should I be bypassed more?

I have a consult on Oct 31st with a doctor for revision.  I am wanting to have my pouch tighten and bypassed more.  My question is I have a little mixed reviews about being bypassed more.  I don't know if it could cause health problems?  I would like some opinions.

Do you know how much you were bypassed in your orig surgery?  Do the research on what is proximal, medial and distal.  From what I've learned, about 150cm is medial ( about the average).  If you had a much higher BMI,  the doc may have gone more distal.   The more you have bypassed, the more mal-absorbtion you have, not only calories, but vitamins and minerals as well. Only you and your doc can decide what you are willing to risk.  Good luck! T

I don't know how much I was bypass 7 1/2 years ago.  It probably was proximal because I was considered a "light weight".  I do have my surgery notes though.  I'm sure I do not want to be distal but I will consider medial.

You should come to the DS forum here on OH and check out the duodenal switch. You are bypassed more and there is more malabsorption, but just remember to take your vitamins and you are good to go; no problems nutritionally. I hope to get the DS in a few months. I have read everything I could on the DS forum and on duodenalswtich.com. I am so sorry I had RnY 2.5 years ago I could scream because no one bothered to tell me about the DS and I just want to get the word out.

It all depends on what length you're considering being bypassed. Response to a response: "You are bypassed more and there is more malabsorption, but just remember to take your vitamins and you are good to go; no problems ' No problems aside from those who've reported protein malnutrition and deficiencies that vitamin supplementation haven't improved..... You really HAVE to take what you read on here with a grain of salt.  There's a reason some people love the DS, good reasons, and reasons why some of us opted for proximal RnY - even AFTER researching the DS and what it involves, valid and legitimate concerns. Any time you bypass the small intestine to such an extreme, you increase the possibility of issues. That doesn't mean that EVERY person who gets distal RnY or DS is destined to have issues - notice I'm emphasizing this here to be clear in what I'm saying - but there's a REASON why there are certain categories of people for whom those procedures are reserved - people with a large amount of weight, whose risks from staying SMO outweigh the possible malabsorption concerns down the road.  Those are the groups who typically are referred to the DS and distal RnY. But do your google homework - there ARE reported issues with protein malnutrition/malabsorption that are unique to the DS and distal bypass in general that should be considered along with the pros and cons.  You'll hear the honeymooners tell you that it's not so, but look at the long term published stats and you'll find those things are more prevalent among those populations than with RnY - again for clarity, I'm not saying that every person who gets those lengths bypassed will be facing that.  But, as with all stats - doesn't matter a hill of beans how many people don't have problems if you happen to be part of that percentage who experiences a problem. Long post here - but some clarity was needed.  Bypassing the small intestine to DS and distal-RnY lengths aren't decisions to be made lightly - there ARE concerns.  It's not as simple as taking your vitamins and having that be an iron-clad guarantee of no issues.  Proximal RnYers also have malabsorptive procedures and take vitamins, and even among that group, there are those who have issues with vitamin deficiencies - why would someone think that increasing that bypass wouldn't pose more of a concern?    One last general thing:  the small intestine is the place where the majority of absorption of your nutrition takes place.  Making the stomach smaller or larger affects the quanitity of what you take in at one time, but making the available amount of small intestine smaller is a much more serious concern.  If something should happen that the re-connected small bowel tissue necroses later on in life, you have less "viable" bowel to work with later on and there's another possible danger.  Any time you cut and re-connect tissue, there's a risk of that happening - none of us who are bypassed, regardless of procedure, are immune to that possibility (go back and browse through the problems some have had when getting revisions to see what I'm talking about) Not a huge concern again if you're of a certain age, and not guaranteed to happen to every individual - but if you did happen to be in that small percentage it happens to, it could be a major problem affecting quality of life if they had to go back in to repair it.  If you "run out" of small bowel, you're in trouble.    *sprinkling my salt grain*

Dr R, your original surgeon does that quite a bit. I have talked to a lot of people who had it done. I would at least call him in vegas. He even answers his own phone :). =Van