protein absorption and regenerating intestines in Texas

Cicerogirl, The PhD
Version
on 9/29/12 8:33 am - OH

According to the ASMBS (and many surgeons) it isn't true that your body can only absorb so much protein at once.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

MsBatt
on 9/29/12 6:58 am

They don't actually remove any of your small intestine from your body---they simply bypass it. As others have explained, there are little things called villi inside the intestine that do the actual absorbing, and the body grows more of them to compensate for the bypassed intestine.

There are two kinds of malabsorption---malabsorption of MICROnutrients, like vitamins and minerals, and malabsorption of MACROnutrients, also known as calories. Calories can be absorbed anywhere along the small intestine, but micronutrients can only be absorbed in certain receptor sites. Many of those receptor sites are located in the uppermost part of the small intestine, and that's the part that gets bypassed.

poet_kelly
on 9/29/12 7:40 am - OH

RNY on 11/04/08

On September 29, 2012 at 9:33 AM Pacific Time, molly3613 wrote:

I was at a rather chaotic post support meeting headed by the bariatric dietitian. The topic was vitamins we need for life etc. I heard her remind one of the group "remember, we can only absorb 30 g. of protein at a time". I need to know what she meant by "at a time". I would have had to shout the question in this mob I was in so I will call in the question tomorrow but thought some of you vets might know. If I drink a shake with 45 g of protein did I waste 15 of it? I like the smoothie king vanilla whey isolate and it says 8 ozs liquid with 2 scoops which contain 45 g protein.

Also I overheard this man in the group say that the reason we lose the malabsorption from 1 year to 18 months out is because the small intestine they cut out (100 cm) GROWS BACK!!!! Now that just cannot be right. And if we lose the malabsorption why continue to take vitamins? He looked pretty sharp but I need a second opinion on his opinion.

What she meant is that she's unfamiliar with the American Society for Metabolic and Bariatric Surgery guidelines and is spreading untrue myths about protein absorption. I'd find another support group and another dietician.

The ASMBS says we CAN absorb more than 30 grams of protein at a time and that the idea that we cannot is just a myth. I'm so sorry this dietician is leading a support group and giving incorrect info to patients.

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.

poet_kelly
on 9/29/12 8:06 am - OH

RNY on 11/04/08

And with regard to intestines growing back, the intestine doesn't grow back. However, the small intestine does grow more villi.

There are these little tiny things in your small intestine called villi. They are like fingers that grab up calories and absorb them. When they bypass part of the small intestine, suddenly there are fewer villi in there to suck up the calories.

However, your body quickly figures that out and it is afraid it's gonna starve. So your small intestine starts to grow more villi in the part that has not been bypassed. After two or three years, you have about the same number you had before surgery so you absorb about the same amount of calories again.

It's pretty cool if you think about it.

However. We continue to malabsorb vitamins because only certain spots in the small intestine absorb each one of those. That never goes away because some of those spots are bypassed forever. Your intestine cannot grow new ones.

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.

Annie_Anaba
on 9/29/12 8:31 am

RNY on 08/27/12

It really is amazing how our bodies compensate for the losses. My NUT told me the same thing about the 30 grams so I'm gonna ask her again. I do not want bogus info from someone I am paying.

molly3613
on 9/29/12 8:40 am - TX

RNY on 01/24/13

I am double checking Monday also. This girl is the bariatric dietician for the Methodist Hospital Weight Management Program in the Texas Medical Center. She has more letters after her name than are in my name. She sure should have been fully vetted and qualified. I have the email for the other "regular" dieticians and will ask them also. It is an important point for us. Proper absorption is paramount.

Cicerogirl, The PhD
Version
on 9/29/12 11:14 am - OH

RNY on 08/27/07

The information from the ASMBS that indicates that the limit of 30g of protein at once is a myth my be found at the following website. It is in the information in the notes at the bottom regarding protein consumption and absorption. If your dietician disagrees with the ASMBS, I would ask on what basis she disagrees.

Lora

asmbs.org/2012/06/asmbs-integrated-health-nutritional-guidelines-for-the-surgical-weight-loss-patient/

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

rockym
on 9/30/12 12:56 am

I'd check out Kelly"s URL. Unfortunately letters behind somone's name is pretty meanless. Her actions are saying she's not up-to-date on the information she gives out.

Cicerogirl, The PhD
Version
on 9/29/12 11:17 am, edited 9/29/12 3:00 am - OH

RNY on 08/27/07

I posted the link to the information from the ASMBS that says the 30g thing is a myth in one of my other replies. When you ask about it, I would go armed with that information and if your NUT disagrees, I would ask her WHY she disagrees... What evidence she is citing that says the ASMBS is wrong?

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

(deactivated member)
on 9/29/12 9:32 am

RNY on 08/31/12

Hi - Many posts are correct with what I've been told (you can absorb more than 30 g of protein) but like some said, if you're sipping on a protein drink over an hour than absorption is spread out a bit.

But, there is one thing I've been told that I don't see posted and that is the warning I got about drinks that are 30+ grams and more. If you consume too much protein, it can be harder on some patients kidneys. That came from two NUTs (one from my insurance program and the other one from the doctor's office). I was also told by my surgeon that absorption of nutrients can vary for some after surgery and to prevent any problems, one must follow the routine of taking those vitamins. I'm told there are many factors that go into play with absorption.

protein absorption and regenerating intestines in Texas

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protein absorption and regenerating intestines in Texas