whats the differences between a bypass and a ds

[j.u.s.t.l.i.z.]

ok im clued up on the band but id just like to know what the differences are between a bypass and a duodenal switch, im stupid on this side of things and would like educating if anyhone can explain it would be much appreciated as im trying to learn about other forms of wls.

cheers

liz x

 

[Brunetteandred]

Duodenal switch hereBOSPA - The British Obesity Surgery Patient Association

RNY bypass here

 

[Rising_Sun]

Hey Liz,

I've cut and pasted an explanation I got from a friend of mine who had a DS. Hope it helps.


"DSer's have a stomach, not a pouch. The difference is this - In a RNY pouch, the pylorus which is the bottom stomach sphincter that controls how much food goes into the small intestine at a time is removed (taken out of action if you like). Very little digestion goes on in a RNY pouch. Think of it as an internal IV drip. This is why there is dumping with the RNY. Sugar is not broken down, and foods that contain sugar are not broken down. No gastric interaction takes place, hence the term "gastric bypass".

With a DS, the stomach is still functional though a large section of it is completely removed as is a greater section of the small intestine. When you begin to chew, digeston begins, by releasing gastric juices into the stomach. The food remains in the stomach for approximately 30 minutes, so the stomach acids have time to do their work. (I've thrown up, and I can attest to the fact that food is indeed broken down!) Then, the pyloris begins to relax and contract, releasing food frm the stomach to the small intestine. The other digestive juices (bile, insulin) do not reach the food in the small intestine, instead, mixing with food in the common channel, where digestion is completed before passing to the large intestine.

The stomach is indeed only 3 oz. in a DS, but it is still a stomach. This is the reason at my hospital the RNYer's get a 2 inch binder full of instructions, with very specific eating patterns, and we DSer's only get a 1/4 inch binder! We eat more than RNYer's do, because we can digest, and they cannot. Of course, immediately after surgery, we both do pureed for 6 weeks, but that's whre the similarities end.The trick with the DS, as I've learned, is to eat just until you feel a little presure, and then stop. Also, no drinking 30 minutes before or after a meal (sometimes this changes after your new stomach matures)."


The down side with DS is the extra stinky poos and foul wind most DSers experience. BOSPA do say that DS offers the greatest weight loss of 80% after 2 years though it also carries greater risks than a RNY.

 

[quetiapina]

Very interesting thread. Why are poos more stinky with the DS?

 

[j.u.s.t.l.i.z.]

thanks red and plus, much appreciated x

 

[shelbell]

The DS is increasingly being done in two stages as well over here. If a patient has a very high BMI, over 55 or so, what they consider now is doing a Gastric Sleevectomy first, which is just the removal of most of the stomach, and then after a few months and a good few stone weight loss, do the duodenal switch to convert it to a full procedure. The sleeve is less risky surgery than the full DS or Bypass, and much quicker.

 

[j.u.s.t.l.i.z.]

thanks shel x

 

[ditsy_dame]

Yes, that's right. I had a sleeve gastrectomy which is the first stage of a DS, but as long as my weight loss is acceptable, I probably won't go on to the second stage "switch" part of the surgery. More and more people are just having the sleeve and getting good weight loss. I've lost 25 lbs in 6 weeks so I'm very happy. The real test comes long term but I think I'll be OK just with the sleeve.

 

[Postop]

I'm a full DSer.

The poop/gas is does stink more but can be helped a great deal by what you eat (e.g. when I eat junk I do it at home) and probiotics. You can check out dsfacts.com or duodenalswitch.com. There are some good explanations there.