Ok Kind of pisssed off

JEG1
on 8/1/13 9:48 pm - WY

I will hazard an opinion, although this is only from my research, and someone else may have a more accurate answer.  The RNY works for both restriction (small capacity for food), and malabsorption (part of the small intestine, where absorption of nutrients occurs, is bypassed) so that less food is taken in, and less nutrients absorbed.  The RNY is considered to be mainly restrictive, and not very much malabsorption.  Your pouch size may still be small; hopefully the outlet of the pouch (the stoma) is still small, which is what the operative report seems to say.

 

Why are you feeling hungry?  Because the large remainder of the bypassed stomach is still producing grehlin, which stimulates hunger to increase food intake.  So even though you have a small pouch, your hunger is demanding more intake.  What he has done is to move the spot where your bypassed intestine rejoins the normal small intestine to a spot much closer to your large intestine.  This is called a Long Limb RNY, because the length of normal intestine bypassed is made longer.  So your food has a much shorter length of intestine to be absorbed in.  This type of surgery has a higher risk of malnutrition if protein cannot be absorbed before everything dumps into the large bowel.  

 

Carbohydrates (sugars, sweets, fruit, bread, rice, potatoes, pasta) can be absorbed much more easily than proteins, because they don't need as much chemical processing in the small intestine.  So, you will need to make sure that you avoid these as much as possible.  Protein may not be absorbed properly, so that a percentage of it will pass on through and not help you.  For instance (and the percentages are just a guess, for illustration)  you might absorb 90% of the calories you eat that are carbs, but only absorb 60% of the protein.  So you could still gain weight while your body starves for muscle maintenance.  You will need to make protein protein intake your top priority.  I would advise that you work closely with a nutritionist to learn the best meal plans for you, and be closely followed by your medical doctor to have the tests needed to monitor for any vitamin deficiencies.  While your intestine is busy not absorbing the protein, it is also not absorbing enough vitamins through food alone.

 

I believe that you will still lose weight, you will just need to work carefully with your health care providers to make sure that you get all the nutrients you need to avoid complications.

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