Hi everyone!

My name is Anthony and I'm 31 years old. I've struggled with being overweight all of my adult life. I am just about 5'9" and currently weight 245 lbs. It may not seem like I have to lose as much as some others and a lot of people tell me that I don't look like I weigh that much, but I know that I don't like the way I feel or look. I have back and knee pain, especially when I am standing for too long. It's also difficult for me to exercise at this weight. I've lost weight in the past via diet and/or medications but it always manages to come back on.

I'm strongly considering the gastric sleeve. My only worry is that I did have my colon removed when I was 16 due to severe Ulcerative Colitis. I now have what's called a "j-pouch", which is basically when they form a new bowel out of your small intestine so that you don't need an ostomy/colostomy bag (I did have one for 3 months in between the 2 surgeries - first surgery to remove the colon, second to reverse it and make the pouch).

I've checked with my doctors and one of the colorectal surgeons said he doesn't recommend the gastric sleeve and a couple of others said their only concern would be having urgent bowel movements due to having less of a digestive tract, but told me to check with the bariatric surgeons to make sure. The bariatric surgeon said he thinks it would probably make me have LESS bowel movements since I would be eating less and the food would be moving slower through my system.

Wish me luck, I am having another virtual consultation next month!

Edited February 21, 20224 yr by amt0890

Best of luck to you! My tip is to ask A LOT of questions. I was afraid to at first, and I regret that. Now I'm suffering horrible GERD and looking to revision from sleeve to bypass as a self-pay patient. ? In the end, you will know what is right for you!!! I look forward to your journey!!!

That's odd that they would call out the sleeve as a concern, rather than the bypass, which actually bypasses some of your intestines. A sleeve just reduces the size of the stomach, and is not mal-absorptive. Most people will report constipation after surgery, but some/many have periods of diarrhea, perhaps caused by constipation remedies?

I don't know much about UC, but I think I would get a second opinion from a GI doc, and ask the bariatric surgeon about your concerns.

I calculate your BMI as 36, which is only qualifying for a WLS if you have other co-morbidities like diabetes, apnea, etc. While you can have WLS at a lower BMI if you pay out of pocket, I would warn you that you may not lose as much weight as you think, and the risks for you are almost certainly higher than for people who aren't in your situation.

16 minutes ago, lizonaplane said:

That's odd that they would call out the sleeve as a concern, rather than the bypass, which actually bypasses some of your intestines. A sleeve just reduces the size of the stomach, and is not mal-absorptive. Most people will report constipation after surgery, but some/many have periods of diarrhea, perhaps caused by constipation remedies?

I don't know much about UC, but I think I would get a second opinion from a GI doc, and ask the bariatric surgeon about your concerns.

I calculate your BMI as 36, which is only qualifying for a WLS if you have other co-morbidities like diabetes, apnea, etc. While you can have WLS at a lower BMI if you pay out of pocket, I would warn you that you may not lose as much weight as you think, and the risks for you are almost certainly higher than for people who aren't in your situation.

I was diagnosed about 10 years ago with sleep apnea and given a CPAP machine that I don't use (I know, not good).

Having had my colon removed and now having a j-pouch, I have many bowel movements a day since a pouch does not absorb water like a colon does, nor does it hold as much stool (basically I have chronic diarrhea). I read on another forum that a woman who had both procedures said her life has been hell (this post was from 9+ years ago though) since having the sleeve done and having a j-pouch. She said that food goes right through her, I guess since there is only so much room in the stomach and then the pouch being the way it is?

Another woman who I am speaking to who had both procedures done said she had the same issue at first, but it got better. She now takes Lomotil twice in the evening so she doesn't have to go so much during the night, but can handle the extra bowel movements during the day.

I'm going to meet with my colorectal surgeon this week (he didn't perform my surgery but is the one who I've been seeing for quite a while now) to go over everything again. It's odd how some doctors say it's fine and others say no way.

2 minutes ago, amt0890 said:

I was diagnosed about 10 years ago with sleep apnea and given a CPAP machine that I don't use (I know, not good).

Having had my colon removed and now having a j-pouch, I have many bowel movements a day since a pouch does not absorb Water like a colon does, nor does it hold as much stool (basically I have chronic diarrhea). I read on another forum that a woman who had both procedures said her life has been hell (this post was from 9+ years ago though) since having the sleeve done and having a j-pouch. She said that food goes right through her, I guess since there is only so much room in the stomach and then the pouch being the way it is?

Another woman who I am speaking to who had both procedures done said she had the same issue at first, but it got better. She now takes Lomotil twice in the evening so she doesn't have to go so much during the night, but can handle the extra bowel movements during the day.

I'm going to meet with my colorectal surgeon this week (he didn't perform my surgery but is the one who I've been seeing for quite a while now) to go over everything again. It's odd how some doctors say it's fine and others say no way.

My guess is that there haven't been enough people with a partial bowel removal who have also had bariatric surgery to be sure what the results will be.

I have had IBS with both diarrhea and constipation during my life due to medications I take. Diarrhea can make your life really complicated, as I'm sure you are aware. When I had diarrhea predominant IBS, I was told to eat more carbs and less fat, veggies, and meat. I don't know if that is true for UC, but I know that would be really hard for me now - I am supposed to do pretty much the opposite!

I would get second opinions from another GI doc and another bariatric surgeon at a bariatric center of excellence. Personally, I'm not sure I would take the risk in your situation, as the sleeve is not reversible. Maybe instead of trying to get thin, focus more on healthy activity and things like therapy for binge eating, if that's an issue for you. I'm not saying these will make you lose a lot of weight, but losing weight is not the end-all be-all in life. Being able to live your life without always looking for a bathroom is pretty important, too.

11 minutes ago, lizonaplane said:

My guess is that there haven't been enough people with a partial bowel removal who have also had bariatric surgery to be sure what the results will be.

I have had IBS with both diarrhea and constipation during my life due to medications I take. Diarrhea can make your life really complicated, as I'm sure you are aware. When I had diarrhea predominant IBS, I was told to eat more carbs and less fat, veggies, and meat. I don't know if that is true for UC, but I know that would be really hard for me now - I am supposed to do pretty much the opposite!

I would get second opinions from another GI doc and another bariatric surgeon at a bariatric center of excellence. Personally, I'm not sure I would take the risk in your situation, as the sleeve is not reversible. Maybe instead of trying to get thin, focus more on healthy activity and things like therapy for binge eating, if that's an issue for you. I'm not saying these will make you lose a lot of weight, but losing weight is not the end-all be-all in life. Being able to live your life without always looking for a bathroom is pretty important, too.

Yeah, it is definitely hard to come across people who have had both a partial colectomy and the gastric sleeve. I guess every case is different. Considering I already have several BMs per day, I could probably live with a few more - it just depends on how many more lol.

At this weight I find it really difficult to get in sufficient exercise. It's very hard for me to digest vegetables (perhaps with the exception of lettuce) and certain fruits having just a small intestine. I've been thinking of trying the paleo diet. I'm just tired of looking and feeling like this.

26 minutes ago, amt0890 said:

Yeah, it is definitely hard to come across people who have had both a partial colectomy and the gastric sleeve. I guess every case is different. Considering I already have several BMs per day, I could probably live with a few more - it just depends on how many more lol.

At this weight I find it really difficult to get in sufficient exercise. It's very hard for me to digest vegetables (perhaps with the exception of lettuce) and certain fruits having just a small intestine. I've been thinking of trying the paleo diet. I'm just tired of looking and feeling like this.

I'm sorry this is so hard.

What if you tried different types of exercise, like swimming? that's excellent exercise and your body weight doesn't make it harder for you. I know when I was heavier I had a hard time with anything except swimming and walking, which I did a lot. I find that now that I'm thinner, I get hurt more because I try to do too much, or for whatever reason, not sure.

You could also work with a physical trainer to see what activities are easier for your body. Or, focus on NEAT (non-exercise activities of thermogenesis). These are things like mopping, vacuuming, law mowing, shoveling, etc. Doing these activities are really great for your body.

yeah, I know it doesn't sound so hard to have extra BMs, but you just can't predict what the outcome would be, and I'd be hesitant to make this big a decision when the doctors disagree.

Have you tried searching for terms on this site that might help you find others who may have been in a similar situation? I did that for bipolar disorder and found that very helpful... but limited.

Welcome to the bariatric community. Feel free to browse around the forums and threads and you'll find lots of helpful information and advice.

Your current situation is very specific. Be sure to ask lots of questions. I had the sleeve and I have regular daily healthy bowel movements.