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Questions and concerns on malabsorption



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I am considering bypass surgery. My BMI is a little over 38 and I have very bad GERD with Barrette's esophagus and a hernia. Because I am obese, my surgeon as said that if the hernia were fixed, it still may not completely help the GERD because I am obese. I have been considering bypass surgery for someone time now, but had other things come up. He has told me that Bypass surgery will solve my GERD problem and he can fix the hernia while he is in there. I had originally wanted a sleeve but he said because of the GERD, he would suggest the bypass. One of my major concerns with the bypass is malabsorption. There is a lady at work who had the bypass and is on 5000 mgs of Vitamin D and is now in the beginning stages of osteoporosis. Malabsorption is a major concern of mine and one of the reasons I wanted the sleeve to begin with.

I am wondering how big of a concern has this been to you? Should it be a concern? Any info is appreciated

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I am 32 months post-op RNY gastric bypass surgery. Before surgery, I had severe acid reflux (GERD) along with a number of other medical conditions such as high blood pressure and diabetes. These conditions went into remission within days after surgery and remained there.

If you have GERD, bypass surgery is generally the recommended approach. If you have the sleeve with this condition it can make the condition worse. Several individuals on this board had sleeve and because of GERD had to have a revision to RNY gastric bypass.

I do not find that the malabsorption issue is a problem. I take a lot more Vitamins now after surgery but their cost is offset by the fact that I am no longer buying prescription medicine for my other conditions that went into remission. I think it may in all likelihood be the exact opposite. After surgery, they periodically require a complete blood workup. This nails any malabsorption issues. The Vitamin regiment is modified after these tests to correct any malabsorption issues. So my body is probably better tweeked than before surgery.

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I went through exact same thing - wanted sleeve, had bad reflux so surgeon said bypass was better, worried about the malabsorption, etc. I am only 7 months out so maybe it is too soon for me to really speak, but I can tell you that once I got past the first few months, I have really felt pretty good. I have had several Vitamin level tests and have always turned out fine. Before my surgery, I have had chronic kidney stone issues (related to a thyroid disorder / Calcium disorder) so I was seeing an endocrinologist. Even with these concerns, he was all for the bypass. He said as long as we monitor the levels and I take the supplements (which way easier and cheaper than all the prescriptions), I will be fine. And correct me if I am wrong @@James Marusek, but have you said recently that the malabsorption does eventually taper off?

My diabetes is clinically cured, I am down 115 pounds and I feel great. I have not had any symptoms of dumping (though I do follow my diet pretty strictly for the most part.)

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I am with both @@Daisee68 and @@James Marusek on this. Malabsorption is actually a good thing that helps with weight loss. As long as you take your Vitamins and get your blood work done as prescribed you don't have to worry about it.

Both surgeries require Vitamins for life.

I have a very severe case of Gerd prior to bypass. It is completely cured along with type 2 diabetes, high cholesterol, high blood pressure and stage 2 kidney disease.

I am so thankful that I listened to my doctors that recommended bypass for that reason. I originally planned on the sleeve as well and changed after recommendations from my Bariatric surgeon and gastroenterologist.

Malabsorption is nothing to be afraid of as long as you do your follow up. I have had the full nutritional panels twice now. The first time everything was perfect, the second time my B1 was a little low. We added a B1 Vitamin and I had a recheck about 3 weeks ago. Everything is normal.

Again I stress that both surgeries require calcium citrate, a Multivitamin, B12 and usually Vitamin D. If you are female and still have your period, they also recommend Iron.

This is a lot less expensive for me than all the drugs I used to have to take.

Stage 3 kidney disease

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calorie malabsorption goes away eventually, Vitamin and mineral malabsorption does not. That's why it's important to really keep on top of your supplements. From what I've heard, deficiencies are kind of rare in people who keep up with their supplements. *Most* of the people who have trouble with it aren't keeping up with their Vitamins.

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Daisee68 said "And correct me if I am wrong @James Marusek, but have you said recently that the malabsorption does eventually taper off?"

After surgery, the part of the stomach that process fats and sugars is cut away, and as a result consuming fats and sugars can lead to dumping. But after a year or so according to my nutritionist, the intestines will begin to perform this function and this type of malabsorption goes away.

But the ability of the body to process food to create Vitamins does not go away. This type of malabsorption continues for the rest of your life.

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Thank you for clarifying

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I had a gastric bypass in 2006, and for nearly 10 years now I've been anemic and low on magnesium, Calcium, iodine, selenium, Vit D. My doc was talking about a transfusion a couple of months ago, and I welcomed the idea. As for Vit D, I've been on 25,000 IU without being in the normal range. So yeah, malabsorption is real. Now that said, based on quality of life and what I knew when I had the surgery, I haven't regretted the surgery. But things went sideways for me a year ago and since then I have learned so much, not about bariatric surgery, but about IBS and auto-immune diseases. I now relate my weight to autoimmune concerns which are tied to IBS - and other digestive concerns. So, even though I am at a good weight (started at 350, now 155, but still have to work at it all the time, FYI), I'm on a gut healing diet and wishing I'd learned about that option before the surgery. The surgery will create a challenge for me in healing my gut. I came to this through Hashimoto's, the Root Cause. Assuming you don't have that particular affliction, I recommend you read The Paleo Approach, Reverse Autoimmune Disease and Heal Your Body. The blog SCDlifestyle was an eye opener, and a book I keep getting recommendations for, but have not read is The Body Ecology Diet. Even if autoimmune disease is a concern for you, these resources will help you understand the root of your GERD. So in summary, I've had 10 years of questionable health and nutrition problems and autoimmune disease challenges and I'm still having to do radical diets to find health, so you might be able to avoid surgery, resolve your GERD and lose your weight without the surgery. Me, I'm still working on it against stacked odds. Whatever path you choose, may you have the best result!

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Spiritfilled, your Barrettes esophagus, what have they done about it. My husband was diagnosed with it and they just monitor it every six months. Just curious.

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I have had life threatening complications after my GB. I had an amazing surgeon and I was very dedicated and healthy before surgery. I had GB, followed by leak in 3 days. I had a huge infection requiring my stomach be opened and 15 days in the hospital. I developed tachycardia requiring 9 visits to the emergency to stop and start my heart in less than 2 months. This was followed shortly by an ulcer and 2 more days of hospitalization. So, 3 months out from surgery I am still on a feeding tube using the detached stomach and not allowed to use my bypass. I have had daily in house nursing care to handle wounds from the opening of my stomach. I have been weak, tired, miserable, and terrified. I believe this was the worst decision I ever made. I haven't been allowed food or beverages in my mouth since the discovery of the infection. I am told by Drs I am a rarity, but you could be too. Please take this decision as the most serious of your life. If you can get back onto exercising and eating right do it. This is a last choice. Look up gastric bypass complication forums. There are so many people out there way worse off than me.

Sent from my iPad using the BariatricPal App

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A good Vitamin is one called Nutra Burst it is a liquid Vitamin which absorbs 98% into your body vs pills or capsules. One tablespoon daily is like eating 10 salads and a bunch of fruit. It can be found at www.totallifechanges.com/makeover2k15 I love it!!

Sent from my SAMSUNG-SM-N900A using the BariatricPal App

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