RNY or VSG

That's an old FAQ they have not updated. Most people refer to the 2008 Guidelines, that had different recommendations for NSAIDS and vitamins for VSG. VSG was newer, and had less data than RNY, and still has much less data.

The new Guidelines were published in 2013, and has MUCH more complete information than the crappy outdated FAQ. They increased the suggested vitamins, and recommend no NSAIDS for ALL WLS patients.

As Gwen pointed out, you can find the complete, NEW guidelines at https://asmbs.org/resources/clinical-practice-guidelines-for -the-perioperative-nutritional-metabolic-and-nonsurgical-sup port-of-the-bariatric-surgery-patient

You all can do whatever you like. But these ARE the new ASMBS Guidelines.

well, that was a boatload to scroll through! I notice it also says you should give up smoking.

shorter: 

One clear class of medications to avoid after Roux-en-Y gastric bypass is the “Non-steroidal anti-inflammatory drugs” (NSAIDs), which can cause ulcers or stomach irritation in anyone but are especially linked to a kind of ulcer called “marginal ulcer” after gastric bypass. Marginal ulcers can bleed or perforate. Usually they are not fatal, but they can cause a lot of months or years of misery, and are a common cause of re-operation, and even (rarely) reversal of gastric bypass.

Some surgeons advise limiting the use of NSAIDs after sleeve gastrectomy and adjustable gastric banding as well. 

link

I had VSG and ended up with horrible GERD -- and I didn't have it before.  So if you already have issues it can definitely make it worse.  

Easier to regain afterward with RNY or VSG?  I think that one is up for grabs and I would ask your doctor to see the empirical research done on regain after VSG vs RNY.  I just attended a bariatric symposium put on by a group of WLS doctors a few months ago and the difference in success defined as sustained weight loss is minimal at best.  And that was based on peer-reviewed research studies. 

Easier to stretch the sleeve?  Ask her to show you the evidence.  The sleeve can be stretched but you'd have to work REALLY hard at it.  And if you're going to work really hard at eating that much and that poorly you'll do the same thing with the RNY pouch.  Because overeating to the point where you damage your surgery is an emotional problem that has nothing to do with the type of surgery you got.  

Do your research and then feel confident about your final decision.  Whatever you decide - best of luck to you!! 

Hi Alit,

You have been given great advice here from our community.  Research, research, research...as you are reading about the VSG and RNY ask yourself can I do this for the "rest" of my life?  This will help you make an informed decision.  Also, visit both forums and view some of the threads going on and what life is like as a VSG'er and RNY'er. Here are some links that may be helpful to you.

Roux-en-Y Gastric Bypass Surgery Forum (RNY)

Vertical Sleeve Gastrectomy Forum (VSG)

 

• ROUX-EN-Y GASTRIC BYPASS INFORMATION
• About Roux-en-Y Gastric Bypass
• Risks and Rewards of Bariatric Surgery
• Nutritional Guideline after Gastric Bypass
• Life After Roux-en-Y Gastric Bypass
• Choosing a Bariatric Surgery Center
• FAQ
• Feature Article
• Forum Contributors

• VERTICAL SLEEVE GASTRECTOMY INFORMATION
• About Vertical Sleeve Gastrectomy
• Advantages and Disadvantages
• Frequently Asked Questions
• Forum Contributors

Good luck to you and keep us posted

 

 

 

My suggestion is to seek out more information regarding the extent of your GERD before making a decision. Can you schedule an endoscopy to check out the damage your occasional reflux has caused? I didn't think my occasional GERD was bad, but it turns out I have Barrett's Esophagus, which needs to be monitored now. The VSG should only be considered, imo, if your reflux has caused no damage. Too many people find that reflux gets much worse after the VSG, which you don't want if your esophagus is already damaged. 

Just my 2 Cents -- If you trust a surgeon to rearrange your insides, why in the world would you not trust his/her recommendation of which procedure is best? If you feel you have an experienced surgeon that you trust -- discuss it with him/her. I can only speak for me and what was best for me. I went with RNY per my surgeons recommendation because of years of Acid Reflux. Yes I also had a hiatal hernia that was repaired during WLS. My personal goal was to resolve my health issues and certainly didn't want to worsen them or create new and exciting ones. Best of luck

I know why I no longer think surgeons give the best advice. I wanted a surgeon who was a top cutter, but they only get about ONE HOUR of required education about nutrition, and way too many of the best surgeons give the worst post op advice. I had the DS, but was given RNY instructions. I see people on this site who have been given crappy post op nutrition and supplement advice every. single. day.

Not only that, but most surgeons don't perform all the surgeries, yet they all just happen to say the one they perform is best for you. No Ford dealer is going to send you over to the Lexus dealer.

surgeon worship is ...weird.  do doctors as a whole know EVERYTHING? they do not. do they know more than you?

depends! 

 

my GP recommended a gastric band, thank god I didn't listen to her. my surgeon? he would have done - and competently! - whatever I said I wanted. he was (he is dead, sadly) a very good cutter.

but did he know the best WLS for me? he did not. he would have given me whatever I asked for.

if you educate yourself you can decide which surgery is best for you. then, find a surgeon. 

Did no one mention the duodenal switch to you? 

 

And NSAIDs are okay for sleevers, with the same cautions that normal people follow. Just not RNY, ever. Are we now making up all new rules?