Question:
I was told that the post-op BPD-DS patients have bowel problems--is this true?

I have been told that the post-op BPD-DS suffer from very greasy, oily, thin bowel movements, coupled with horrible-smelling gas. When weighing these possible post-op side-effects against the possible dumping from a Lap-RNY, I thought the dumping syndrome sounded mild. Could I hear a little from both side regarding these issues? I'm pre-op and am quickly approaching the time when I will have to make my final choice. I'd just like to hear some very candid stories from both sides---in an effort to help me chose which procedure will be right for me. Thank you.    — Karen C. (posted on August 17, 2002)


August 16, 2002
I had a lap BPD/DS in Oct. 2001 at Mt. Sinai in NYC. I have lost 108 lbs to date. I currently do not have diarrhea--in fact, I have episodes of constipation and have to take a stool softener. The diarrhea,gas and loose stools were an issue immediately post op. The oily stools--similar to the side effects of Xenical--disappeared after a few months. At 10 1/2 months post op, I eat virtually everything in small amounts with no side effects. Email me if you have any other questions. Good luck!
   — dantevolta

August 16, 2002
For the first three to six months, as my intestines were adjust, I would occasionally have very loose stools, such as when I ate ice cream or pizza or a Taco Bell Taco salad. My gas was legendary because my body was learning to digest fiber in a shorter period of time. However, that went away with a moderate amount of embarrasment. Now, my gas is no worse than my sister or boyfriend's. I can control it well enough to make it outdoors or to the bathroom. My stools are firm and formed, with the only distinction being that they float if I eat something with fats, thus I call them "floaters", or sink if I eat stuff with a minimal amount of fat, thus I call them "sinkers". I poop twice a day, after breakfast and after dinner. And, because I had the DS and have retained the pyloric valve in my stomach, I have a normally functioning stomach and will never have to worry about stoma strictures, staple line disruptions, leaks or dumping. I eat whatever I want (ok, so I don't want donuts anymore since that much sugar, yeast and grease does give me gas and bloating), but I do eat Breyer's ice cream a couple of times a week. I have lost over 250 pounds and am not having any trouble keeping it off. I am bouncing right now between 240 and 250 because I am going through a series of surgeries to remove excess skin and I am retaining water in the swollen tissues. However, once fully recovered, I will continue to lose weight to be about 190. Given I was over 500 pounds 2.3 years ago, I am happy. I already, at 250 pounds wear a size 16-18 top and size 20 shorts. I will end up wearing a consistent size 16 and am thrilled. Good Luck to you!
   — merri B.

August 17, 2002
Lap RNY here. I dont dump but do get a icky feeling if I eat too much of bad food choices. THIS IS GOOD! It reminds me to behave myself. Those foods made me MO in the first place. Down 120 pounds the RNY is great....
   — bob-haller

August 17, 2002
I had the DS 11 months ago and for the first 6 months as my body was adjusting to it's new system, I had several very soft oily stools every day, but my body has adjusted now and I have usually one or two bms in the morning that are well formed. They always float though, no matter what I eat. I never have "sinkers" anymore (LOL). I do not have excessive gas except when I eat simple carbohydrates such as flour and sugar. So in that respect, the surgery works the same way for me as the RNY. I steer clear of these foods because of the subsequent consequences (I get gas instead of the RNY dumping), although I can have very limited amounts occasionally with no problems. <p>I've lost 122 pounds and am 15 pounds from goal. I'm thrilled with my surgery and the results. I wish you the very best in your research and whatever surgery you choose. God bless!
   — artistmama

August 17, 2002
For the first week after surgery, thin - green - watery. I think that's pretty much the same after all bowel surgeries. For the last 2 years they have not been greasy, oily or thin. I have 3-4 BM's a day. Most of them are soft, some of them are unformed, some of them are just regular poops. During the first 6 months if I ate something extremely greasy, I would get orange "oil slicks" in the toilet - fat passing through my system undigested. Not a problem unless you want to fish around in the toilet for some reason, I guess. My gas stinks - it also smelled bad before surgery. I have yet to smell gas that is fragrant. I must note that I think the flatulence post-op has a tendency to linger more than pre-op. Just like some RNY patients vomit regularly, and some don't - some DS patients have diarrhea, and some don't. I'm a don't, and my husband is a don't. -Kate-
   — kateseidel

August 17, 2002
I had the BPD-DS two months ago, and I was prepared to deal with some unpleasant "bathroom side effects" after surgery. Happily, that hasn't been the case at all! The only problem I had was some mild diarrhea in the first two weeks post-op, but that turned out to be a side effect of one of the meds I was on. After my surgeon discontinued the med, my diarrhea disappeared immediately and hasn't come back. Other than that, no problems at all. During the first month, I generally had one bowel movement a day (if that). Now that I'm able to eat a little more, I often have two. No big deal. I've also had very little problem with gas. In fact, I have significantly LESS gas now than I did as a pre-op, and what I do have seems to be odorless most of the time. Now, I know that some other DS patients haven't been as lucky. I've heard stories about "oil slicks" in the toilet or in ones pants, very pungent gas and BMs, multiple trips to the toilet throughout the day, etc. It does seem that all of this normalizes significantly after the first few months, however. For me, the benefits of the DS (especially the lower risk of late regain) were enough to outweigh any concerns I had about my post-op bathroom habits. I'm very happy with my decision.
   — Tally

August 17, 2002
Okay, obviously, I am the only 3 year BPD/DS postop having bathroom issues. I can't even stand the gas that I give off and the diahrea is caused by fatty foods or sugars usually. In my case, I have found out that I have an infection in my stomach and intestines that the doctors have not been able to cure in a year. This is directly due to the BPD/DS as my intestines are now looped and are causing this infection. I am going in for a reversal Tuesday. This was not a light decision. After being thin for 3 years, it's difficult to handle the fact that I may get large again. I had to weigh that with the fact that this infection, and loop, left untreated surgically can and will kill me eventually from malnutrition. I know I cant' be the only person with bathroom issues from the BPD/DS but it's not talked about all the time. Good luck in your decision. Barbara
   — Barbara H.

August 17, 2002
I had a BPD-DS on October 8, 2001. I have lost 130 pounds so far, and couldn't be happier. I do have gas (quite smelly) and loose stools when I eat too many carbs or too much fat. If I stick to simpler foods, life is great. The way I see it, this is a way of learning to eat the right foods consistently - something that obviously was an issue in the past, or I would not have gotten to the weight I was. Each person needs to make a decision on what they can live with. I am delighted with the surgery I chose. Good luck in your decision.
   — Spunkwoman S.

August 17, 2002
I had DS in June. I have soft stools, but have had no diarrhea. If I eat too much fat...generally something deep-fried and greasy--french fries, bacon, etc don't do it...then I do get oily stools. I can count the number of times it's happened. Again...I'm only a couple months out, so I'm at the end where things are expected to be worse. The odor continues to lessen over time...like others, my gas wasn't pleasant before but it's definitely stronger now. But it's improved enough that, if I must, I will go in a public restroom. Initially, I just wouldn't leave the house until I'd had a BM! Not anymore. The DS was best for me because I got to keep my pyloric valve, much lower chance of frequent vomiting, can still take NSAIDs as often as I need to for headaches and don't have to worry about how many carbs are in something to avoid dumping! I've spent the last twenty years obsessing about food...I'M DONE! When I'm hungry, I just want to eat what I want, when I want, stop when I'm full and not worry about being sick! Now...I can do that. A brownie lasted me all week! Who'da thunk??? Just my two cents...
   — Pamela B.

August 18, 2002
I had Lap RNY on 6/4/02--down 50.5 lbs and feeling really good. No oil slicks here! As for dumping--I dont. As for BM---I go 1-2 times a day and its much smaller amount than before which makes sense since I'm eating much smaller portions! As for tooting....not tooting as much as before surgery. The first 4 weeks I was tooting cos of the air from the lap procedure....but it was basically just that...air. I havent had to run away from myself cos of the stench!!! LOL So I'm very very happy with my decision. What you may wish to do is contact another surgeon that does the Lap RNY and ask him/her their thoughts on Lap vs DS. Might help in your decision process.
   — Bambi C.

January 29, 2003
IMHO the rumor that the BPD D/S automatically causes smells and gas is as absurd as the RnY rumor that all Rny's dump. I had the BPD D/S 16 mo ago and I'm as normal as can be... and I eat NORMALLY. No small amounts.. no hunger issues. Let me stress this...I eat normally.. as a normal person.. NOT as I did pre-op when I pigged out.. and not as a RnY with a small pouch. But normally as in what my normie sized girlfriends would eat. Ahhhhhhhhhhhhhhh finally! It feels soooooo good!
   — Pamela C.

September 30, 2003
I am an RNYer and I have had a few bathroom problems: I had some bad constipation in the beginning because of the food restrictions and having to eat higher amounts of protein. I took colace for the first month or two until I could get in a decent amount of fiber. Then it was fine. I have had some urgency with bowel movemonts but never an "if I don't get to the bathroom, there will be a mess" kind of emergency. I have had some diarrhea from dumping and from foods that seemed safe but turned out not to be. The dumping syndrome is avoidable for the most part-- you have to stay away from sugary foods and possibly simple carbs and really fatty food because they can can cause you to dump. Also, if you eat these foods and discover that you don't dump, you have just defeated one of the mechanisms of the RNY. If you choose to have the RNY, do yourself a favor and don't "test" yourself to see how much sugar makes you dump-- you may find out that you don't. I don't know much about the DS, so I won't comment on it.
   — lizinPA




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