Need some info on lack of intestinal adaptation with DS

MsBatt
on 10/2/13 1:42 am

Thanks for the correction! So---how much (or I guess I should say how little) DO they usually bypass in a proximal RNY? I think I got that figure from someone's surgical notes.

cajungirl
on 10/2/13 4:12 am

I think it varies by surgeon and/or patient.  I can tell you I'm bypassed only 80 cm which is less than 1 meter.  If I remember correctly the shortest they go is 75 cm up to 150 which would be proximal.  Above 150 cm would be distal (again if I'm remember this, a lot has happened in 9 years).

Proximal RNY Lap - 02/21/05

 9 years committed ~  100% EWL and Maintaining

www.dazzlinglashesandbeyond.com

 

PattyL
on 10/2/13 5:26 am

Kudos to you for caring enough to ASK!  Your future patients will be grateful.

By the time the average proximal RNY person is @ 2yrs postop, their body has adapted to the bypass of the small bowel.  This is why so many have problems maintaining their loss starting at about 2 years.  I don't have any real peer reviewed study to back this up so you can call it anecdotal.  But I have seen this so many times I believe it to be true.

It is also true that the same type of adaptation happens with the DS.  But we start out with so much more gut bypassed than the proximal RNYer that it's much less likely a DSer will have significant regain.

Another thing that happens very rarely is Common Channel regrowth.  It happens more frequently in young patients.  Around 10 years ago there was a young woman here who had the surgery at 16.  Back then, she was one of the youngest patients I was aware of.  She was reoperated and they found her CC had tripled in length resulting in weight gain.

The next wrench you can throw into the works is the guts themselves.  10 competent bariatric surgeons could measure out the cc on one individual patient and none of the measurements would be identical.  Intestines are motile and a little bit like earthworms.  You can see the same worm twice and sometimes it's short and sometimes much longer.  So my bypass may not be equal to yours.

Last there are the superabsorbers.  They are quite real even though the medical community is hesitant to admit they exist.  These are the folks with almost no metabolism who can gain weight on 800 to 100 cal per day.

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