How much small bowel is bypassed with RNY?

 It is my understanding that many surgeons are not bypassing as big a section as previously to help ease malabsorption of nutrients.  The hormonal benefits of RNY occur primarily due to bypassing the duodenum which is about 26cm (10in) long so anything over that is thought to be only useful to enhance malabsorption, if necessary for weight loss.

This is just my understanding.  I do need to ask the Dr about my lengths though.

Per Dr. Chin, I had 150 cm bypassed.

When I asked the surgeon "How much of the intestine do you bypass?" he said 100 cm. I took that to mean that food would flow from my pouch to what once was 100 cm from my pyloric valve

Well that is the question at hand and I really don't know how your RNY was done, but the things I reading and seeing look to me like that 100 cm would be your Roux limb where bile is not mixed with the food.

Take a look at this illustration and see what it looks like.

www.baileybariatrics.com/img/rny.jpg

It seems that some surgeons call the Roux limb a bypass, but that's really not what it is as food still travels through it. You can't absorb fats in the Roux limb, but you can absorb calories from proteins and carbs there.

Kerry

 Yes but that answer is immaterial. Even if the billary limb is 100 cm, it means when attached to the pouch that 100 cm has been bypassed. 

150cm

As of now, I don't believe I have much caloric malabsorption.  I also have shoddy metabolism that helps me to gain on 1200-1500 calories if I'm not exercising.

I DO have micronutrient malabsorption that makes some DSers vitamin regimen seem minor in comparison.  And it continues to worsen in some cases each year.  My K started to tank last year.

Sheesh Andrea, what is the deal with your system and absorbing vitamins?

It's hard for me to fathom you having so much trouble absorbing vitamins when you only have 150 cm bypassed. When I compare that to how much I have bypassed it's bewildering how I could absorb anything. My Biliary limb or completely bypassed is 430 cm leaving only 300 cm, of which only 125 cm have bile mixing with the chow. Yet, so far, I'm not having and real difficulties keeping my labs in line. My biggest project has been the D3 and I'm taking 100,000 IU a day, but it is working and my D3 did come up and is in the normal range now.

The only thing that makes any sense to me about this is that the stomach and duodenum have a lot more to do with vitamin and mineral absorption than is normally thought. Seems very strange to.

Kerry

Well, we need to keep in mind that there is pepsin created in the part of the stomach that is in the remnant for most RNYers (depending on the surgeon) and this pepsin is important for a great many nutrient absorptions to even begin.  While very few are actually absorbed IN the stomach, a great many things do begin their process with the pepsin that comes from the stomach, plus additional proteolytic enzymes that generally hit in the duodenum (which, of course, hit in the jejunum for me).

Researching the nutrients as I have?  Makes me wonder how ANYONE with an RNY absorbs ANYTHING, actually.

I'm not disagreeing with you Andrea, just sayin; if you're having such problems absorbing, it seems like I should be having more problems. You've got 150 cm bypassed, I've only got 125 that isn't either bypassed or alimentary with no bile mixed in. While I have a whole lot more small bowel bypassed, it sure seems like having more stomach and duodenum makes a huge difference in how we absorb.

This thread has been very interesting; at least for me.

Kerry

150 for me