

Insulin resistance/decreased insulin sensitivity
Chronic low-grade inflammation
Impaired glucose uptake in muscle and liver tissue
Altered lipid metabolism aka increased cholesterol, leading to damage to small and large arteries.

Weight loss by any means will help improve type 2 diabetes. However, the altered hormonal environment created by gastric bypass surgery has an immediate effect in significantly decreasing the severity of type 2 diabetes.

Research Insights on Gastric Bypass & Diabetes Outcomes

The scientific evidence clearly demonstrates that the majority of individuals with Type 2 diabetes will experience dramatic improvement in glucose control following gastric bypass surgery. 80-90% of patients are cured of diabetes at 12 months post-op. Remission rates of over 70% have been observed up to 12 years after surgery in some large studies. This obviously depends on long term weight loss and lifestyle improvements.

Observations reported in clinical research include:

Improved HbA1c levels (term blood sugar control)
Decreased reliance on glucose-lowering medication
Increased likelihood of reaching blood sugar targets within a few years post-surgery

These findings are not universal. Outcomes vary significantly depending on the duration of diabetes, residual pancreas gland function, baseline glucose levels, and individual success in lifestyle factor habits after surgery. As for all weight loss surgery patients, the small habit changes are the major determinant of long-term success.

What “Remission” Means & What It Doesn’t

In the context of Type 2 diabetes, “remission” refers to a state where blood sugar levels fall within a non-diabetic range without glucose-lowering medications. This term does not necessarily indicate a cure and is not permanent for all individuals.

Important points to consider:

Definitions of remission vary between clinical guidelines and studies
Remission may be temporary or sustained, depending on multiple factors.
Ongoing monitoring is typically required, even if medication is reduced or ceased.

Understanding How Gastric Bypass May Influence Glucose Metabolism

One of the key questions in diabetes research is how changes in the gut following gastric bypass surgery might influence insulin and glucose regulation, independent of weight loss. Some studies suggest multiple overlapping factors at play.

Possible mechanisms include:

Increased secretion of hormones (e.g. GLP-1) that support insulin activity
More rapid delivery of food to the lower small intestine triggers different metabolic responses
Decreased inflammation and changes in liver fat and glycogen metabolism
Alterations in the gut microbiome, which may influence glucose processing

These effects are still being studied. While weight loss is clearly a major contributor to improved glucose control, improvements in glucose control are noted immediately after surgery, even before substantial weight loss has occurred.

Who Might Benefit & Who May Not

Gastric bypass is not a one-size-fits-all approach. The likelihood of seeing changes in blood sugar levels after surgery may depend on various factors.

Factors that may influence outcomes:

Duration of Type 2 diabetes (shorter duration associated with more favourable results)
Pre-surgery blood glucose levels and burden of medication use
Age and other co-existing health conditions
Post-surgical follow-up and adherence to lifestyle guidance
Level of pancreatic beta-cell function (insulin production capacity)

People who have had Type 2 diabetes for many years, or who require insulin, may have different outcomes than those with more recently diagnosed diabetes or who manage it with oral medication only.

Risks, Limitations, & Long-Term Considerations

Like all major surgeries, gastric bypass carries some risks. Nutritional deficiencies, changes in digestion, and surgical complications are rare, though possible. Gastric bypass therefore requires ongoing medical oversight and a willingness to commit to lifelong dietary and movement changes.

Potential challenges to keep in mind:

Vitamin and mineral supplementation will be required
Follow-up appointments are essential to monitor metabolic health
Digestive changes can affect food tolerance and absorption
Psychological adjustment and support may be beneficial for some people

Not all people will achieve sustained glucose control after surgery, and diabetes may return in the future, depending on metabolic and lifestyle factors.

Current Guidelines & Research Consensus

Major diabetes and obesity societies acknowledge that metabolic surgery may be considered as part of a broader treatment plan for certain people with Type 2 diabetes and obesity. This recommendation typically follows lifestyle change and medical therapy attempts and requires a comprehensive clinical evaluation.

Guidelines often suggest:

Surgery may be an option when BMI is above a specific threshold and diabetes is not well controlled
Individual assessment is essential to determine suitability
Long-term follow-up is a criti cal part of any treatment plan involving surgery

These decisions should always be made in consultation with a qualified healthcare team, including medical, surgical, and nutrition professionals.

Learn More About Gastric Bypass

At Dr Ben Dodd - Brisbane Upper GI Surgery , we help people explore whether gastric bypass surgery might help manage their Type 2 diabetes. If you’re interested in learning more about Gastric Bypass in Brisbane , get in touch via our contact page or call to book a consultation. Our team can provide information, discuss your personal circumstances, and outline what a tailored treatment pathway might involve.

Laparoscopic Cholecystectomy: What To Expect Before & After Surgery

Tue, 19 May 2026 01:25:11 GMT

Gallbladder disease can cause minor to severe abdominal and back pain, nausea, bloating, burping and diarrhoea. Gallbladder disease consists of sludge, gallstones, polyps and inflammation. When medical advice suggests surgery, many people are offered a laparoscopic cholecystectomy . This minimally invasive approach has become a common option for removing the gallbladder. Understanding what happens before, during and after the procedure can make the experience less daunting.

This blog explains laparoscopic cholecystectomy, how it differs from gallbladder surgery in the past, and what patients can expect at each stage of the journey. It also highlights recovery milestones, possible side effects, and considerations that patients and their families should consider.

Understanding Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy involves removing the gallbladder through a 4 small incisions in the abdomen. A thin camera (laparoscope) and surgical instruments are inserted to operate while the surgeon watches the inside of the abdomen on a screen.

Key points:

The gallbladder is removed completely, preventing future gallstone problems.
Small incisions, local anaesthetic in the wounds and abdominal cavity mean much less pain and reduced scarring compared to traditional open surgery. Most patients are able to go home on the day of surgery. Most patients will not need strong opioid pain killers after surgery.
The modern laparoscopic procedure means conversion to open surgery is extremely rare.

How It Differs from Open Surgery

Historically, gallbladder removal required a large incision under the ribs. This method, called open cholecystectomy, caused significant discomfort and a 5 -7 day stay in hospital. Pneumonia and leg clots were much more common. Bile duct injuries, requiring major reconstructive surgery, were all too common. Late complications of adhesions and incisional hernia were a significant problem.

Main differences include:

Pain and risks: Modern lap chole often involves no post-op pain due to the use of local anaesthetic in the wounds before skin incision. Improved understanding of bile duct injuries in the past has developed strict ‘rules of safety’ for modern day lap chole. Bile duct injuries are now, in the hands of well trained and attentive surgeons, largely avoidable.
Hospital stay: Laparoscopic surgery is usually done as a day case.
Recovery time: Laparoscopic chole now results in return to normal activities in 1-2 weeks. Heavy lifting should be avoided for 4 weeks to minimize the risk of wound hernia at the umbilical wound.

Preparing for Surgery: What to Expect

Preparation is an important stage in any operation. Before a laparoscopic cholecystectomy, patients usually undergo several checks and discussions with their surgical team.

Common steps include:

Medical assessment: Blood tests and imaging studies may be required to help confirm suitability and fitness for surgery.
Medication adjustments: Patients may be advised to stop certain medicines, such as blood thinners and SGLT-2 diabetes medicines, before surgery.
Fasting: No food or milky drink for 6 hours before the procedure is usually required.
Consent discussion: The surgeon outlines the procedure, risks and alternatives.
Safety: Multiple final checks on the day of surgery.

Being well-informed reduces anxiety and provides clarity about the day of surgery.

The Day of Surgery: Step by Step

On the day itself, patients are admitted to the hospital and prepared for the operation.

A typical pathway includes:

Admission check-in: Nurses review paperwork and conduct final health checks.
Anaesthetic administration: General anaesthesia is given so the patient is deeply asleep throughout.
Surgery: The surgeon makes small incisions, inserts the laparoscope and instruments, and removes the gallbladder. A dye test of the bile ducts (intra-operative cholangiogram) is routinely performed to ensure remaining bile ducts are not injured.
Completion: The incisions are closed with absorbable stitches.

The operation usually takes 40-60 minutes, depending on individual patient circumstances.

Early Recovery in Hospital

After surgery, patients spend time in the recovery area until they are fully awake.

Typical early recovery includes:

Minor discomfort at incision sites: Pain relief is provided as needed. Shoulder ache, due to the gas inflating the abdomen during surgery, is normal for the first 12-18 hours. Heat packs and simple analgesia usually manage this adequately.
Minor bloating, nausea, burping or diarrhoea with eating. Usually mild/moderate and temporary, for 1-2 weeks only.
Eating & drinking: Most patients eat a normal diet immediately after surgery.
Walking: Early gentle movement is encouraged to reduce the risk of blood clots and improve healing. Heavy lifting (more than 10kg) should be avoided for 4 – 6 weeks.

The hospital team monitors vital signs and provides discharge instructions before going home. Patients who are unsafe to go home will be kept in overnight.

Common Symptoms After Surgery

It’s normal to experience a range of temporary symptoms during recovery. Recognising which are expected can provide reassurance.

These may include:

Mild abdominal discomfort.
Tiredness or fatigue in the first week.
Loose stools or bloating after eating fatty meals.
Shoulder or back ache related to trapped surgical gas, usually only for 12 hours.

These symptoms generally resolve within the first 1-2 weeks. However, patients should be aware of concerning signs such as fever, worsening abdominal pain, or yellowing of the skin and eyes, and seek medical advice if these occur.

Recovery Timeline: Returning to Daily Life

Recovery varies from person to person, but many are back to light activities within days. Some find they need a little longer, especially if they have a physically demanding lifestyle.

Typical milestones:

First week: Rest, short walks, and light meals, if required. Avoid heavy lifting.
Week two: Many can resume desk-based work and gentle activities.
Weeks three to four: Gradual return to exercise, driving and more routine tasks.
Beyond one month: Most patients are fully back to normal routines.

Dr Dodd will provide tailored advice to guide safe activity levels at follow-up appointments.

Risks & Considerations

Like all operations, laparoscopic cholecystectomy carries potential risks. While complications are uncommon, it is important to be aware of them.

Possible risks include:

Bleeding or infection.
Injury to nearby organs such as the bile ducts or intestines.
Blood clots in the legs or lungs.
Anaesthetic-related side effects such as nausea.

Discussion with the surgical team helps patients understand how these risks apply to their situation.

Adjusting to Life Without a Gallbladder

Most people live normally without a gallbladder, given the fact it hasn’t been functioning normally for some time. Some patients may notice subtle digestive changes. These often improve as the liver increases its secretion of bile with meals.

Possible temporary changes include:

More frequent stools after fatty meals.
A period of bloating or indigestion.
Needing to adjust diet to find what feels most comfortable.

Keeping meals balanced and limiting very rich or greasy foods can help during the early months after surgery. It is rare for such side effects to be a major problem long term. Patients with IBS, especially with diarrhoea, are more at risk of long term side effects.

Considering Laparoscopic Cholecystectomy in Brisbane? Let’s Talk

If you have been advised to consider laparoscopic cholecystectomy in Brisbane , discussing the procedure with a dedicated Upper GI and Bariatric can provide clarity and peace of mind. At Dr Ben Dodd - Brisbane Upper GI Surgery , we offer laparoscopic cholecystectomy as part of our surgical services. Dr Dodd performs laparoscopic cholecystectomy every week and appreciates the nuances of who should and should not proceed with surgery. Our team welcomes you to get in touch via our contact page or give us a call to arrange a consultation. We are here to guide you through each stage, from preparation to recovery. Dr Dodd will happily answer all questions and always explains the option of avoiding surgery.

5 Signs Your Gallbladder Needs Removing & Why Laparoscopic Surgery Is the Best Choice

Mon, 04 Aug 2025 01:19:11 GMT

Have you ever felt persistent pain in your upper abdomen, especially after meals, and wondered whether your gallbladder might be to blame? For many people, gallbladder problems start with subtle symptoms that gradually become more disruptive to daily life. In some cases, removal of the gallbladder becomes the most suitable option for lasting relief.

In this blog, we’ll explore five signs that could indicate your gallbladder might need to be removed and explain why laparoscopic cholecystectomy in Brisbane is often the preferred approach for gallbladder surgery.

1. Persistent Upper Abdominal Pain

One of the most frequent indicators of gallbladder trouble is pain in the upper right part of your abdomen. This discomfort can:

Start suddenly or build gradually over time.
Often occur after eating meals high in fat, like fried foods or creamy dishes.
Feel sharp, cramping, or like a dull ache that doesn’t ease quickly.
Radiate to your back, between your shoulder blades, or into your right shoulder.

Some people describe the pain as a tight pressure or fullness under the ribs. While occasional discomfort might pass on its own, pain that returns regularly or becomes severe should prompt a medical assessment. Ongoing pain can indicate gallstones blocking the flow of bile or causing inflammation, which may require surgical intervention.

2. Nausea & Vomiting

Digestive issues like nausea and vomiting can be linked to gallbladder dysfunction. These symptoms may:

Occur shortly after eating, particularly fatty or heavy meals.
Be accompanied by bloating, discomfort, or a feeling of fullness.
Become persistent, affecting appetite and daily life.

While occasional nausea can happen for many reasons, repeated episodes—especially when paired with pain—can be a warning sign of gallbladder irritation or inflammation. If vomiting occurs alongside severe pain or fever, prompt medical care is important.

3. Bloating & Indigestion

A gallbladder that’s struggling to function properly may disrupt your digestive system. You might notice:

A feeling of fullness even after small meals.
Frequent burping or gas.
Unexplained bloating, which can feel tight or uncomfortable.
Indigestion that doesn’t improve with over-the-counter remedies.

These symptoms often relate to the gallbladder’s role in storing and releasing bile, which aids in digesting fats. When bile flow is obstructed or inconsistent due to gallstones, digestion can become sluggish, leading to ongoing discomfort.

4. Changes in Stool or Urine Colour

The gallbladder helps regulate the flow of bile into the digestive tract. If bile ducts are blocked—often by gallstones—it can lead to noticeable changes, including:

Light-coloured stools : Bile pigments contribute to the typical brown colour of stool. Without enough bile, stool may appear pale, greyish, or clay-coloured.
Dark urine : Excess bilirubin, a by-product of red blood cell breakdown, can build up and darken urine if bile flow is restricted.
Jaundice : Yellowing of the skin or eyes can occur if bile backs up into the bloodstream.

These changes can be subtle or significant. They’re important signs that bile isn’t moving through the system as it should, which may require medical evaluation and possible gallbladder removal to prevent further complications.

5. Fever & Chills

An inflamed gallbladder, known as cholecystitis, is a more serious condition that often demands prompt treatment. It may cause:

High temperature or chills.
Significant tenderness in the upper right abdomen.
Pain that worsens when breathing deeply or moving.
Fatigue and a generally unwell feeling.

This inflammation is often due to gallstones blocking the cystic duct, leading to a build-up of bile and irritation of the gallbladder wall. If untreated, it can result in infection or even rupture. Anyone experiencing fever combined with abdominal pain should seek medical care promptly.

When Is Gallbladder Removal Recommended?

Not everyone with gallstones or gallbladder symptoms needs surgery right away. However, removal may be recommended when:

Pain and digestive symptoms become frequent or severe.
Gallstones block the bile ducts, leading to complications.
There’s evidence of inflammation or infection.
The gallbladder is not functioning properly.

For many people, surgery helps relieve discomfort and prevents further health risks.

What Is Laparoscopic Cholecystectomy?

Laparoscopic cholecystectomy is the medical term for minimally invasive gallbladder removal. Instead of one large incision, this technique uses several small incisions through which a tiny camera and surgical instruments are inserted. The camera allows the surgeon to see inside the abdomen on a screen, guiding precise movements.

What to Expect Before Surgery

If your doctor recommends laparoscopic cholecystectomy in Brisbane, you’ll typically undergo:

A physical examination and medical history review.
Imaging tests like ultrasound to confirm gallbladder issues.
Blood tests to check for infection or liver function changes.
A conversation with your surgical team about the procedure and what to expect.

Preparing for surgery may involve fasting for a specific period and adjusting certain medications as advised by your medical team.

What Happens During Surgery?

During laparoscopic gallbladder removal:

You’ll receive general anaesthesia, meaning you’ll be asleep and comfortable throughout the procedure.
The surgeon makes small incisions in your abdomen.
A laparoscope (small camera) is inserted to guide the surgery.
The gallbladder is gently separated from the surrounding tissue and removed.
Incisions are closed with sutures or surgical tape.

Most procedures take about one to two hours, although times vary based on individual circumstances.

Recovery & Post-Surgery Care

After surgery, you’ll spend time in recovery as the anaesthesia wears off. Once home, you might experience:

Mild pain or soreness around the incision sites.
Temporary bloating or shoulder discomfort due to gas used during surgery.
Changes in bowel habits, which typically settle over time.

Your healthcare team will provide instructions about wound care, diet, and activity levels. It’s important to follow these guidelines and attend follow-up appointments to support a smooth recovery.

Is Gallbladder Removal Safe?

For most people, laparoscopic cholecystectomy in Brisbane is a safe and well-tolerated procedure. However, like any surgery, there are potential risks, including bleeding, infection, or injury to nearby structures. Discussing your health history and concerns with your surgeon helps you understand your personal risk profile and make informed decisions.

When to Seek Urgent Medical Care

While complications are uncommon, seek medical help immediately if you experience:

Severe abdominal pain that doesn’t improve.
Persistent fever or chills.
Jaundice (yellowing of the skin or eyes).
Difficulty breathing or chest pain.

Prompt medical attention helps prevent further complications.

Book a Consultation for Gallbladder Surgery in Brisbane

At Brisbane Upper GI Surgery , we support patients in exploring suitable treatment options for gallbladder problems . If you’re experiencing ongoing symptoms or have been diagnosed with gallstones, we’re here to help you understand your choices and feel more comfortable moving forward. Contact us today .

IFSO 2024 is here!!

Thu, 05 Sep 2024 03:37:00 GMT

Attending the IFSO 2024 conference in Melbourne with Drs George Hopkins, Terri-Lynne South, Paige Lanyon-Roberts and Kevin Lah. The bariatric world comes to Australia to debate the latest innovations and improvements in metabolic and bariatric surgery. Lots of discussion around obesity medicines and how they integrate with the role of surgery to offer the best outcomes for patients.

As ever, these interventions are tools to help us make subtle changes to our thoughts and actions. Over time, these changes compound (like bank account interest), allowing us to become and remain lean, despite our persistently dysfunctional modern food environment.

As ever, it requires a team of great people to help patients achieve their phenomenal weight loss and health span potential. Surgeons, nurses, anaesthetists, dieticians, bariatric physicians, secretaries, psychologists and bariatric physicians.

Come and see us to discuss your health transformation.

https://www.instagram.com/ifso2024

https://medsurgweightloss.com.au

https://www.lifestylemetabolic.com.au

Are you considering weight loss surgery?

Wed, 28 Aug 2024 22:06:00 GMT

Are you considering weight loss surgery? You are not alone. Almost 1/3 of adult Australians should consider weight loss surgery based on their weight excess and associated medical conditions. Bariatric surgery in expert surgeons hands is now extremely safe. The benefits are extensive, as outline by the American Society for Bariatric and Metabolic Surgery here: