RnY vs. Duodenal Switch

I am scheduled to have surgery in the fall and have the choice of a Duodenal Switch and a Roux en Y.  I have 96 excess pounds to lose.  

For whatever reason the RnY scares me more than the Switch - but in researching the operations it said diarrhea and flatulence are common after a Switch.  I work in a professional (and male dominated) environment, so smelly gas and uncontainable bowels are not something that will be helpful in my professional development :)

Please share why you chose your type of surgery and whether you would make a different choice now.

Thanks

I had my Rny on 04/29 and choose it because I had diabetes and high blood pressure. Since my surgery I have not needed any insulin. I was on both types pills and needles. I have lost 27 pounds so far. I feel pretty good and went back to work full time on 5/27/15. So I am still learning a lot and feel grateful for a chance to use my tool for better health.

I had the DS 11/19/14 after having my lap band removed.  It has been far easier than the band ever was!  I have had no diarrhea, in fact I have one bm a day, first thing in the morning.  No gas issues at all. I am totally satisfied with my food options probably because I can eat a lot of fat, heavy cream, full fat Greek yogurt, full fat cheese, butter, meats, etc. I don't feel "deprived" at all.  Also, I'm down 98 pounds in 7 months!  So far it has been the best decision I ever made!  Good luck on your journey.  I hope you find the best surgery for you.

thanks for the info.  good to know that the DS doesn't automatically mean diarrhea and bad gas :)

So you have NO dietary restrictions? have you had issues with malnutrition (lack of vitamins)?

I definitely have dietary restrictions, I don't have to eat low fat.  I try to get 100-120 grams of protein a day, 100 grams of fat & keep my carbs low.  In regards to the vitamins, as with any malabsorption procedure, it is vitally important to get the proper amount of vitamins in each day.  I personally don't find this hard to do and it has become part of my normal daily routine. I am only seven months out and my labs are good, but this is obviously not enough time for me to comment on the labwork component of the DS.

I just wanted to offer my experience to you in regards to the "diarrhea and bad gas" issues associated with the DS.  I have had none and the other people that I have personally been in contact with who have had the DS also have had none.  When I was researching the DS prior to having the surgery I too was concerned because people said that there could possibly be issues with this, however I have not found this to be true at all.

Again, best wishes in finding the best surgery for you.  

I considered the DS 8 years ago, but opted for the RNY in part because of the possibility of the digestive issues and I  part because of the extreme lack of absorption of vitamins.  Hell, I don't even like the lack of vitamin absorption with my RNY, but it was my best option at the time.  If I had only needed to lose less than 100 pounds, I definitely wouldn't want the extreme malabsorption of the DS.  

There are significant potential vitamin deficiencies with RNY, and even more with the DS.  My surgeon stopped doing the DS because too many people weren't being compliant with the vitamin regimen post-op, though... too many patients were coming back with medical problems caused by vitamin deficiencies.

Personally, if I were making the decision now, I would opt for the sleeve and not have ANY lack of vitamin absorption.  VSG wasn't an option 8 years ago, though.

The only person I knew personally who had the DS when I was making my decision had terrible problems with oily diarrhea and noxious gas.  Some people since then have told me that she could have controlled it by changing what she was eating, but I don't know that to be true.  She seemed to eat the way a DSer should eat and did NOT eat a lot of carbs.

If you are willing to commit to taking the vitamins consistently for the rest of your life, though, the DS has great statistics for maintaining weight loss.

I am curious, though, as to why the RNY scares you more when it is a less drastic surgery than the DS.

Lora

Thanks for the info

I think the RnY scares me because they leave the active, stitched up stomach inside you.  in my experience, if there is a possibility that something will leak due to funky scarring - it would happen to me.  I just don't like the idea of the diarrhea and gas

I admit that it sometimes is kind of weird knowing that my remnant stomach is in there not doing much except producing some gastric juices, BUT complications related to the remnant stomach are very rare and the vast majority of leaks are in the pouch not in the remnant stomach. The rate of leaks is very low, and is about the same with VSG as with RNY.

The most common of the rare issues with the remnant stomach are ulcers caused by NSAID use (which is prohibited after RNY) and, even more rarely, gastrogastric fistulas between the pouch and the remnant stomach.  

The advantage of retaining the remnant stomach is that it can be put back into service in the very unlikely event of physical damage to the pouch or in the case of some illness such as cancer that would require removal of the pouch or a large portion of it.  With VSG, there is no remnant stoamch to fall back on.

Bad gas can happen with either---I've seen many, many RNYers post about paint-peeling gas. And both surgeries can cause both diarrhea AND constipation. Really, it comes down to how your body reacts to surgery, and how you choose to eat.

I can only tell you about MY experience. I had my DS 11.5 years ago. For the first few months, I was learning what my body did and didn't like, and yes, I had some bad gas (by that, I mean stinky and painful, not uncontrollable) and some loose stools. NO diarrhea---diarrhea means urgent, sometimes uncontrollable, multiple, frequent stools with the potential to dehydrate. For the first couple of months, I'd have 4-5 very soft BMs per day. By the time I was 6 months out, I was going twice, usually within thirty minutes of getting up in the morning. ( I still go twice every AM, except for the rare times when I get constipated---but that's a different story.)

I have no more gas now than I did pre-op, and I actually more in control of it---there are certain things that I KNOW will give me gas, and it's my choice whether to eat them or not. I can sort of 'schedule' my gas. (*grin*)

There are NO foods that I never eat (well, other than the things I just plain don't LIKE, LOL!), but there are some things that I choose to limit because I know there will be consequences. The number-one gas producing food that I MUST limit is grilled veggies marinated in Italian dressing. Sounds pretty benign, right? I can eat them for one meal, but if I risk eating any leftovers the next day, I KNOW what will happen. Sometimes it's worth it.

No, I would not choose a different surgery. My DS has been great for me. Yes, I do toss back a handful of vitamins and minerals 3 times a day, but it's become a habit. I never have to think about it any more, I just do it.

Thanks so much... i think it is a bit daunting to have a choice without knowing how your body will react.  So thankful that people are so helpful and honest on this site... i guess it's because we all know where everyone is coming from :)