I think the issue is more with the duodenal switch patients because the duodenum is taken out it's the a portion of the intestines where the enzymes are... along with a portion of the intestines the stomach and the appendix along with the gallbladder.. it doesn't really affect patients that have had the roux-en-y the lap band or the sleeve. Sorry to hear about the constipation. I've been there maybe three times since 2012.