why should i go with the ds instead of the rny??
The truth is, the research shows that the DS gives you the best odds of taking the weight off and keeping it off. It also comes with a more normal way of life than the RNY. No dumping. And you can still eat almost anything like a normal person.
http://www.dssurgery.com/generalinformation/comparison.php
But isn't that the issue? NORMAL People don't eat ALMOST ANYTHING!!!
Especially Lard Logs and donut burgers.
How about posting some independent research studies as opposed to companies and societies that have finacial incentives to steer you in one direction or another?
<=== This is a hungry child. I once thought I was too but it turned out that I was never hungry ... but boy, ... was I a child!
http://www.obesityhelp.com/member/alleygnat/blog/2009/05/26/
on 12/9/08 1:46 am
Post Date: 8/10/05 3:10 am
Both the DS and the RNY have two parts to the surgery - what is done to the stomach (restrictive part) and what is done to the intestines (malabsorptive part).
In the RNY, they section off the majority of the stomach which remains in the body, but unused (thus the term gastric bypass). Because this area is 'blind' - not accessible via oral medication or endoscopy, RNY'ers are advised to avoid NSAIDS or non-steroidal anti-imflammatory drugs such as aspirin or ibuprofen due to the potential for ulcers. DS'ers don't have this problem because there is no blind portion - the unused part of the stomach is removed instead, so we can take OTC drugs. For people with *other* problems, such as lupus or migraines or a family history of ulcers, this can be an important factor in their decision.
The remaining portion (nicknamed The Pouch) is anywhere from 1-3 oz. (About the size of a large egg). This then feeds directly into a newly restructured part of the intestine with no valve regulating how quickly food moves from the stomach into the intestine.
Instead of a valve, there's simply a hole - kind of like a doorway - which leads into the intestines. This is called a stoma. The stoma is not flexible, so it cannot expand if you try to put something through it that is too big. This is why RNY'ers are told to chew their food VERY well, and are advised AGAINST having fluid with meals, because just like a sink drain, solid stuff will go down easier if you 'flush' it down with water.
Because there is no regulation there, three-fourths of all RNY patients suffer a syndrome called Dumping. For some people, dumping just makes them feel a little bad. Others vomit. Still others have a more severe reaction that feels more like a bad case of the flu, and a rare but potentially dangerous reaction can be like a diabetic attack.
Dumping Syndrome can be both a positive and a negative factor - if you immediately suffer a REALLY bad reaction to eating sweets, you're going to learn (the hard way) to avoid foods that aren't good for you. It's called Aversion Therapy, and if you learn better from the stick than you do from the carrot, this will keep you on the straight and narrow.
In the DS, they literally do a gastrectomy, removing the outer curvature of the stomach (making it physically smaller), but leaving the actual functionality of the stomach intact as it was before surgery. The remaining portion of the stomach is kind of "banana" shaped, and you start with about 3-5oz stomach - a little larger than the RNY, but still MUCH smaller than it is now.
You have multiple places in your body where you have a sphincter type muscle - the one everyone is familiar with is your anus, at the 'bottom' (pun intended) of your intestines. Well, you have a similar 'ring of muscle' at the pit of your stomach called the pyloric valve. Because this valve remains in use, DS patients do not have any dumping because the pyloric valve is still regulating how often food moves into the intestines as it does for you right now.
In both surgeries, the stomach/pouch will expand over time to about twice it's post-surgery size. This leaves long-term RNY'ers with about 3-5oz and long-term DS'ers with about 10-12oz.
Then we move into the lower portion of the surgery, which is essentially the same for both with a few small, but significant differences. The small intestine has three sections/phases - called the jujuneum, the illeum and the duodenum. (Forgive my spelling if it's wrong - it *is* 4:30 in the morning)
Right now, it is one continuous line. What they do is cut it in two and reattach them in a Y formation. One branch of the Y comes down from the liver with the digestive juices. The other portion comes down from the stomach (DS) or the pouch (RNY) with food. The two them come together into what is called the common channel which then has both digestive juices and food. It is in the common channel that most digestion takes place. (Some digestion takes place all throughout the whole digestive system, starting from saliva in the mouth, all the way to the colon)
The primary differences between the two in the lower part are this:
1) In the RNY, the common channel is generally longer - perhaps 275cm. In the DS, it's generally shorter - about 100cm. Everyone absorbs carbs like a non-WLS patient, but we malabsorb for protein, fat and calories - DS more than RNY, again due to the shorter common channel.
The 'big' problem this causes the DS'ers is too much fat can cause bad-smelling gas and/or diarrhea - and it's the one thing everyone who has every heard of the DS has heard of. However, for MOST people, this isn't a huge problem, is easily controlled with products like Beano, and watching what they eat.
2) The Duodenum is bypassed in the RNY, and it is functional in the DS. What makes that important is that this is where protein, calcium, iron, and vitamin B12 are absorbed. So even though the DS has a greater malabsorptive factor (the shorter common channel), it actually has more normal nutritional absorption than the RNY because the duodenum is still involved in the digestive process.
Now - BOTH types have to watch what they eat, and be aware that they are susceptible to nutritional deficiencies. For the most part, these can be controlled with diet, but if your diet is out of control, you can do *severe* damage to your health if you ignore this.
DS patients specifically need to make sure they take calcium & protein, and the fat soluable vitamins. RNY patients need to make sure they get protein, calcium, iron & B12. (Some need B12 shots, but not all). A person who has never had surgery needs about 60g of protein a day. RNY need about 80g. I've seen recommendations for DS patients of 90-120g.
Everyone should take a multi-vitamin, and get exercise, with or without WLS surgery. A low-carb, high-protein diet is recommended to make sure you get in your protein, and you'll find LOTS of suggestions on what to eat on every board - both food, protein shake and supplement-wise.
Source: Blackthorne (Kirkland, WA)
One of the reasons I chose the DS is that my primary insurance covers DS but not the VSG. Also, I wanted a fully-functioning stomach with the pylorus valve intact and to be able to eat like a non-WLSer and not have to worry about dumping, puking, or getting the foamies. Plus, I wanted to be able to take meds like a non-WLSer.
Reason I didn't want RNY: When the local TV station was doing a medical investigation of "gastric bypass" surgery about 10 years ago, the reporter used a two-liter bottle for the pre-op stomach and unscrewed a bottle cap from the same bottle for the post-op pouch. I knew right away that I would never opt for that kind of surgery!
I have seen RNYers and lap-banders being able to eat only a couple of small bites before they say that they're full. Plus, I did notice that one RNYer ordered an egg omelet at a restaurant, but she was able to eat only the ham dices in the omelet and not the egg itself. To me, that's not real eating!
Also, I learned in the surgery prep seminar that RNYers have to cut foods into sizes of erasers on pencils to accommodate their 50-ML pouches. Real DSers eat just like any non-WLSer!
Hope this helps!
Vicki 
DS (lap) with Dr. Clifford Deveney. Cholecystectomy (lap) with Dr. Clifford Deveney 19 months post-op.
Has not weighed myself since 1/2010. Letting my clothes gauge my progress instead.
As for the "oranges" - that's what we call them! If you eat foods very high in Fat - you WILL get them and orange oil WILL come out - b/c DSers do not absorb Fat - you'll figure it out as you go along and if you're willing to put up with the repercussions, indulge away! Just don't be surprised if you find yourself "afraid to fart!" You might get more than you bargined for...it's a fact of life post -op!
I'm glad I had the surgery - no question - but I could certainly do without the terrible gas! and I'm sure my husband feels the same!
Good luck to you!
Hi Valerina,
I don't think every DS'er gets the "oranges", and if they do it's usually something they see in the toilet, not something that stains their underwear. Everyone's experience is different, and every pre-op should be prepared for the worst, but it really isn't the norm to have oil slicks outside of the bathroom. I'm not saying that the occasional "shart" might not happen, but that's something you can control. Xenical causes oil slicks that show up uncontrollably, and that just isn't a "fact of life" for the DS'er.
The gas issue is usually well controlled too, by adjusting the diet to avoid trigger foods (usually simple carbs), and the use of a good probiotic. I think most people will eventually also experience some bacterial overgrowth and will need to use a course of Metronidazole (Flagyl) from time to time.
