Question:
Side effects of Deudenol Switch

I have been considering having a DS but have heard such horror stories I'm scared. Can some DS's tell me Is it true that you have bad gas, loose stools, an odor, and gray coloring. And if so, does it last forever? I think I could probably deal with everything but the gray skin coloring and body odor. I don't mean to hurt anyones feelings I just don't know how to ask any other way.    — [Anonymous] (posted on July 28, 2001)

July 28, 2001
You think you could probably deal with everything but the gray skin coloring and body odor.. What about Malabsorption syndromes: here is a link to check out what malabsorption can and does cause http://www.merck.com/pubs/mmanual/section3/chapter30/30a.htm
   — [Anonymous]

July 28, 2001
The only thing I experience is acne-like when I was in 7th grade. Trust me it wasn't any fun then either. However, I'll take pimples over the weight any day. On occasion I may have gas and rarely diarrhea(depends if I ate too fatty of food, I also don't have a gallbladder to help the breakdown of fats)However, that happened preop too. I usually had gas if I needed to have a BM. nothings changed. The gas isn't any worse. Maybe on the rare occasion but..... I think in almost 4 months not including the hospital I may have had 2 bouts with diarrhea if that. So, for me this isn't an issue. My skin is healthy looking and people are amazed. There are 5 of us in town who have had a WLS and I'm the only DS. I know all but 1. Everyone I know tells me how much better I look. One guy looks sick-sallow,gray skin and everything. He had the open RNY! He can't eat but a few crackers and soup-his surgery was Oct. However, he says he's thrilled with the weight loss. I can eat everything and anything and I need to be careful. I have my labs drawn and will know the safe ranges so not to depend on anyone if there's a problem. I take 1 flintstone 3xday,1 ADEK 3x day and I calcium 3x day. I don't think the malabsorbtion is a big issue-for me. However, that can change and that was a risk I was willing to take. My body dsn't react as I've read so many RNY's do because mostly everythings intact-the pyloric valve,duodendum and all. Not all of us have horror stories. I definetly want to encourage you to talk to more patients about their personal experiences. Before my surgery I spoke with no less than 2 dozen DS patients alone. Only 1 had problems. I know more now that don't have complications/issues either. Any further questions please don't hesitate to ask. Open BPD/DS on 4-11 down 55 lbs and 26 1/2"
   — Linda M.

July 28, 2001
I don't know where you are hearing these horror stories but they are simply not true. You will have malabsortion with either the RNY or DS. You take supplements for the rest of your life and it's a non-issue. I don't have any more gas than I did pre-op. My BM's are looser, but that's okay. My skin looks fine, check out my profile. I have lost 80 lbs in 4 months with relative ease.
   — Tracy P.

July 28, 2001
I had the DS and am very happy with it. I would do it again in a second. I sometimes have loose stools if I eat alot of fatty foods, and it smells like Sh*t just like everyone elses, nothing a little spritz of air freshener won't take care of! I do not however, break out into a sweat or get cramps (dumping) I have full control and do not have to scope out a bathroom each time I go to a public place. I have not met any of my DS peers that have grey skin. I can eat a somewhat normal meal, as my stomach is zucchinni size, rather than thumb size. Of course everyone is different, and of course everyone is partial to their surgery. I chose the DS because from the information I have obtained, chances of keeping the weight off are better. In my support group I am seeing several RNYers attempting to get a revision to DS, which is a very difficult procedure to do from what I understand. Both surgeries can be successful. I don't think one is better than the other. It depends on you, and what your needs are. If you are an avid sweet eater, RNY may be the best route for you because your body will not tolerate a lot of sugar. If you are a high fat eater, DS may work better for you, as the fat is mal absorbed. I am able to eat sweets in moderation without it hindering my weight loss, but never had a sweet tooth to begin with, so it was never a real issue for me. I hope this helps somewhat. You can check out more about DS at www.duodenalswitch.com.
   — [Anonymous]

July 28, 2001
7-29-01 This is such a frequent question asked on this site. Go to the library and you can read so many responses already given to this query. But I will give my own 2 cents now (and again) so as to help you and others. The horror stories you have heard have probably been propagated by people who have not had the DS, know noone personally who have had the DS, have a vested interest in performing the RNY, are confused about the DS and haven't done any research into the modern BPD-DS, or are just plain studid and dangerous. The DS is not experimental, it has been offered for many years and most patients and doctors report wonderful success with few problems. It may help you to realize that the big difference and the only diference between the DS and the Distal RNY is the upper (stomach) portion of the operation. The intestinal reconfiguration and reconnection is pretty much similar in the Distal RNY and the DS. (with the exception of the duodenum intact in the DS and not in use in the RNY) Both of these operations rely on malabsorption to effect the weight loss and so why don't we all just decry the RNY as a dangerous surgery, too? Oh, I guess that is because people are more willing to accept the explanations for malabsorption as long as it is associated with a RNY but align malabsorption with the DS and you are going to suffer, smell, discolor, and generally walk around like Charlie Brown's Pig Pen in a never ending search for a bathroom nearby!!! I know that if you read about people who have had any distal proceedure, like Michelle Curran, Vitalady, who is well respected here on AMOS (because she is so well informed) she has a distal RNY and takes vitamins and supplements every day and in massive quantities. (In all fairness, too, she needs to take extra nutrients because with the RNY-Distal she does not have a stomach to function in food digestion nor does she have the duodenum in her food track to help with the absorption of calcium and other nutrients as does the DS patient, but she advocates supplimentatin for DSers due to the malabsorption-I agree, too, to a point) But taking vitamins, calcium, iron, or eating protein first and in sufficient quantities is usually all that is necessary to maintain good health with the DS. As far as turning color, I truly have not heard of this other than people who just look pallid due to illness or other conditions. Remember that just because a person has had WLS that does not mean that everything experienced is caused by the surgery. That would be like saying that everything that was wrong with us preop was because we were fat, from diabetes to ingrown toe nails (sound familiar?) Also to address your concerns about bowel movements and gas, yes, there are usually more frequent bowel movements and gas with the DS and any Distal RNY because they are designed to malabsorb, they are supposed to pass undigested, unused food so that the body doesn't take it in and make us stay fat or put on weight and if that is yur concern do not have any distal proceedure and definately do not take Xenical) That is is component of the Distal RNY and DS that has been studied and adjusted over time to effect the greatest weight loss with the minimal side effects. Prior DS and Distal RNY surgeries had a common channel of 50 cm. and there were many instances of diarrhea, frequent loose or soft stools, and gas and other problems related to malabsorption. So the doctors and scientists, after publishing data and as modern technology and practices advanced, have found that increasing the common channel to 100 cm, in effect doubling the length, have virtually eliminated the former problems (pardon the pun) and yet have still seen tremendous weight loss, like having the good without the bad intestinally. This is all a part of the modernization and evolution of surgical treatment of obesity and this entire intestinal component is to be studied and considered when making a choice for surgery. Many doctors who recoil at the thought of the DS will operate and create a Distal RNY and so have basically created a DS (type) intestinal track and then there are many doctors who would never construct a distal or medial RNY due to concerns about deficiencies and so only do proximal reconnections. That is the doctor's choice and may not be yours, but people have lost tremendous amounts of weight with Proximal RNY and with Distal RNY and with BPD-DS. Sometimes it feels like a witch hunt out there in WLS-land due to people's destructive misinformation. A chief offender, unfortunately, is the ASBS site and NIH sites, which both have very old information about the BPD which is virtually never, ever done anymore, and so little, about the BPD-DS (information is so old about this different operation, the BPD-DS is not the BPD, get that right) which is the modern operation which is the Gold Standard in this surgery class, and make no mistake the DS is not the same thing as the BPD and that is where misguided souls are so dangerous. To say that you will have all these problems with malabsorption is just not fair. Would people on this list tolerate the constant misinformation about the RNY or VBG? We have seen that they will not and are constantly defending those operations. It is not a matter of defending and going to war over the different operations, it is about getting accurate, realistic information out there and a person truly doing all the research into every type of option. I know many, many RNY people, proximal, medial, distal, transected, not transected, BPD-DS with 50 cm. common channel, 75 cm. common channel, 100 cm. comon channel, and everyone experiences different things. I think to listen to the scare tactics and what not is too bad. That is like accepting all of the hideous misinformation about WLS in general. We have all heard about how this surgery won't work, how this surgery will kill us, how this surgery will prevent us from ever eating more than a thumbful of food, and on and on it goes. And we know that all of that isn't true, that those people are ignorant and referencing what happened 25, 30 years ago. WLS has come so far, just like heart surgery, limb reattachments, or cancer treatments, and modern medicine is constantly retooling and modifying treatments and methods to have the best outcomes with the minimal risks and side effecdts. Please, do not only go by what "they" say. Go to the source and get accurate, current research. It is a pity that so many people say they have thoroughly researched WLS and then can't tell you anything about the DS, saying well, that's not the operation I had. Your point? You said you did research into WLS, well, maybe not. Be aware that the DS is a great operation but not readily available in most of the country so that may limit your options but it doesn't limit the availability of information. Lest anyone feel the need to rant and rave about all of this, I will tell you that I had a Lap BPD-DS on January 6, 2000 (weighed 375 pounds) and I personally have experienced significant loose stools, gas and diarrhea. (I also have diverticulosis pre op so was more predisposed to possible problems)Dietary modifications will sometimes help this situation (gee, just like the RNY have to make dietary modifications regarding sugars and sweets) but over all I look just fine, never looked better in my life, (could that be because I lost 210 pounds, all the comorbidities, and wear a size 14) and whatever adjustments I needed to make regarding my bowel movements I have adapted to. Same with all the adaptations I had to make regarding the supplements I need to take. like less of them. like no more diabetes medication, no more hypertension medication, mo more antidepressants, no more diuretics, no more pain medicine, no more cPap, no more anything than before. Just the vitamins and their variations (iron, calcium, etc.) Of course there are people with situations that are individually considered, exceptions to the norm, that is why research documents all events, and why you need to see what is an acceptable risk to you, (for me diarrhea wasn't a risk, it was already a frequent part of my life anyway) but to label one operation with false accusations is wrong and I hope that you will carefully consider what I have written, at length!!! :-)
   — Fran B.

July 29, 2001
At almost 2 years postop Open DS, I always get a chuckle out of questions like this. Once you do more research, go to DS support groups where you can see postop DS'ers first hand, you will get the same chuckle! Fran said it best. These rumors are based on uninformed/misinformed people like the anonymous poster below. The DS does not cause Malabsorption Syndrome. This is exactly how incorrect information gets started. The DS has a malabsorption aspect to the procedure meaning, you will not absorb a certain percentage of calories and nutrients. The nutrient part is compensated, in my case, by taking a daily multivitamin and a couple of Viactiv every day. That's all there is to it. If you are commited to the surgery and compliant with taking your vitamin every day, there will be no nutritional deficiency, only weight loss, and more importantly, NO WEIGHT REGAIN! RNY patients also have to take daily suppliments, in larger quantities, from what I understand, including iron & some of the B vitamins. The gray coloring....now that's a new one....For over 2 years I've asccociated with postop DS'ers and their skin in not gray. Personally, my skin has never looked better. Preop now, that's a different story!! My skin was horrible! You're just in the beginning stages of research, like Fran says, go to the source: http://www.duodenalswitch.com. There you can see, not only the clinical published reports and get the straight facts, but you can see over 100 DS patient profiles... Look at their before & afters. You're doing great asking these questions! Keep researching...you'll find the facts...Good luck to you! http://www.mywls.com/discus
   — [Deactivated Member]

July 29, 2001
I am the original poster of this question. I want to thank everyone for answering and I wanted to let a few people who commented on my question know that the horror stories I have heard were from the doctor I was considering for my RNY. After reading Fran's comment, just as I realized when he was telling me, he has a vested interest since RNY is the only procedure he does. (Although he does distal as well as proximal) So I will take your advice and continue to do my research. And yes, I have done quite a bit of research on the RNY, but have not on the DS. I couldn't find a lot of information on the list because not every category has questions. I also consider asking questions in this group part of my research.
   — [Anonymous]

April 29, 2002
Doing all the research that I,ve done, The real question should be distal, medial, or proximal. The D/S is great in that you retain a functional stomach that predigests food before entering the intestines. There is no trouble with blockages with the D/S. The trouble with gas and loose stools should be less with the D/S than with a Distal RNY because of the predigestion done in the stomach also vitamin absorbtion should be a little better. but when you compare a D/S with a proximal RNY the gas and stool problems are a little worse with the D/S. The D/S does have a better success rate with weight loss and maintaining the loss. Both are better by far then Jenny Craig....lol
   — Mark L.