HELP!!!!!!Is it a bad idea to have a DISTAL RNY what is the difference

HELLO,

I am having my Rny surgery on 7/8 and i was informed it is distal 150cm what does this mean .. i am confused i have been reading and i am understanding there is less weight loss. My Doctors assistant advised me i would loose more ?? I am confused someone please educate me that knows the correct answer... I want to know if this is the case to let him know not to do a distal he recommended it because of the fact that i told him my bowels are sometimes hard for me?? Please if anyone can answer this??????

Others can give their opinion, but only your doctor knows your medical situation and can make recommendations based on your health history. After all, s/he is an expert and we're just regular people!

If in doubt, call your surgeon's office and get more information.

There are two types of RNY--proximal and distal.  This refers to how much of your small intestine is bypassed.  Nutrients and calories are absorbed only in the small intestine.  Once your food reaches the large intestine, that's the end of the line as far as absorption goes.  Your small intestine can compensate up to a point by growing more villi--the finger-like structures that line your small intestine and actually absorb the nutrients and such into your bloodstream.  This usually takes about 12-18 months or so and until that happens, you won't absorb as much from your food.  This is why we say the RNY is both malabsorptive as well as restrictive.  

Now, if you get a DISTAL bypass, that means that more of your small intestine is being bypassed and because of that, there is a chance that you will always have some malabsorption because the intestine you still have access to just isn't enough to do the full job.  Because of this, you may have to increase your vitamin regimen beyond what is usually recommended for RNY patients.  Check with your surgeon on this.  The Duodenal Switch WLS is a combo of the gastric sleeve and a Distal bypass and DS people malabsorb for life and I think they have to take a bit more vitamins than RNY folks because of it.

You will need to keep on top of your bowel situation post op.  Make sure you are drinking enough water daily.  I've heard that not skimping on fats can help and I take a daily probiotic.  

You've made me curious as to how much of my intestine has been bypassed.  150 cm is about 5 feet.  Your small intestine is about 20 feet long, so your surgeon is bypassing about a quarter of it.  I need to contact my surgeon and find out!  :D

Let us know if you have any other questions!  :D

Jen

@jenorama Thanks for the info also read the post from Lora and the link very informative..

Actually, 150 is the point at which they usually distinguish between proximal and distal... So with 150cm you can technically call it proximal OR distal and be correct.  

I'm not sure what you have been reading, but people with a significantly longer bypass will sometimes lose more weight. Studies (see link below) usually show only a very slight difference, though, so most surgeons don't consider it worth the trade-off in terms of lack of vitamin absorption and so they stick with the standard bypass. As I said, though, if your surgeon is going for 150cm, you aren't getting a significantly longer bypass, so it doesn't really matter.  You are getting the bypass that most surgeons use.

Here is a link to one study where the entire article is online.  You don't need to read all the technical stuff... just look at the graph about half way down.  Look at how minimal the difference is.

So there really isn't anything to stress out about. Besides, most long-term studies of weight-loss surgeries show that people with the DS lose the most, the fastest, and maintain greater loss, followed by the RNY (for all 3 category es), and then the VSG. By five (some studies use 7) years out, though, every study I have seen shows that what matters the most is not which surgery you had but the extent to which you have permanently changed your eating habits.  

Lora

Thank you so much Lora for answering my questions... I was confused so again Thanks!!!

This forum prompted me to investigate whether I had proximal or distal....DISTAL, well, wha-da-ya-know, time to re-educate myself...a little late but not for you.