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I had bypass 10 years ago. It cured my GERD. For most people, bypass improves if not cures it.
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By your logic we should also call DS & SADI sleeve gastrectomies. Heck, it's even in the name for SADI-S: single anastomosis duodeno-ileal bypass with sleeve gastrectomy. Either way, both surgeries probably have more in common with sleeve than traditional bypass in that they retain the pyloric valve and the bulk of the stomach is removed. Yes, they all bypass a section of the small intestine, but RYGB only bypasses the duodenum whereas traditional DS bypasses the duodenum, jejunum, and proximal ileum. SADI-S sort of splits the difference. Where and how much of the small intestine is bypassed makes a HUGE difference in nutrient absorption since the various parts of the small intestine affect absorption differently. Grouping them all together just because they bypass a part of the small intestine makes as much sense as grouping them in with sleeve gastrectomy since they also are pyloric-sparing surgeries. Aside from the technicalities of the surgeries themselves, In practice DS/SADI are pretty rare, so trying to group them in with RYGB just seems really odd to most of us here. Heck, the name of the surgery specific board here is "Gastric Bypass" not "Roux-en-Y gastric bypass". If that's not enough for you, just do a Google search for "gastric bypass". Pretty much every result you get is going to be one that is using the term interchangeably with Roux-en-Y gastric bypass. Let's get back to the question at hand and why I called this out. By you grouping all three of these surgeries together and claiming they all need additional supplementation of vitamins ADEK is factually incorrect. Gastric Bypass patients do not need this. For someone that seems concerned about taking vitamins that "aren't needed", please don't spread misinformation about what others need.
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Having second thoughts
catwoman7 replied to monikapaintsstuff's topic in PRE-Operation Weight Loss Surgery Q&A
there really isn't malabsorption at all with sleeve. There is with bypass - that's why we take more vitamins than sleevers. But the vitamin thing is really second nature after a while - you just go on autopilot. major complications with either surgery are pretty rare. With sleeve, the most common one is GERD, but not everyone gets it, and for most who do get it, it can be controlled medically (e.g. pantaprazole, which you said you're already taking). Some people with severe GERD do revise to bypass, but it's not a huge percentage that have it that badly. But yes - it IS a potential issue. The most common issue with bypass (besides dumping, which about 30% of us deal with (I never have), but that can be controlled by not eating a bunch of sugar or fat at one sitting, which we shouldn't be doing anyway). The second most common is a stricture, but those are an easy fix. They just do an endoscopy and stretch it out. I had one. Happens to about 5% of us, according to the PA in my surgeon's office (if they're going to happen, it'll be within the first three months after surgery - it's very rare for them to occur after that). if you need more time to think about this, though, then take it. It's a big decision. But as SpartanMaker said, you almost never hear anyone say they regretted it. The only regret most people have is that they didn't do it sooner. I had it at age 55. I wish now that I'd done it at least a decade earlier. P.S. I had GERD prior to surgery, so I went with bypass. I know the chance of having it get worse (for those who already have GERD) with sleeve is only 30%, but I didn't want to risk it. Besides, sleeve was still pretty new when I had my surgery, and I was a little afraid of it turning into "lapband 2" - but it's been around long enough at this point that I wouldn't have had that particular worry. It works well and it's safe. But I still would have chosen bypass for myself because I was afraid I'd be one of those whose GERD would get worse. -
Why did you prefer Gastric Sleeve over Gastric Bypass?
FifiLux replied to HopeBar's topic in Gastric Sleeve Surgery Forums
Sleeve was recommended to me by the surgeon as I have pernicious anaemia and after reading up on both I felt the sleeve was more for me, so I could be in more control, especially given that I could then get a revision to bypass if needed. -
Having second thoughts
monikapaintsstuff replied to monikapaintsstuff's topic in PRE-Operation Weight Loss Surgery Q&A
I don't know much about that, is it different from the sleeve and the bypass? -
Hello! My name is Zach, and I am a 2nd year medical student conducting a research project, "Evaluating GERD symptom alleviation following robotic Roux-en-Y gastric bypass surgery", which essentially seeks to evaluate the efficacy of robotic gastric bypass surgery in relieving GERD symptoms. I was interested in minimally invasive surgery long before starting medical school, and decided to spend my past summer working alongside a bariatric surgeon in my hometown. While working with him, I noticed how many of his patients stated that their GERD had resolved after undergoing robotic gastric bypass. My time there was limited, so I was not able to really share this survey with his patient population. Below is a link to a survey that follows the guidelines outlined in the official GERD health-related quality of life questionnaire. I would greatly appreciate your help with this! My goal for this survey is that your responses will allow me to publish a paper from an educational perspective, illustrating how efficacious robotic gastric bypass is at alleviating not only weight loss, but symptoms of GERD as well. While I hope that all of you have had nothing but success following your surgeries, I understand that this is not always the case. I would love to hear all of your various experiences and perspectives, whether they are positive or negative. This survey below is entirely anonymous. You should not be asked to sign-in to Microsoft in order to complete the survey, and I will not have access to your name or any other patient identifiers aside from your age. When you first open the link, you will see information regarding informed consent. After agreeing to participate, you will then see seven screening questions. After that, you will begin the actual survey, in which you will answer questions regarding various symptoms before and after your surgery. This survey should take about five minutes of your time. Survey link: https://forms.office.com/Pages/ResponsePage.aspx?id=5CBDHRt_fk2_8ubn-Q2YhAxSQabe5PdIrhihxZU9cCZUQ1hSQjE3WkozVEFHTUQ5N0RTNERSMUNPMy4u If this type of post is not allowed, I understand and apologize! I hope to have the opportunity to share your experiences with this survey and shed some light on the relationship between gastric bypass and GERD. Thank you all in advance! -
How much in ounces am I supposed to be eating after bypass
RissaLyne posted a topic in Gastric Bypass Surgery Forums
I'm kind of confused on how much I should be eating at this point? I don't want to over eat. -
Heartburn and hernia--time for bypass?
ajb1029 replied to ajb1029's topic in Gastric Sleeve Surgery Forums
So update-spoke with a surgeon today who recommended what I have been thinking--hernia repair and do the bypass. I had worries about lack of iron absorption with the bypass but I found out today because I am having to use so much famotidine I basically have very little to zero acid which is necessary for absorption so famotidine is REALLY unsustainable. Also found out on fluoroscopy, my sleeve is not dilated, but I have a kink at the top, which he said is not helping the reflux on top of the hernia. So now I need all the prayers, warm vibes and well wishes that my insurance can do the right thing and not make this a huge pain in the ass to the point I give up and go to Mexico. Also-just to get my ducks in a row--anyone SUCCESSFULLY fight and get a revision covered for use of medical need not weight loss where it normally wouldn't be covered? I'm not gonna lie, I'm not hopeful. Also, does anyone have experience with and can recommend the best Mexico center for sleeve to bypass with hernia repair? Just so I have plan B. Thanks for any insight or help anyone can give!! Sent from my SM-S908U using BariatricPal mobile app -
Wegovy not working
ShoppGirl replied to wendywitch7's topic in GLP-1 & Other Weight Loss Medications (NEW!)
That’s awesome. I have been very pleased with my revision to SADI. My surgeon didn’t mention the intestine length thing but he did have me do the barium swallow, an endoscopy and a gastric emptying study before saying that the SADI would be an option as well as the bypass and it was up to me which I wanted to do. There are pros and cons to the SADI revision. statistically (which by definition means there are outliers that are more or less) but the majority of people lose faster and the loss is more durable which got my attention but the possibility of bathroom issues is significant (fortunately I didn’t have this at all until I recently started chemo but I don’t think it has anything to do with the surgery). One con though of SADI is that many doctors have never heard of it. From my family Dr, to the urgent care, ER physicians, gyno, radiologies, breast surgeon, etc. Even the gastro dr who will be doing an endoscopy and colonoscopy on me Monday has never heard of the SADI but my bariatric doctor said he will explain my anatomy to her and it will be fine. I always tell them it’s a modified version of the Duodenal Switch with one anastomosis instead of two and if they still look confused I tell them it’s not exactly but kinda like a bypass and a sleeve combined. But obviously I need the person putting a camera in there to understand better than that. I think you will be very pleased with your results from either one but another thing to consider is if you have a complication or need revision to the SADI how many doctors are able to operate on you. My surgeon told me that if I had a complication he would stabilize me but he would send me to a nearby hospital if I needed any type of revision. I appreciated that he was willing to admit his limits and I was okay with that but I guess it is a risk you may want to ask about. Your surgeon may very well have done lots of these but mine had not. Also, not a lot of doctors will do a revision to the SADI just because of regain. You would be more likely to find someone to revise a bypass. Not that we are hoping to need a third surgery but obesity is complex and a lifelong struggle so it’s something to think about. I wish you the best of luck. And hope to hear about your surgery date soon. -
Hello, On 8-12-21, I had a revision from a VSG to a SADI ( mini bypass). My doctor did not adjust my sleeve and now I’m several days postop and I am left with the same hunger and food intake capability that I had before the surgery. I’m just curious, if anyone else had the SADI that didn’t include an adjustment to your stomach, and if so what was that Experience like for you? Were you satisfied with your weight loss? I’m starting to get concerned, did I choose the wrong revision or surgeon.
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My lap band removal was terrible. I lost a lot of weight in the beginning and ended up gaining all my weight back and then some after a couple years of having the band. I kept it about 10 years. I had my band out last January and ended up having bypass last October. The band removal was very uncomfortable, i had a drain and I just felt overall terrible compared to bypass which was an easy surgery for me….that band was the Bain of my existence personally….bypass a lot lot lot better so far for me. Good luck and get that miserable thing out.
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Bypass surgery in a couple of day and panicking!
Justarwaxx posted a topic in Gastric Bypass Surgery Forums
Hi 👋 currently at the pre op anesthesia appointment with a mild cold and scared my surgery would be postponed (even tho it's for my safety) but I think I am already mentally ready for it so I just want to get it over with. From where j am, there is no pre op diet. I just get into it so I've been having mini food funerals .. I am ready to do it and I'll need ur support because my negative mind gets the best of me. (What if I don't lose weight? What if I regain it all? What if .....) My operation is confirmed for 15th Aug (if I pass the anesthesia today) Wish me luck -
Obviously you need to decide what's right for you. I was in the same boat as you in that they discovered inflammation during my EGD. I had already been leaning toward RYGB anyway, but that sealed the deal as far as I was concerned. My doctor stressed that even though I wasn't having issues with GERD, there was a strong possibility I'd develop issues if I insisted on SG. As far as risk is concerned, all surgeries carry some risk and since RYGB is a more complex surgery, you are correct that some studies show a marginally higher risk profile. Interestingly, other studies show no difference. Keep in mind that obese people are all going to have a higher surgical risk for ANY procedure than a normal sized person. Other factors that increase risk are things like heart disease, diabetes, smoking, etc. Also, surgical experience and the quality of the facilities play a huge role in overall risk. My point is that cross sectional studies showing risk are not equivalent to YOUR risks of surgery. In terms of "convertability", I think my opinion is somewhat the opposite of yours. Technically, RYGB is completely reversible, since unlike SG, nothing is removed from your body. This to me was a huge plus in my decision making process. When we look at revisions, keep in mind that revision of SG due to GERD is pretty common and those revision surgeries basically revise the patient to gastric bypass to alleviate the GERD. I can't speak to your malabsorption concerns since first of all, malabsorption in and of itself is potentially a good thing for weight loss. i can see a concern for malnutrition, but I was willing to commit to a lifetime of vitamin and calcium supplementation. I also try hard to eat a fairly healthy diet, thus also upping the chances that I have no issues with malnutrition. If you are not willing to commit you those things then yes, this may be an issue for you. Keep in mind that while it's less common, SG patients can also suffer from malnutrition. It's actually recommended that all bariatric surgery patients use supplements and eat a healthy diet and I think as long as you do those things, neither surgery is going to be an issue. Best of luck whatever you decide.
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Seriously considering VSG to RNY revision 10yrs later
GreenTealael replied to mi75's topic in Revision Weight Loss Surgery Forums (NEW!)
I never see anyone as far out from revision as I am (5+ yrs) post here anymore. Where are all of our Vets? Go with a surgeon who does a lot of revisions if you can. They may have more experience with complicated anatomies. Good luck! -
For me it has been a life changer. I had the sleeve and lost weight but not as much as I had hoped and then I gained it right back plus some. Never did have the metabolic changes or the changes that made it a little easier to eat healthy so when I got done with my SADI revision I know right away that it was going to be different this time. I mean I still want pizza and burgers but I don’t hate chicken and fish now either so it makes it a little easier to make the healthy choice most of the time. I also exercise a lot and I think that has made all the difference in my commitment to my new lifestyle as well as My mood and overall health. Obviously I can’t say I know if it would have been better or worse with the Bypass but statistically as a revision the SADi does provide more loss and a more durable loss. Of course it is never so not as much long term research has been done and bypass is the tried and true gold standard but as a revision the loss is statistically less than as a virgin surgery. I think for me it was a perfect fit but you will want to keep in mind that you need to understand your surgery well enough to explain it or call your surgeon and ask them to when it is appropriate. Most of my doctors have never heard of it and when I was about to get an endoscopy/ colonoscopy done and the dr hadn’t heard of it I called my surgeon to see if that was okay and he called to explain my anatomy to them. Another thing to consider is whether you surgeon is resleeving your stomach. Mine did not. He said the difference in weight loss was not significant amount to take the risks that come with reducing the pouch. Something to do a bit of research on to decide if it’s worth it to you. If you have any specific questions about my experience let me know.
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Has anyone else experienced severe, stabbing pain in the left side of their abdomen after eating - sometimes not even then but random times. About 3 inches to the left of the navel that is sharp & stabbing. Bowels normal for patient, never experienced constipation, no particular food sets it off and lasts for up to 30 minutes? Patient is 4 months post sleeve revision to mini gastric bypass.
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Happy Friday everyone! 😁 Hope we are all doing well! It is bloody hot in the UK today so I am doing my best not to melt in my office 😩 My bariatric nurse has flat out told me I need to be eating more, and I am really struggling to get on top of this. She tells me to aim for 20 mouthfuls per meal 😥 I will keep pushing myself by eating more frequently, but I would love to introduce more fruit into my diet. Are there any fruits which I should stay away from to avoid dumping with the bypass? I know berries are like the gold standard, but I am a bit nervous about other fruits! So far I have only had some raspberries and kiwis 🤣
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Having second thoughts
SpartanMaker replied to monikapaintsstuff's topic in PRE-Operation Weight Loss Surgery Q&A
Regarding malabsorption of gastric bypass, I find that most people contemplating surgery way overestimate the impact of this. In gastric bypass, only a small part of your small intestine is bypassed. Just from a nutrient absorption perspective, the amount of malabsorption is around 5 to 10%. That's really an oversimplification however, because different nutrients are absorbed differently across various parts of the small intestine. I'm not an expert on depression meds, but if that's your major concern, it's entirely possible your current prescription might work just fine if you did end up having bypass surgery. I don't take any depression meds, but I do take a pretty high number of other medications and have not had to take MORE of any of those meds due to malabsorption. In fact, most of them I've had to reduce or stop entirely because I'm a healthier, smaller person than I was before. Even if it did become an issue for you, I'm sure your doctors would be able to find the right combo of meds for you. Regarding remembering to take vitamins, it's really not a big deal. Like anything, you get used to it over time and there are ways to remind you if you need those reminders. -
Mini Bypass reversal
Arabesque replied to lessismore1001's topic in Mini Gastric Bypass Surgery Forum
I think you mean revision. A reversal would mean they rejoin your digestive system to what it was before surgery i.e. back to normal anatomy. (It’s high risk and your digestive system may not function the same or as effectively.) You can’t reverse a sleeve. But if you’re going from one type of weight loss surgery to another where they alter your digestive system further like sleeve to a bypass, or bypass to Sadi, etc, that’s a revision. It may change the responses you get unless you do mean reversal of course. 😊 Revisions aren’t uncommon, for various reasons, but haven’t heard of a reversal here. -
also, your surgeon may not want to do a re-sleeve. Some still do but many consider it to be too risky and it yields too little reward (the weight loss for a second sleeve is statistically less than a virgin sleeve which is already less than the other surgeries). The typical surgery for revision is usually the bypass although a newer alternative to that is to revise to a surgery called the SADI which is what I just did and it is a little more aggressive so it yields faster loss and so far the research shows more durable loss as well. I have lost quite a bit rather quickly with it. You don’t need to know any of this yet. Your doctor of course will know if any of the options apply to you and explain them at that point but just know that it may be a little different surgery if you do go with a revision. One that alters your intestines this time which is a bit riskier.
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My understanding is sleeve is more prevalent as a first time surgery, but a not-insignificant number of people have revision from sleeve to bypass down the road because of GERD or insufficient weight loss. There are reasons you may choose one over the other, and you want a surgeon who is just as comfortable with either. If he is suggesting one because he's better at it (sleeve is a much easier surgery to perform) then he is not the surgeon for you! This video has some good information on both surgeries from a doctor who does both:
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Conversion from sleeve to bypass
Mark1107 replied to Georgetown's topic in Revision Weight Loss Surgery Forums (NEW!)
Just switched from the sleeve to bypass. I had a hh the first surgeon didn’t fix. Been in constant pain for 5 years with ulcers and major gerd. Now with bypass surgery last weekend already I can drink with out hurting. I’m excited to experience life again after 5 years of misery. The bypass is the way to go. -
Conversion from sleeve to bypass
Chelle Parris replied to Georgetown's topic in Revision Weight Loss Surgery Forums (NEW!)
I just had a sleeve to bypass 3 weeks ago 23lbs down so far. -
I had bypass surgery and have always had GERD. Treated with omaprazole and lifestyle. Surgery was still the best thing I ever did for myself. Gerd is nothing compared to being 100 pounds overweight.
