Lynch Syndrome

Hi there,

I'm hoping that there's someone out there I can connect with.

I have Lynch Syndrome and currently going through the WLS process.

My Question: If you have Lynch syndrome, did you get the RNY or Sleeve and what was the reason you got one over the other?

Thanks to all who view, and those *****spond!

Hi Vindy

Welcome to OH! I had not heard nor have any knowledge of Lynch Syndrome so I google and noticed one article mentioned taking aspirin on a regular basis was part of the regiment for this syndrome. Do you take aspirin on a regular basis per your doctor's advice? If so, RNY is not for you. It's well known if you have RNY, NSAID's on a regular basis can lead to ulcers and bleeding.

Here is a link to a few articles featured on OH that discuss weight loss surgery and meds.

https://www.obesityhelp.com/index.php?s=NSAID

Keep us posted on how you are doing and check out the VSG and RNY forum also

• Gastric Bypass - RNY
• Vertical Sleeve - VSG

Regards,

Kathy

Member Services

Kathy it was my understanding the ASMBS didn't recommend Nsaids anymore for VSG either.

The problem with NSAIDs for RNY vs VSG is that both types can develop ulcers and bleeding. But RNY can develop that in the remnant stomach and that could only be detected and treated with surgery. A person could get very sick or die due to internal stomach perforation.

VSG ,,- can be stopped, and easier detected, plus taking meds that can protect the lining of the stomach and small intestine is possible. We can't do that in RNY.

They used to do a blanket no NSAID recommendation (or at least whoever wrote the papers posted on their site did) as that reflected that most surgeons at the time were bypass centric and usually had blanket protocols for all, but now that most have gained more experience with the sleeve, many have joined their colleagues from the DS world who have been doing sleeves for twenty years or more in being more flexible in their use. The latest recommendations suggest following your surgeon's advice, but specifically recognizes the marginal ulcer problem with the RNY makes them a general no-go for them. The prospect of problems within the remnant stomach is also a concern.

https://asmbs.org/patients/life-after-bariatric-surgery

Q: Which medications should I avoid after weight loss surgery?
A: Your surgeon or bariatric physician can offer guidance on this topic. 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. Corticosteroids (such as prednisone) can also cause ulcers and poor healing but may be necessary in some situations. Some long-acting, extended-release, or enteric coated medications may not be absorbed as well after bariatric surgery, so it is important that you work with your surgeon and primary care physician to monitor how well your medications are working. Your doctor may choose an immediate-release medication in some cases if the concern is high enough. Finally, some prescription medications can be associated with weight gain, so you and your doctor can weigh the risk of weight gain versus the benefit of that medication. There may be alternative medications in some cases with less weight gain as a side effect.

I had heard some surgeons yes and some no on the VSG but 100% yes for RNY. Thanks for the update

With Lynch, the VSG would usually be preferred as that preserves the ability to do routine end-to-end monitoring of the entire GI tract, without the blind stomach and limb that the RNY has, and also preserves the ability for endoscopic evaluation of the bile and pancreatic ducts. Now, if one has other pre-existing conditions that may normally bias one toward the RNY (GERD is the primary one) then it is trade off time - medical care is often a game of trade offs and compromises. The RNY can be done without the remnant stomach left behind, though that involves its own trade offs, and still leaves a blind duodenum.

I would suggest having a consult with a bariatric practice that is associated with a major cancer center, as those guys usually do double duty as GI cancer surgeons and would have more specific experience with these kinds of trade offs, and get their opinion on what would be the best for your specific situation.

Good luck....