Duodenal Switch Forum (DS)

About the Duodenal Switch or BPD-DS

The BPD-DS, or Duodenal Switch
The biliopancreatic diversion with duodenal switch goes by many names. Some refer to it by the initials BPD-DS. Many call it the "duodenal switch" or just "the switch" for short. The National Institutes of Health refers to the procedure as an "extensive gastric bypass with duodenal switch." While less commonly performed than the gastric bypass, this operation has received a great deal of attention recently, particularly on the Internet, because it provides excellent weight loss while allowing you to eat larger portions than a gastric bypass. In order to avoid too many initials and confusion, we?ll refer to the operation here as the duodenal switch.

Like the gastric bypass, the duodenal switch causes restriction: this means that it reduces how much food you can eat before getting full. However, the duodenal switch is also a highly malabsorptive operation. This means that it reduces the percentage of calories that you absorb from your food.

In the duodenal switch, roughly one half of the stomach ? the left half ? is permanently removed. The stomach goes from the size and shape of a small pineapple to the size and shape of a banana. The pylorus, which is the valve at the outlet of the stomach, remains intact. This reduces the rate at which food leaves the stomach, so ?dumping syndrome? ? common with the gastric bypass ? is generally avoided.

The banana-shaped stomach is then connected to the last 250 centimeters (8 feet) of small intestine. This means that the rest of the small intestine ? the ?biliopancreatic limb? ? is completely bypassed. The biliopancreatic limb of the small intestine is connected 100 centimeters from the end of the small bowel. It is only in this section of the gastrointestinal tract ? known as the ?common channel? ? where food mixes with the digestive enzymes.

The Duodenal Switch is a Big Operation!
The duodenal switch is a substantially ?bigger? operation than the gastric bypass. It is a bigger operation for 2 reasons. First, a major portion of the stomach is permanently removed, which makes the procedure completely irreversible. Second, a large section of small intestine is bypassed, resulting in substantial malabsorption. This means that you will need to take more nutritional supplements after this operation than with any other! And, the risks of long-term nutritional deficits are greater with duodenal switch than with any other weight loss operation.

Why would someone want to have a larger operation? The duodenal switch has 2 major advantages:

• The pylorus remains intact: this usually keeps dumping syndrome from occurring after surgery.
• Since the stomach pouch is larger than with other bariatric operations, you can eat larger portions than with the gastric bypass or LAP-BAND®.

Living with the Duodenal Switch: Supplements and Side Effects
It is necessary to take a number of nutritional supplements after the operation than after gastric bypass. These usually include:

• Multivitamins (usually twice per day)
• Iron supplements (usually twice per day)
• Calcium with vitamin D (usually twice per day)
• ADEKs (fat-soluble vitamins) usually 3 times per day

Additionally, there are some very significant side effects that accompany this procedure, including:

• Frequent soft bowel movements (up to 4-6 per day)
• Frequent passing of foul-smelling gas
• Changes in body odor
• Gas pains or bloating
• Hair loss
• Intolerance of certain foods (varies from person to person)

It is difficult to say exactly which of these side-effects you will experience because everyone is different. We have listed the ones that are most common.

Deciding on the Duodenal Switch and Finding the Right Surgeon For You
The decision about which operation is best for you is a complicated one. Although the information presented here may be helpful, you will be able to learn substantially more about the benefits and risks of the duodenal operation during your consultation with your bariatric surgeon.

Next: >> Insurance Coverage for Duodenal Switch

This information has been provided courtesy of the Mount Sinai Program for Surgical Weight Loss. Please visit them at http://www.SurgicallySlim.com.