Dear HealthSmart,

I’ve heard there are various options for weight loss surgery, and gastric bypass is not necessarily the safest or most effective. Is this true? What options are available?

HealthSmart asked Dr. Amir Ghaferi, M.D., Assistant Professor of Bariatric Surgery at the University of Michigan Medical School. Here’s his response:

The Sleeve Gastrectomy is actually the most common of all bariatric weight loss surgeries, accounting for roughly 50% of procedures done. This procedure essentially takes the stomach, which normally looks like half of a heart, and makes it into the shape of a banana. The second most common procedure is Gastric Bypass, which accounts for approximately 20-25% of all bariatric weight loss surgeries. This procedure makes two new connections in the digestive tract. The stomach is divided into a small upper pouch and a much larger lower “remnant” pouch, and then the small intestine is rearranged to connect to both of these pouches. The third most common type of surgery is revisionary for patients who’ve had some sort of bariatric surgery in the past and need revision. The lap band, once popular and widely performed, has fallen out of favor. Bands are more commonly being taken out as opposed to being put in. There are several other kinds of procedures, none of which have gained tremendous popularity due to being less effective and having more potential negative side effects.

Dear HealthSmart,

Why is it that older people are more susceptible to developing urinary tract infections?

HealthSmart asked Dr. Joseph Ouslander, M.D., Senior Associate Dean of Geriatric Programs at Florida Atlantic University. Here’s his response:

As we age there’s an increase in bacteria in our urinary tracts, an occurrence that is more common in women than in men. This is due in part to a lack of estrogen in women in the post-menopausal stages of their life. In men, an enlargement of the prostate and subsequent increased retention of urine are large contributors. It may also have something to do with the body’s lack of immune response to the bacteria. It’s very common to be asymptomatic with the presence of a urinary tract infection, especially if your immune system is impaired due to conditions such as diabetes.

Dear HealthSmart,

I occasionally faint after standing for long periods of time. I never fully lose consciousness and it has never been serious, but I worry this is an indication something is really wrong. What could be happening?

HealthSmart asked Dr. Blair Grubb, M.D., Director of the University of Toledo School of Medicine Cardiac Electrophysiology Program. Here’s his response.

It sounds like you’re experiencing a vasovagal syncope which is the medical term for what is commonly referred to as fainting. Syncope is a symptom rather than a specific disease or medical condition and usually occurs when there is a decrease in the amount of blood and oxygen going to the brain. When the cells of the brain do not receive enough oxygen from blood to function adequately, syncope can occur. A drop-in blood flow to the brain for as little as eight to ten seconds may result in syncope. This decline in blood flow could result from an extremely large number of problems, making the diagnosis of syncope challenging. While syncope is often benign, it may sometimes be the warning sign of a more serious condition. Recurrent syncope, even from benign causes, can impair the ability to operate a motor vehicle and lead to injury from falls. Luckily, with proper medical evaluation, most causes of syncope can be identified and managed.

Do you have questions on health or wellness you’d like answered by the nation’s leading medical researchers? If so, you can send to Editor@WashNews.com. HealthSmart is a national newspaper column from the Washington News Service in DC. Due to demand, we are unable to reply to all inquiries. Responses through the column are no substitute for care from physicians or other medical professionals.

Copyright Ellen James Martin 2021