Malabsorption with RNY?
My surgeon said that we did malabsorb calories for a year or two post op. He also said some other stuff that I know was just plain wrong, like telling me drinking soda would stretch the pouch, so maybe he was wrong about the malabsorption, too.
I know that I did malabsorb fats and still do. Um, I can tell when I poop. I'll refrain from giving details (unless anyone wants a detailed description of my poop).
It seems obvious to me that some people malabsorb protein a lot after RNY, because they have to take in a very large amount of protein in order for the total protein level to be good when they get labs done.
Since fats and protein are macronutrients, it seems to me that if we malabsorb those, we could also be malabsorbing calories. I don't know if that's correct, it just makes sense in my head.
I know that I did malabsorb fats and still do. Um, I can tell when I poop. I'll refrain from giving details (unless anyone wants a detailed description of my poop).
It seems obvious to me that some people malabsorb protein a lot after RNY, because they have to take in a very large amount of protein in order for the total protein level to be good when they get labs done.
Since fats and protein are macronutrients, it seems to me that if we malabsorb those, we could also be malabsorbing calories. I don't know if that's correct, it just makes sense in my head.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Hey, I'm just telling it like it is.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Well this is very disturbing to me. If we don't malabsorb then I am gonna be very pissed off that I had major surgery to have my guts re-routed for nothing! Why on earth would doctors perform this very complicated and risky surgery that's marketed to include malabsorption if it is not true? Otherwise, people could just have the band or sleeve and not have their guts rearranged. And why would insurance companies pay for this surgery to be done if it doesn't do what it's supposed to do? I can't see insurance companies paying out thousands of dollars (per patient) for RNY, instead of just approving the sleeve or band.
Tammy 
Luck 'o the Irish
HW399/SW362/CW219/GW130
*37 lbs were lost pre-op
I was going to say the same thing. Why on earth would they be performing a surgery that causes life time malabsorption of vitamins but does nothing about malabsorbing calories? Where is the logic in that. I can understand the point of causing malabsorption of vitamins because it is worth it to facilitate the caloric malabsorption, but to perform a surgery that would cause vitamins to be malabsorbed for no good reason sounds stupid. If they have found that malabsorption is insignificant to the success of the RNY then why are they still doing it that way?
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
The surgery bypasses the duodenum. That is a weight gaining machine that is bypassed. The bypassing of the duodenum also helps with diabetes etc. In the beginning it was unclear why r n y was so successful and doctors only recently learned why r n y cures diabetes almost immediately in some patients. There is a discovery that the hormonal changes caused by the r n y is what brings about success. The smsll pouch effects a prper vega nerve response and is a more imminent factor than just the restriction. Do some reading on the studies involving the ghrelin manufactured by the stomach.
Just like Kelly, the proof that I malabsorb fat (which is more calorie dense than carbs) is in the toilet every day. There is no denying that. I have no idea about absorbing carbs, but I do know that I avoid them anyway with the exception of dairy carbs and whole grains & legumes. The RNY is not a magic cure. People can still out-eat the surgery if they don't change their eating habits. It is a tool. I was never quoted a magical number.
What studies I have read have said that in some super sized patients, the duodenum is possibly highly efficient, absorbing more calories than the body demands. Scientists don't know if this is a short circuit from brain to duodenum or another kind of mechanism. The RNY (and DS) bypasses the duodenum, which forces the lower part of the small intestine to absorb calories & nutrients, and the jujenum & illeum isn't as efficient at absorbing as the duodenum, at least not in the first 2 years.
What we do know is that the RNY is effective to take weight off quickly the first 18 months-2 years and then it takes more effort and diligence to lose & maintain. Again, it is a tool to help get the weight off. It isn't a magical cure.
What studies I have read have said that in some super sized patients, the duodenum is possibly highly efficient, absorbing more calories than the body demands. Scientists don't know if this is a short circuit from brain to duodenum or another kind of mechanism. The RNY (and DS) bypasses the duodenum, which forces the lower part of the small intestine to absorb calories & nutrients, and the jujenum & illeum isn't as efficient at absorbing as the duodenum, at least not in the first 2 years.
What we do know is that the RNY is effective to take weight off quickly the first 18 months-2 years and then it takes more effort and diligence to lose & maintain. Again, it is a tool to help get the weight off. It isn't a magical cure.
Distal RNY 6/11 SW 456 CW 311 Complications: Small bowel strangulation 12/23/2012, non healing surgical incision--ongoing. Still.
Third paragraph: malasorption http://www.rnygastricbypass.com/
Yes, there is malasorption after RNY. It does diminish over time as your body becomes used to the new, re-routed plumbing. It's malasorption for nutrients and calories. That's why we have to take so many freaking vitamins to compensate. That's why we have to super-load the protein. It's to make sure we get enough in to absorb what we can.
You can't re-route & shorten pipes and say it delivers the same amount of water, it doesn't work that way. You go from 6 feet of intestines to 5 feet you, lose about 12 inches of surface area that used to absorb nutrients and calories. This is an analogy - I don't know that my measurements are precise. The concept is right.
Yes, there is malasorption after RNY. It does diminish over time as your body becomes used to the new, re-routed plumbing. It's malasorption for nutrients and calories. That's why we have to take so many freaking vitamins to compensate. That's why we have to super-load the protein. It's to make sure we get enough in to absorb what we can.
You can't re-route & shorten pipes and say it delivers the same amount of water, it doesn't work that way. You go from 6 feet of intestines to 5 feet you, lose about 12 inches of surface area that used to absorb nutrients and calories. This is an analogy - I don't know that my measurements are precise. The concept is right.
Below is my response to another poster regarding malabsorption and how long it lasts. Think this plays into your post as well.
"One of the reasons we have malabsorption in the first place is that part of the intestine is removed. Inside the intestine are little finger-like appendages called villi. This is where absorption takes place for nutrients and minerals and calories when we eat. Without these we get the benefits of quick weight loss the first 1-2 years after surgery. But the body being the magnificent and efficient entity it is, begins to grow more villi in the remaining intestine because it knows it needs to repair itself. When the villi are regrown there is more absorption of all the calories we ingest. And if the energy expenditure is not equal to or greater than the calorie intake there will be weight gain without fail. That is why the surgery is a "tool" not a "cure." It is hoped that in the first 1-2 years an individual will develop the lifetime habits needed to make the surgery a life time success. Those who don't do this and don't understand how the body works are at a great risk of some or total regain.
So utilize your "tool" to its greatest advantage and know that to be successful will require conscience work the rest of our lives."
"One of the reasons we have malabsorption in the first place is that part of the intestine is removed. Inside the intestine are little finger-like appendages called villi. This is where absorption takes place for nutrients and minerals and calories when we eat. Without these we get the benefits of quick weight loss the first 1-2 years after surgery. But the body being the magnificent and efficient entity it is, begins to grow more villi in the remaining intestine because it knows it needs to repair itself. When the villi are regrown there is more absorption of all the calories we ingest. And if the energy expenditure is not equal to or greater than the calorie intake there will be weight gain without fail. That is why the surgery is a "tool" not a "cure." It is hoped that in the first 1-2 years an individual will develop the lifetime habits needed to make the surgery a life time success. Those who don't do this and don't understand how the body works are at a great risk of some or total regain.
So utilize your "tool" to its greatest advantage and know that to be successful will require conscience work the rest of our lives."
Most Active
Recent Topics