Uncategorized Archives - Dr. Ivaylo Tzvetkov MD, PhD Bariatric Surgeon

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Dr Ivaylo Tzvetkov is a long standing member of International Federation of Surgery for Obesity with positive feedback from patients and colleagues. He is practicing safe and medical based and relevant to highest clinical international standards weight loss surgery. He has performed more than 780 Bariatric procedures in the Read more

Improvements of health and quality of life after weight loss surgery

More than half of the European population is overweight [body mass index (BMI) >25 and <30 kg/m2] and up to 30% is obese (BMI>30 kg/m2). Overweight and obesity are associated with many comorbidities such as: insulin resistance/type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, cancer, liver steatosis, gastroesophageal reflux, obstructive sleep Read more

Who are patients, candidates for weight loss surgery?

According to IFSO / International Federation for Surgery of Morbid Obеsity/ there are a number of widely accepted criteria which make a patient suitable for Bariatric weight loss surgery: Weight greater than 45kg above the ideal body weight for sex, and height. BMI > 40 by itself or >35 if there Read more

Gastric Bypass Surgery Diet


Gastric bypass surgery is a lifesaving procedure. You will lose weight. You will reduce your co-morbidities. You will feel better and look better. However, to be successful (long-term), you have to change your diet.
This sounds simple, but it’s not. Be prepared for a struggle. You’ve spent much of your life building and reinforcing bad eating habits. Those have to change.
Knowing what you can and can’t eat is the first step towards a healthy diet. Your diet for the first five weeks after gastric bypass surgery is important for two reasons.
1. Your safety. Eating the wrong food could put undue pressure on your healing stomach.
2. Resetting your bad eating habits and replacing them with new healthy habits.

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BOMSS Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery September 2014

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2. Postoperative care and biochemical monitoring
It is essential that patients are monitored following bariatric surgery to ensure that they are both meeting their nutritional requirements and to mitigate risks of developing nutritional deficiencies as a result of the surgical procedure. The type and frequency of monitoring should reflect the bariatric procedure, but also the needs of individual patients. There is therefore recognition that nutritional monitoring may need to be individualised. There should be full access to appropriate members of the MDT including the physician if required. Details of the suggested biochemical monitoring by procedure are shown in Tables 2-4.

2.1 Urea and electrolytes, liver function tests
It is recommended that urea and electrolytes (U&E) and liver function tests (LFT) are monitored for all procedures. The frequency of monitoring depends on the procedure. Dehydration can occur in the early stages following surgery with patients finding it difficult to maintain an adequate fluid intake. Abnormal liver function tests due to non-alcoholic fatty liver disease are common or may relate to other conditions and require further investigation. Changes such as low albumin may be a sign of dietary non-compliance or malabsorption especially following the BPD/DS (30-32). However, low albumin levels are not only an indicator of malnutrition but may also indicate underlying inflammation and infection.

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Obesity and heart damage

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Number of obese years a risk factor for heart damage

Johns Hopkins researchers have shown that the number of years spent overweight or obese appear to ‘add up’ to a distinct risk factor that makes those with a longer history of heaviness more likely to test positive for the chemical marker of so-called ‘silent’ heart damage – high-sensitivity cardiac troponin T (hs-cTnT) concentrations – than those with a shorter history, according to an analysis of clinical data collected on more than 9,000 people. The research, ‘Weight History and Subclinical Myocardial Damage,’ published in Clinical Chemistry, suggests that maintaining a healthy weight across the lifespan is important for keeping the heart healthy and minimising damage as people age.

The authors caution that their study wasn’t designed to find or measure a direct cause and effect relationship between being overweight long-term and a higher risk of heart disease, but rather to shed light on possible relationships between the two.

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Bioproducts Toxic for Obesity Reduction

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През последните години нарастват съобщенията за хепатотоксични реакции от билкови препарати и хранителни добавки, приемани за корекция на теглото и проявите на метаболитен синдром. Ние докладва- ме 2 случая на остро токсично чернодробно увреждане (остър хепатит) от смесен тип. Диагнозата е по- ставена на базата на критериите за лекарствено индуцирано чернодробно заболяване, приети от Българско- то дружество по астроентерология и е изключена друга причина за чернодробното увреждане. При първия случай – жена на 39 г. възможна причина за наблюдаваната хепатотоксична реакция е приемът на „Липоре- дукт плюс”, който съдържа сух екстракт от стрък от цариче, кори от зърнастец, корени от ревен, корени от сена, както и ябълков оцет на прах, а при втория (жена на 36 г.) – билковата комбинация „Златно чудо” която включва пчелен мед, екстракти от елеутерокок, червена боровинка, глог, бял равнец, лайка, бял трън и ленено семе. Проследяването на пациентките показа благоприятен изход с отзвучаване на симптомите и нормализиране на чернодробните ензими, билирубина и протромбиновото време. Лицата с наднормено тегло, затлъстяване и чернодробна стеатоза или друго чернодробно заболяване трябва да бъдат предупреж- давани за възможни нежелани реакции при прием на билкови препарати. Те трябва да се търсят активно. Незабавното спиране на приема на подозираното хепатотоксично вещество ще намали тежките случаи.

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Bioproducts Toxic for Obesity Reduction