Hi, I'm trying to decide between sleeve and bypass, and I know the vitamin requirements are more stringent with bypass. Are the vitamins you need to take after bypass all available in chewable/liquid/small tablets, or do you have to take capsules or large tablets? I can't swallow capsules and struggle with larger tablets.

Also, how common are vitamin deficiencies after bypass? If I've had B & D vitamin deficiencies before (I had a B12 deficiency when I was vegetarian that did not improve with supplements...had to start eating fish and eggs to correct it, and have to take at least 10,000 IU of Vitamin D daily to have normal levels), am I more likely to develop vitamin deficiencies if I get bypass? I'm afraid of the malabsorption if I may not respond as well to supplements...

I uses Vitamin patches from PatchMD. Before bypass I had a hard time swallowing pills because they would get stuck because I also had a restriction. Now I just take so many other pills that I use the patches because they are easy.

I am just over 3 years out. I have my vitamin levels checked every year. 1st year I was a LITTLE low on B12 & this past year B12 was good & I’m slightly low on D. B12 can be fixed with a shot every few months. D is no big deal.

My daughter uses the chewable from BariatricPal. Her doc said they should be chewable that is going to break into a powder or like a starburst but NOT like a gummy.
Talk to your doc office & see what they want you to do.
Pretty much everyone should take a daily vitamin anyway.

vitamin deficiencies aren't common at all as long as you keep on top of your vitamins. My clinic has both types of patients (VSG and RNY) on the exact same vitamin regimen. It's just that if you start slacking off on taking them, the consequences are worse if you have bypass.

Vitamin D deficiency is very common among the general population, not just WLS patients. I just saw a study online that said 41% of adults in the US are deficient in D. If yours is low, they'll usually put you on a prescription version. I had prescription vitamin D before I ever even had bypass. Once it gets to a normal level, you switch over to an over-the-counter version of vitamin D.

with B12, you have to take it sublingually or via injection since the RNY pouch lacks intrinsic factor to absorb it. Most of us take it sublingually - although injection is an option if you're still not absorbing it properly. I think I read the usual dosage (with injection) is 1000 ml a month (although that's neither here nor there at this point). Most of us have no trouble absorbing it sublingually, though.

The only supplement I take via capsule is my B-complex, but there are tons of brands that have B-complex in tablet form.

the only large tablet I ever had were those huge calcium tablets - but you can find those in chewable or liquid form. Citracal also makes a "petite" version that is the size of a standard tablet.

Edited May 27, 20215 yr by catwoman7

Thanks, I know D deficiencies are common, but just worried that I had B12 deficiencies before as a vegetarian that did not respond to supplements...they only normalized after I started eating eggs and fish. Just wondering if I may be more inclined toward deficiencies and may run into a problem if I don't absorb supplements well...

I had the sleeve done 10 years ago and missed the memo on not drinking carbonated water. I stretched my tummy out and got hungry again, of course means more food and weight gain. ? On the 19, I had the bypass done. It’s more aggressive than the sleeve and the advances in 10 years convinced me to do it. I’m less than 2 weeks in but I think, if I follow the rules, this will be the fix.
good luck on your journey

5 hours ago, wendy100 said:

I had the sleeve done 10 years ago and missed the memo on not drinking carbonated Water. I stretched my tummy out and got hungry again, of course means more food and weight gain. ? On the 19, I had the bypass done. It’s more aggressive than the sleeve and the advances in 10 years convinced me to do it. I’m less than 2 weeks in but I think, if I follow the rules, this will be the fix.
good luck on your journey

I was told that there is no such thing as "stretching your belly out". My surgeons staff told me that is a myth.

Hmmm I can tell you from firsthand experience that it’s not a myth . My doctors and staff told me that this is why the rate is about 60% for sleeves. I believe that it’s harder to do with the bypass but was told it’s still possible.

I did a little googling and not one of the five sites said it was NOT possible to stretch your pouch out. But that was a google search ?

15 hours ago, wendy100 said:

I did a little googling and not one of the five sites said it was NOT possible to stretch your pouch out. But that was a google search ?

I wonder if its different with sleeve's vs. bypass?

That’s a great question... I will put the question to the folks that did mine and see what they say. The way I understood the difference between the two was that both surgeries did the pouch for a stomach but the bypass also rerouted the small intestine. But I am no expert ?

12 minutes ago, wendy100 said:

That’s a great question... I will put the question to the folks that did mine and see what they say. The way I understood the difference between the two was that both surgeries did the pouch for a stomach but the bypass also rerouted the small intestine. But I am no expert ?

the stomachs are done differently. With sleeve, they just lop off about 80% of one side of the stomach - leaving a narrow tube that goes from the esophagus down to the bottom of the stomach - so the food still goes through entire length of the stomach, through the pyloric valve into the small intestine. The 80% they remove is pulled out of the body and goes into the garbage.

with bypass. they split the stomach horizontally with staples. the top 1/3 of the stomach is now the "pouch". The bottom 2/3 is still there, but isn't used (well, it does create some enzymes that are passed into the small intestine to help with digestion, but the food never goes into the bottom 2/3 of the stomach anymore. Instead, they put a hole in the top 1/3 of the stomach (the pouch), and put a piece of the small intestine up there, so the food goes directly from the pouch into the small intestine.

I've read that stretching either the bypassed pouch or the sleeved stomach isn't common - but you can do it by chronically overstuffing it (we're not talking about blowing it on Thanksgiving - but rather, by overeating day after day after day...). However, it's very possible to stretch the hole that goes between the (bypass) pouch and the small intestine (that hole is called the stoma).

10 hours ago, catwoman7 said:

the stomachs are done differently. With sleeve, they just lop off about 80% of one side of the stomach - leaving a narrow tube that goes from the esophagus down to the bottom of the stomach - so the food still goes through entire length of the stomach, through the pyloric valve into the small intestine. The 80% they remove is pulled out of the body and goes into the garbage.

with bypass. they split the stomach horizontally with staples. the top 1/3 of the stomach is now the "pouch". The bottom 2/3 is still there, but isn't used (well, it does create some enzymes that are passed into the small intestine to help with digestion, but the food never goes into the bottom 2/3 of the stomach anymore. Instead, they put a hole in the top 1/3 of the stomach (the pouch), and put a piece of the small intestine up there, so the food goes directly from the pouch into the small intestine.

I've read that stretching either the bypassed pouch or the sleeved stomach isn't common - but you can do it by chronically overstuffing it (we're not talking about blowing it on Thanksgiving - but rather, by overeating day after day after day...). However, it's very possible to stretch the hole that goes between the (bypass) pouch and the small intestine (that hole is called the stoma).

Thanks for the info. I recently heard that stretching out the pouch for bypasses is very hard to do. Like you said you have to overstuff yourself on a daily basis. I don't know how anyone could do that without being/feeling sick.

I was told the stomach will stretch the smallest bit just life but never as big as pre surgery and weight gain is not due to anatomy but due to reverting back to bad habits

That sounds more like what I did ?. But I still had a limit on how much I could eat. Perhaps the soda water didn’t help matters.