Gastric banding.  Gastric sleeve.  Roux-en-Y bypass.  There are in increasing number of procedures available that fall under the category of bariatric surgery.  This is also increasing coverage for the procedures by insurance if certain criteria are met.  Roux-en-Y is the most common form of surgery used.  But are these procedures safe?

Let’s get one thing on the table right now.  ANY time you alter digestion, be it with drugs that suppress acid production (Nexium, prilosec, etc..) or with surgery this is a price to be paid.  That price can be severe, with the end consequence being death.

I have mentioned before that the body does two things–digestion, and everything else.  We already know that malabsorption of nutrients leading to nutrient deficiencies occurs. We know that the risk of gallbladder problems goes up.  We know that the bariatric surgery patient’s diet is forever altered.  Far too often, the patient puts the weight back on because they never learned the right way to be eating for their body in the first place.

But what about the short term?  Well, there are rapid positive changes that can occur such as reversal of diabetes and weight loss.  But what about after that?  We’ve already mentioned the long term nutrient deficiencies that will plague the bariatric patient for the REST of their lives.

This particular article begins to shed light on some more severe consequences of the Roux-en-Y bypass surgery.  Elevation of cancer markers in the rectum are known to be present 6 months after the procedure.  This study looked at what happens 3 years later.  Do the markers improve?  Not even close.  There remains, 3 years after the procedure, a 4,000% increase in the tumor marker macrophage migration inhibitory factor in the rectum.

It is still too early to determine what this does to the risk of colorectal cancer.  But, if I were to place my bets, I’d bet that the rates of colorectal cancer in these patients are going to be markedly elevated.  Some much for the short term benefits…

The bottom line is that the right lifestyle changes are always your best answer.  Our office has also had success with our in house weight loss program as well, that helps to educate patients while assisting with initial rapid weight loss.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.


Please note: I reserve the right to delete comments that are offensive or off-topic.


  1. A year and a half ago I under went gastric bypass with some complications with adhesions which was corrected with a second surgery, then a third to correct a hernia. I also am experiencing pain at the sites of the belly button as being 3,6,9, with bloatedness, flatulation (strong smell of very bad sulfur) vaginal ordor, no discharge, frequent bowel movements (approx. 10 a day).
    I’ve had a CT scan but dont know the results as of yet. Neverheless, I’m worried that these signs maybe stomach or intestinal cancer. Can you help me and give me a possibe idea what this might be. I know that without examening me it might be impossible to diagnosis, but you could at least try i would be very greatful.
    thank you
    m garza

  2. Are you in AZ? The best bet would be to get you to a provider who understands nutritional deficiences that can be caused by gastric bypass surgeries because they can wreak havoc on your body.

  3. My wife got a gastric bypass in October of 2007. She began to lose weight, her diabetes disappeared. In the summer of 2008. 9 months after the operation. My wife began to puke a lot. I was very careful with her meals as I did all the cooking. In August of 2008, test started to be done. In November of 2008, my we were told that my wife had a form of stomach cancer. I researched the type of cancer she had, it was strange, the cancer was commin in men. My wife passed in Feb. 2009.
    The symptoms had been masked for the year she lived after her operation. Weight loss, anemic (she was always low on iron). I have often thought about it and wonder. Could the operation she had not only masked the symptoms of her cancer, but caused it.

  4. First of all, I’m very sorry for your loss. Gatric cancers are never a good thing.
    There is no doubt that gastric bypass surgeries drastically alter our ability to absorb nutrients, which opens up many bad possibilities. On the other hand, diabetes and being overweight dramatically increases our risk of many cancers as well. There may not be a clear cut answer in your wife’s case. It is for reasons like this that I am such a strong advocate of prevention and lifestyle changes–these are the only true ways to improve your health.

  5. Okay, I found this page by typing in can gastric surgery cause stomach cancer. I have a friend who had gastric surgery in October. He was doing great, up until a week before Christmas. He was slouched over in sever pain went to the hospital and they had thought he had fluid in his stomach, so they did an emergency surgery. When they went in the surgeon had said he had a small amount of cancer. Anyway about a week later, so around Christmas another doctor told him that they couldn’t operate on his stomach that there was just too much. So he was in the hospital up until a week and a half ago, when he was discharged and went home ( on a Tuesday). That Thursday he went to get a second opinion since they had told him stage 4, but they still could not tell him any spot that the cancer had spread to. Well he died 2 days ago and I really think that something may have been covered up by the hospital. I wonder if something happened during the original surgery, is this possible? I don’t remember ever seeing this guy sick before this.

  6. Jen,

    I’m sorry to hear what happened. Did your friend have have gastric bypass or a band? With a bypass, they would clearly have visualized anything that was present in the cavity at this time. Maybe not so with a band, though. Hindsight is always 20/20 and many times being overweight increases the risk of many types of cancers. Because of this, it’s hard to say whether the cancer was present before or may have been accelarated by the changes following the surgery.

    Dr. Bogash

  7. Ok after reading your posts and some of the responses you all have me scared to death. I had Roux n y bypass in Feb 2005 and other than gerd I have not had any complications. I have the usual gas and occasional constipation but reading your posts I’m scared Ill get colon rectal cancer or stomach cancer. How would I ever know if the bypassed part of my stomach develops cancer? Endoscopy done last year revealed changes in esophagus related to reflux…on ppi for that and Md said stomach pouch and branches looked good. I’m 47 and take daily supplements and everyone says I look healthy….gained back 20 lbs also but otherwise eat fruits veggies protein and rare treats. But still u have me afraid

  8. Sally,

    Remember that bypass surgery increases your risk, but does not guarantee that you WILL develop cancer. Bypass surgery does so much to destroy the way your digestive system works that you have to work extra hard to avoid any problems in the future. The same can go for those who have had his or her gall bladder removed. I would suggest looking into my colon cancer ebook and following the suggestions.

    Hope this helps to reassure you somewhat!

    Dr. Bogash

  9. I wasn’t aware having your gall bladder removed increased someones risk either. I had that removed in 1999. I take supplements and eat plenty of fruits and veggies most days. I would think a smoker or drinker would have as much of a risk as anyone as would someone that consumes a lot of red meat or animal based products. I guess I just don’t see how bypass in and of itself increases risk more than staying obese and unhealthy. Either way God already knows when and how I will die so I will eat as healthy as I can while still treating myself once in awhile. Stress and worry alone increases all kinds of ailments including cancer

  10. Sally,

    There are probably multiple things at play with a bypass. I hope this was all explained by your surgeon, but frequently it is not. First there is the nutrient / vitamin / mineral deficiencies that occur. You sound like you’re very aware of your diet–that can help. A very high quality multivitamin can help (as well as fat soluble vitamins like D and A). Probably a huge issue is that the Roux-en-Y bypass removes the region of your stomach that makes stomach acid. Without stomach acid you really do open up a huge Pandora’s box of problems. Adding a PPI to this mess may just make things worse.

    As for the stress–you are WAY correct on that one!

    Dr. Bogash

  11. I am on a ppi because of reflux….considering weaning myself off this as ive read alternative opinions that state its lack of acid and not too much that is causing reflux. What would you consider a good quality multivitamin? I currently take a chewable bariatric vitamin once daily and D3 1000 and sublingual B12 and calcium citrate.

  12. Sally,

    I would completely agree with reflux coming from poor digestion rather than too much acid. What brand multi? Do you have a link to it? Have you read any of the blog posts on D? You are under what I normally recommend for the average person with a gall bladder.

    Dr. Bogash

  13. The multivitamin is made by TwinLab and is called Bariatric Support Chewable Multi. Bought from Vitamin Shoppe online. How can I optimize my digestion short of asking for a reversal of the surgery? I’m 8 years postop.

  14. And should I be taking even higher doses of D3 B12 and Calcium? They are in the multi as well but I take 1000 of each of D3, B12 and Calcium

  15. Sally,

    This seems to be an ok multi, but I usually steer patients away from the cyanocobalamin form of B12 (hopefully that is not the form in your B12 supplement). Overall, it’s difficult to get an idea of what levels people should be taking. You need to find someone in your area that is knowledgable and can give you good advice on what levels and forms to take. Wish I could help more, but without a detailed health history it would be inappropriate for me to make specific suggestions.

    Dr. Bogash

  16. Sally,

    It is not the preferred form for the brain and there is some concern that the cyano form undoes what the B12 is trying to do. Almost all lower quality supplements use the cyano form.

    Dr. Bogash

  17. Wondering if you can tell me if too much B12 can be toxic? Many supplements I’m seeing are 2500 or higher

  18. Well this entire thread has freaked me out! I am on the waiting list for gastric sleeve, i have done everything possible to try and lose weight, I get so far then it all falls apart, i am very health conscious and consume juices made from fresh kale, spinach, etc daily. My surgeon has basically told me that once you get to a certain scale on the BMI chart surgery is basically the only option to get any sort of long term result, like i said i am great for so long then i get this incredible hunger kick in and just get super frustrated (i weigh 115kilos) i was not obese as a child or young adult, this all happened 8 or so years ago (i am 37) my surgeon has told me this is my body fighting back, as a survival mechanism the body wants to stay fat, it thinks its fighting off a famine….the statistics he has given me for keeping the weight off long term is something like 1 person in every 200 can do it, pretty dim!!! surgery is the only way to biologically alter my body he claims…alot of what he says make sense, i dont wanna believe it but i am living what he is saying! But no way do i want to severly compromise my health in the long term and put myself at risk of all this nasty nutrient deficiences and cancers, this has really put me off! arghhh!

  19. Angela,

    To suggest that this is the “only way” is completely off base. In the same light, did your doctor give you statistics on the failure rate of the bypass surgeries? I hope so. If he has not, your doctor is one-sided. I would suggest you find someone in your area that does functional medicine and can help you identify what the problem is for you in regards to long term weight gain. There is always an answer.

    Dr. Bogash

  20. Hi there Dr Bogash

    Yes I agree with you, surgeons way to “fixing” a problem is by cutting, i will be honest and say that i am worried about passing up the operation as everyone i have spoken to who have had the gastric sleeve have absolutely no regrets, BUT i cant seem to find anyone who is 6+ years post op (gastric sleeve has not been around as long as other surgerys) and that really concerns me… I have started a juice detox, been reading jason vale’s books and watched doco Fat sick and nearly dead and about to watch forks over knives this weekend, I am a big believer in a plant based diet and find it easier leaning towards this way of lifestyle as it is more of a ethical choice for me, if i do consume any meat it is off the organic grass fed variety, for some reason i seem to follow something alot better if its something i really believe in, the gastric sleeve surgery scares me as i worry alot about nutrient deficiences not just macro but micro nutrients and i dont want to kill my body slowly inside not feeding my cells with all the goodness vegies and fruits can provide.. I will continue looking through your website, its super interesting!! thanks Ange 🙂

  21. Angela,

    Thanks for the feedback on the site! It means a lot to me if it can be used as a resource. Where do you live? I might be able to find a resource for you. Don’t forget about short burst aerobic exercise and paying attention to the large amount of environmental chemicals we are exposed to. Stress greatly affects weight and hunger as well.

    Dr. Bogash

  22. Hey there Dr Bogash

    I am from little old New Zealand at the bottom of the world! Ha ha ha ha! Yes I have been doing the short bursts of aerobic exercise and i really enjoy it, it most definately gets those endorphins pumping! I do 30 second sprints on the treadmill, then 20 second rest, i do this on the bike also, i can only do 15 minutes at a time though as I am absolutely knackered after that! Yes your website is very imformative you have done a brilliant job, really respect people that look at the big picture and not just the short term picture 🙂

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