Question:
Distal Or Proximal- What's the difference and seeking opinions on which is "best".

I also had someone ask me 150 or 200. What does that mean?    — Trin2rilax Cheryl McCoy (posted on May 30, 2003)

May 30, 2003
Hiya... If I am understanding what I have read Proximal is where less than 150 cm of intestines is bypassed and Distal is over 150. Again this is what I have taken these terms to mean hope it helps.
   — lillbitofsin

May 30, 2003
That was my understanding also... the different amounts of intestines bypassed... my surgeon told me that they determine how much to bypass by the BMI. If it is bigger then they bypass more... smaller.... less.
   — Eleanore Davis

May 30, 2003
Usually people who have alot of weight to lose, like 150-200 pounds or more get the distal (more intestine bypassed) and those with less weight to lose get the proximal. As to which is best, that would be a discussion with your surgeon as to which is best for you. Personally, I'd prefer the proximal, or less intestine bypassed, as the more bypassed, the less nutrition is absorbed naturally(since the areas bypassed are where the normal absorbtion of vitamins from food occurs) and the more care you will have to take to supplement essential vitamins to stay in good long term health.
   — Cindy R.

May 30, 2003
i wanted a distal bypass because i needed to loose over 200 pounds, but my surgeon said "no" he does not do distal's because a person can still loose the desired amount with a proximal bypass and the side effects (like diahrrea and too much malabsorbtion causing malnutrition) and the long term effects are too advirse, so he will not do a distal bypass period, i guess it depends on your surgeon.
   — janetc00

May 30, 2003
I had a distal bypass due to the fact I needed to lose 200+. However, understanding the malabsorption issues prior to surgery, I had to commit to a strict vitamin and protein regime after surgery. I take a bunch of vitamins and 4-5 protein shakes per day. If you are not committed to intaking all of these things, a proximal might be better for you. I believe it is very possible to achieve your weightloss with EITHER type of surgery, but commitment to vitamins and protein supplementation is something you might want to take into consideration with the distal (my doc has his proximal patients supplement with vitamins/protein as well, but much less than a distal patient). For me, I am very happy I went distal especially due to my fear that sugar/milk will make me dump, so I stay away from these things. Taking all the extra vits and protein is worth it to me in exchange for dumping and great weightloss. Best of luck to you in whatever you decide is best for YOU! :)
   — [Deactivated Member]

May 30, 2003
One needs to state what they mean by these terms as there are NO national standards. Many surgeons do a 150cm bypass on people who have large amounts to lose. Some call this medial, some call it distal. Whatever you call it, 150cm bypassed is very safe and typically does not require any more vitamins than a person with 100cm bypassed. I take 2 multi-vitamins and 1200mg of calcium a day and B12 once a week. This is the same for all my surgeon's patients and seems to be pretty typical from what I have read. <p>There are a few surgeons around the country that do much longer RNY bypasses. However, there is not much documentation to indicate the long term effect of this. It would require more vitamins and most likely protein drinks for the rest of your life because with a small pouch, as most RNY's have, you could never eat enough food to keep from becoming severely malnourished. In my opinion, very long bypasses are made to go with a DS procedure because the long bypass is coordinated with the stomach changes etc. <p>The bottom line is you will do equally as well with a 100cm bypass as a 150cm bypass if you are committed to working the program to the max. That said if you have a lot to lose (around 200 lbs) the 150cm bypass will probably help the weight come off a little faster and likely help more in the long run of keeping it off. I have a min. of 200 lbs to lose and 270 to reach some ideal number on an insurance chart. My surgeon did a 150cm bypass with a 1/2 ounce pouch. The pouch size is the other critical component, not just the amount bypassed.
   — zoedogcbr