Good evening everyone,

You've seen me posting here since my journey started last year. I'm continuing to share aspects of my story in case it helps someone else along the way.

I'd been having GI symptoms for a month and a half and reported them to my WLS clinic the whole time. Initially, they passed it off with the traditional feedback to take smaller bites.

After I wasn't eating solid food anymore, they ordered the EGD, which showed bile reflux. I got tossed a couple prescriptions and told to call them in 10 days after the Levsin course. The Levsin did help. I called back and asked for a refill. I carefully described my symptoms and evolution again and they tried telling me that by the time the new prescription was gone, I'd be all better. Yeah, I knew that wasn't happening.

Every day I'd been spending time massaging my stomach and intestines as a pain management technique. I decided to just keep calling them. They finally asked to schedule a CT scan for last Tuesday (over a week out from the call because full).

The scan showed mild thickening of the terminal iileum. They called me on Wednesday, May 3rd with a referral to a GI specialist to schedule a colonoscopy. Said it was indicative of Crohns or Ulcerative Colitis. I started calling the specialist to get scheduled.

I'd been on leave for the unexplained neuropathic pain and had tried to return to work that day. Early Thursday morning I had an emergency symptom. I'd eaten very little since Tuesday, drank less, and only took my supplements. I still felt massively full. Dr. Google told me pretty much the only reason for said symptom was a bowel obstruction.

Don't be me. I waited hours so I could drop my dogs off somewhere. I knew it wouldn't be a quick clinic visit, and it wasn't. The hour and change drive in to the ER was excruciating. They still dismissed my symptom until the second CT scan came back showing a bowel obstruction. They basically accused me of eating slabs of meat when I'd barely been on any food for weeks.

Anyway, they rushed me into an exploratory lapararoscopy to see what was indicated. Fortunately, there were no twists or hernias or other issues he could find. Thankfully, no resection needed. They inserted a tube into my stomach through my nose and proceeded with bezoar protocol. That part lasted two days and I do not recommend it.

Ultimately, I spent over five days in the hospital after fighting to be heard about my symptoms for over a month. The surgeon has no idea why I went from a clear scan Tuesday to obstructed Thursday. He's not convinced it's because of surgery but the likelihood is higher because of our rewiring.

His advice is the same things we all hear. Small bites, chew well. I'm not a fan of how it went down and I'll work on being an even more vocal advocate in the future.

Please, please say something if you have symptoms. It's scary how fast things can turn. Have a wonderful evening. Thanks for reading the ramble!

It appears when I started taking B complex and B 12 it eliminated that issue

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Thanks for this feedback and perspective! Yes, he knows how to do a traditional DS but their office doesn't offer it as an option because of the increased risk of health issues. It's part of why I'm surprised that's the solution they've come back with. Appreciate you sharing the info on the surgeon in New York. It can't hurt to ask, even if it would be out of network for me to use any other surgeon for a WLS procedure. GERD was definitely mentioned but I don't think bile reflux was discussed, so that's something to be aware of.

Your explanation for why a revision would work is super helpful. Thank you!

Sadly, this has been since my gallbladder came out, so I'd guess it's related. I'm hoping there's a way to attempt to treat it medically, first. Not exactly willing to jump back on the table for a third surgery in under a year.

Either way, appreciate you weighing in!

There have been some who coming through here who have had bile reflux problems with their SADI (and its cousin, the mini bypass) as that is one of the potential side effects of those simplified configurations (take a look at the anatomy diagram and see how the stomach empties into the intestine downstream of the bile ducts, which are normally downstream of the stomach in the natural anatomy. With the traditional DS, bile secretions have to go down the entire bypassed channel, several feet, to the anastomosis at the start of the common channel, and then back upstream several feet to get back to the stomach. That's why bile reflux is all but impossible with the traditional DS. (The added limb between the stomach pouch and mainline intestine on the RNY serves the same purpose, if it's long enough, which is why bile reflux is fairly rare with that, compared to the single anastomosis procedures.) There's always trade offs! I'm not familiar enough, experience wise, with the SADI to speak with any authority (the surgeons we have been associated with only do the traditional DS and VSG, so no direct patient experience in our support group to draw from,) but perhaps the limbs can be moved around some to further distance the stomach from the bile ducts; there is allegedly some minor technique tweak for the mini bypass which is supposed to reduce the incidence of bile reflux, so perhaps there is an analogous tweak for the SADI (or maybe that's just marketing hype.)

I don't know who your surgeon is (reassuring that they are suggesting the traditional DS, inplying that they know how to do it!) but perhaps a second opinion from another SADI surgeon would be useful. I know Mitch Roslin in NYC has been a big promoter of the SADI as a simpler, more accessible alternative to the traditional DS, which he also does, and seems to have done a lot of development on it - perhaps a phone consult could be useful?