Revising my DS to a sleeve? Help please!

Hi guys,

I had my DS 8 years ago in 2005 and went from 250 to currently 145. In the past 2 years I have been struggling with severe diarrhea and enormous amounts of gas that are so severe that some of my pants don't fit at those times because of my bloating.  I've tried everything: many probiotics, rounds of Flagyl, pancreatic enzymes like Creon, prescription anti-diarrhea meds and completely eliminating all carbs/sugar/lactose. Some of those things help a little bit but after a while it all stops working and I will go back to having severe diarrhea. 

I can't live like this anymore because I'm currently going to the bathroom 6/7 times per day with very extremely urgent bowel movements (like if I'm driving I will have to pull over into any place that has a bathroom, even if it has to be the dirtiest gas station it will be either that or poop my pants). My life resolves around only being able to plan things if I know there will be a bathroom around. Going to the beach or a nature park scares me to the point I won't go any more because of a lack of bathroom facilities nearby. This is very depressing because it's disabling me from doing so many things. 

So with such a reduced quality of life I am now looking at surgical options. I saw a surgeon today and he recommended completely reversing the malabsorbative component of my DS and converting me to a VSG sleeve. He thinks if the reverses my DS without the sleeve I will gain weight because right now I have the capacity to eat a normal amount of food so a sleeve will help restrict the amount I eat, which would then be fully absorbed. 

I am so desperate at this point. I would really appreciate any advice you guys can give me. 

THANK YOU SO MUCH!!!!

What is your calcium citrate intake like? Since you've covered all of the other potential culprits, calcium intake comes to my mind first, in that you may not be getting enough.

Hi T Lady,

I've been following VitaLady's recommendations and my calcium levels are normal. They were low at some point but are back to normal now.

Calcium citrate makes things firm up like crazy for me. If I don't get in enough, things are very runny and very similar to what you are describing. I had to play with the balance of runny or constipated or normal, based on calcium citrate, stool softeners, mag oxide and fat intake. I saw your reply below that if you get too much calcium citrate, you'll get constipated and get hemorrhoids. Yes, I do as well, but then I'll add in a stool softener with each dose of calcium citrate. If it's still bad, I add in 1 or 2 magnesium oxide pills before bed and up my fat intake even more. You could try upping your calcium citrate and back off the magnesium oxide if you are taking that. Vitalady tends be on the constipated side as well and has an entire ritual for emptying her bowels, one of those is mag oxide. It may not work for you, but it wouldn't hurt to try that. Another person posted similar symptoms a few months back and upped her calcium after myself and a few others suggested it. She had great results. Good luck, I know it must be frustrating right now. You said your calcium levels are normal. So are mine, but my PTH levels are too high, meaning my bones aren't getting enough, even though I'm taking the recommended dosages. Do you know what your PTH levels are?

I know you wish you had your surgical report and your common channel length. If you do decide to revise, please seek the experience and knowledge of a true DS revision surgeon like Rabkin, Roslin, Keshishian, etc. These docs have enough insight to figure out what's probably amiss by looking at your configuration and then they can decide on the right course of action to keep your weight off, while increasing your quality of life. I am now a firm believer that a DS must be tailored to each patient (ie:Hess Method).

I have played with different types of iron.  When I get diarrhea (which I was plagued with it the first 6 months), I take 4 pills of 65 mg Ferrous Sulfate.  Regular iron (Tender Iron) will definately help with diarrhea, but the little Ferrous Sulfate pills block everything.

Probiotics did help over time.  They were not an over night cure.  But I do notice that things work better when I eat yogurt every day also

Calcium is also very blocking for me.  I have to take magnesium with every calcium dose (and sometimes a couple extra pills at the end of the day).  But I also take calcium by itself, and no more than 1800 mg at one time (3 doses).  I also take the iron by itself with no food - jus****er and vit c.

It's interesting that you can't narrow it down to a food or something in your environment.  You have eliminated all the food groups I would have gone for.  I've thought about this reversal, and hope you keep posting on this journey.  I would be interested to know how it works out for you.

I do find that when I take extra Iron or Calcium it will stop (I do this when I have something important to attend to and may not be able to run to the bathroom as frequently or conveniently.)

The problem is then I get constipated and when I finally have to go (I'm sorry to say this) it's like giving birth to several huge bricks, which then give me bleeding hemorrhoids:(

Did you and the surgeon discuss the option of adjusting the lengths of the different limbs rather than reversing the "switch" part entirely? It's possible that creating a longer common channel to lessen your malabsorption would be sufficient.

Ii have no idea what surgeon you spoke with, and can only recommend that you consult with an experienced DS surgeon if you haven't already, and even if you have, get a second  opinion from another DS surgeon, because I do think he's right that you will gain weight with just a stretched out sleeve.

Larra

Hi Larra,

We discussed that and he said that it may help but it's not guaranteed, which would then mean I would need additional surgery.

I went to Dr. Robert Marema in St. Augustine.

I know you said you cut out all carbs, but have you cut out all gluten? You may be gluten intolerant and this can cause serious gas and bloating. I am sensitive to gluten and have to watch it or I am miserable.

Hi ElijahsMama,

I was tested for celiac disease and I don't have it. I do find that when I completely eliminate gluten I feel better but still not in the way I did when I initially had my surgery 8 years ago. It's so strange that this started happening about 2 years ago and I can't seem to figure out any more ideas to try:(