Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Feedback please!! Sleeve verses bypass



Recommended Posts

Bypass -I only dumped once very early due to flavored meds. I sometimes get discomfort like a dull ache with too much sugar but No nausea/vomiting. I ate a half piece of pumpkin pie (so 1/16 of the pie) and didn’t dump. I’ve had a mini piece of Halloween candy, 1 cookie or 1-2 bites of regular ice cream and never did. Each time was only that 1 thing and I purposely ate Protein with it so it wasn’t just sugar on an empty stomach. No alcohol trued as of yet and no plans to. I had GERD so felt for me the sleeve wasn’t an option.

Share this post


Link to post
Share on other sites

Any of these procedures may predispose you to some kind of problem as a result of the anatomical changes that the surgery makes; this doesn't mean that you will have such a problem, just that the problem shows up in more often than in the general population.

With the sleeve, the main predisposition is for GERD, as a result of cutting back the stomach volume more than its' acid producing potential - usually the body adapts and adjust things over time, but sometimes it doesn't. I have mild GERD which is well controlled with mild OTC medication; a few get it so severe that no med controls it and they have to get their sleeve revised to correct it, while others - most people - have no problem with it at all. GERD problems may also result from poor surgical technique, and was more common when the sleeve was new to the WLS world 8-10 years ago and most surgeons were still figuring it out (this is why I traveled to a practice that had already been doing them for some twenty years, so avoid this kind of "learning curve" problem. Most surgeons in the US today are experienced enough with it that this isn't much of a problem anymore, but it does seem to show up more in countries that are farther down that learning curve, such as Canada and Australia.

People with the bypass will also sometimes develop GERD, though usually more in line with general population numbers, and seems to often be associated with chronic over eating, volumetrically if not calorically.. This may also be why some with the sleeve also develop GERD after some years.

The bypass is predisposed to dumping and its close cousin, reactive hypoglycemia, as a result of rapid stomach emptying from the lack of the pyloric valve in the active GI system metering the stomach contents into the intestines. Some people with the sleeve, or even no stomach surgery at all, may dump as well, but it is rare. It is generally controlled with additional dietary restrictions.

The bypass is also predisposed to marginal ulcers, typically around the anastomosis between the stomach pouch and intestine. This is a result of the section of intestine being used not being resistant to stomach acid like the duodenum is (the part of intestine immediately downstream of the stomach in the natural anatomy, which is bypassed along with the remnant stomach in the RNY), leaving a very sensitive suture line that is easily irritated. This is why NSAID pain relievers and other similar medications are a big NO-NO with the RNY, but are better tolerated with the sleeve based procedures; one still needs to be cautious with them, but they are more usable with a sleeve than a bypass.

For the benefit of the OP, with no prior GERD history, but a history of orthopedic problems, I would be inclined to go with the sleeve, owing to its better tolerance for the various pain relievers that you are inclined to need at different times.

Good luck - none of this is easy, as it is often a matter of trade offs, and sometimes it's less a matter of good vs. bad as it is bad vs. less bad, or bad vs. not-great.

Share this post


Link to post
Share on other sites

Thank u so much.
Have a speedy recovery!!!😊

Share this post


Link to post
Share on other sites

3 hours ago, RickM said:

This is why NSAID pain relievers and other similar medications are a big NO-NO with the RNY, but are better tolerated with the sleeve based procedures; one still needs to be cautious with them, but they are more usable with a sleeve than a bypass.

great feedback overall - although one thing I wanted to comment on: a lot of surgeons are now advising their sleeve patients to avoid NSAIDs, too, so this may or may not be a factor anymore...(back when I had my surgery, it WAS, but now - not as much. Some (medical) opinions have changed on this...)

Share this post


Link to post
Share on other sites

3 hours ago, catwoman7 said:

great feedback overall - although one thing I wanted to comment on: a lot of surgeons are now advising their sleeve patients to avoid NSAIDs, too, so this may or may not be a factor anymore...(back when I had my surgery, it WAS, but now - not as much. Some (medical) opinions have changed on this...)

Yeah, the recommendations vary from doc to doc. Early on, most surgeons simply copied their RNY protocols for their sleeve patients - diet, supplements, drug interactions, etc. Those who had been doing sleeves for a long time - primarily the DS crowd - had lots of experience indicating that NSAID use was fairly benign (indeed, that was one of the selling points for the DS or VSG over the RNY.) As more got familiar with the sleeve, they often loosened up on their restrictions. At the same time, the medical world in general has become more cautious about NSAID use in general - for everyone - so we have two conflicting trends. The main point is that there is a physiological difference between the two procedures that influence their relative tolerances for these meds, and that is something that should be considered in these decisions. Ideally, none of us will need to take these meds, but the world isn't ideal, and that's where these compromises come into play.

Share this post


Link to post
Share on other sites

I personally chose the sleeve. It matched the excess weight I wanted to lose, seemed to be the less invasive surgery and according to my EDG I've never had GERD or issues with that. I also wasn't interested in dumping or anything so I wanted sleeve from the start.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

    • Aunty Mamo

      Tomorrow marks two weeks since surgery day and while I'm feeling remarkably well and going about just about every normal activity, I did wind up with a surface abscess on on of my incision sights and was put on an antibiotic that made me so impacted that it took me more than two hours to eliminate yesterday and scared the hell out of me. Now there's Miralax in all my beverages that aren't Smooth Move tea. I cannot experience that again. I shouldn't have to take Ativan to go to the lady's. I really looking forward to my body getting with the program again. 
      I'm in day three of the "puree" stage of eating and despite the strange textures, all of the savory flavors seem decadent. 
      I timed this surgery so that I'd be recovering during my spring break. That was a good plan. Today is a state holiday and the final day of break. I feel really strong to return to school tomorrow. 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
      For second breakfast on workdays, I will have a low-fat yogurt with two tablespoons of PBFit and two teaspoons of no sugar added dried cherries. I will have ingested 35-45 grams of protein at this point between the two breakfasts, with 250-285 calories, and about 20 carbs.
      For second breakfast on non-workdays, I will prepare two servings of plain, instant oatmeal with a tablespoon of an olive oil-based spread. This means I will have had 34 grams of protein, 365 calories, and 38 carbs. Non-workdays are when I am being very active with training sessions, so I allow myself more carbohydrate fuel.
      Snacks on any day are always mixed nuts, even when I am travelling. I will have 0.2 cups of a blend that I make myself. It consists of dry roasted peanuts, cashews, pumpkin seeds, sunflower seeds, pistachios, and Brazil nuts. This is 5 grams of protein, 163 calories, and 7 carbs.
      Breakfast and snacks have been the easiest to nail down. Lunch and dinner have more variables, and I prepare enough for leftovers. I concentrate on protein first, and then add vegetables. Typically tempeh, tofu, or Field Roast products with roasted or sautéed vegetables. Today, I will be eating leftovers from last night. Two ounces of tempeh with four ounces of roasted vegetables that consist of red and yellow sweet peppers, sweet potatoes, small purple potatoes, zucchini, and carrots. I will add a tablespoon of olive oil-based spread, break up 3 walnuts to sprinkle of top, and garnish with two tablespoons of grated Parmesan cheese. This particular meal will be 19 grams of protein, 377 calories, and 28 grams of carbs. Bear in mind that I do eat more carbs when I am not working, and I focus on ingesting healthy carbs instead of breads/crackers/chips/crisps.
      It's a helluva journey and I'm thankful to be on it!
       
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×