Question:
Does our malabsorption have a time limit?

I just read somewhere recently that after awhile (approx. 18-24 mo) our malabsorption we have from RNY surgery ends and our small intestines begin to absorb normally again. Then I recalled my surgeon's Nutritionist I saw pre-op said basically the same thing when I saw her back in August, 2002. Could all this true???? If it is true, does it matter if you're distal or proximal? I know over time our pouch stretches somewhat too, so does this mean our tool actually expires? Please help me get informed on this issue. I was so upset when I realized what was being said. Thanks bunches!!    — thumpiez (posted on March 6, 2003)

March 5, 2003
Very intersting question, and it poses more. If all is true, why do we have to continue to take B12 shots and all the extra iron, calcium, etc.? I will be interested in hearing from others with more knowledge than I. Jill
   — Jill C.

March 5, 2003
This is precisly what I have been told. Our small intestine grows villi (sp?) which then starts to absorb. Yes the pouch will stretch but they are talking about from 1/2 oz to maybe 3-4 oz, not back to the football. So you will always have restriction working for you if you listen to your body. <p>In answer to the other poster you will always need B-12 because you no longer use your old stomach. The intrinsic fator is produced in the old stomach and that is how b-12 is absorbed etc. Just because our small intestines learn to absorb they do not suddenly start functioning like our old stomachs. So resign yourself - vitamins and b-12 and calcium the rest of your life. A small trade-off in my book.
   — zoedogcbr

March 5, 2003
Ewe...this thought traumatizes me, as I think the malabsorption has been the main factor in helping me reach a normal size - I better get and keep those good habits, and QUICK!
   — rebeccamayhew

March 5, 2003
My surgeon told me that after awhile, the body compensates to absorb more, so yes, I would say you would absorb more as time goes on. The pouch stretches some, but not to pre-op size. It will still be a "tool". These changes are why surgeons push patients to optimize the so-called "window of opportunity".
   — mom2jtx3

March 6, 2003
After surgery, our bodies fight very hard to get back to "normal." The portion of our intestines that remains in the food tract adjusts during the two years or so to absorb more nutrients. During this "intestinal adaptation" period, the small bowel lengthens and balloons, the villi become larger, and peristalsis slows. Basically, our bodies are doing everything possible (through little understood mechanisms) to allow us to absorb more of what we eat. Whether or not the adaptation completely compensates for the intestinal bypass probably depends on how extensive the bypass is. There is actually a study going on right now at Mt. Sinai in New York City that is looking at post-WLS absorption after the RNY and the BPD-DS. One of the members of the Duodenal Switch Yahoo group is participating in the study. She is several years post-op from the BPD-DS, and her personal results show that she is currently absorbing only 50% of the calories she consumes. (Don't ask how they determined that...let's just say she went through a lot of s*** in the name of science! :-)) This is similar to the results of the 1998 Scopinaro report on the BPD, which found that, on average, BPD post-ops were absorbing 58% of their calorie intake at 2-3 years post-op (the range was 32%-71%). So, it's pretty clear that the process of intestinal adaptation does not overcome the malabsorption of distal procedures. Hopefully the new Mt. Sinai study will shed more light on this issue for RNY patients as well.
   — Tally

March 6, 2003
It is my understanding that the reason good eating habits, protein, vegies, fruits, carbs is so important is that when it does start back you will be able to maintain (even continue to lose some). If it stayed the same with the low absoration, you would continue to lose. You may have read on the message board that there are a few that are having this problem now. They are still losing and losing too much.
   — Cookie G.