malabsorption

I've seen some recent questions about malabsorption after RNY so just thought I'd repost this.

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.

Wow, that is neat and something I did not know. Ty.

Interesting, Wish they could perfect it so it would be a little more efficient but I am sure they are working on it.  It is a miracle in itself to be able to move body parts around to do what they want it to do.  The body is an amazing thing.

If by efficient you mean that the malabsorption of calories would last, they do know how to do that - the duodenal switch, or DS, does that.  I think there are pros and cons to both types of surgeries, though.

I think the body is just fascinating.  It is pretty much self-regulating, you know.  Like, if you tried to make a machine or computer that would make all the adjustments to keep itself calibrated like the body does naturally, well, it would be almost impossible.  It would be so complicated.  But the body just does all this stuff naturally, as long as we keep it in reasonably good health.

I am also amazed that the lifespan of an artificial knee -- even with all the technology and special materials we have -- is still 10-20 years whereas the natural knee can last 70 or more years!

Also, when blood clot(s) significantly block a portion of a vein for an extended period of time, the body is able to reroute the blood flow using other veins in the area (even enlarging them when necessary) to compensate for it.

Lora

Kelly, I have been thinking about the malabsorption issue and the regrowth of villi. I am an RN. I just wonder for those who have not met goal and most likely have re-grown the villi in the small intestine, if something could be done to increase the malabsorption. If doc's can do EGD's (very gently, of course), why can't they go past the stoma into the small intestine and cauterize some of the newly grown villi to increase the malabsorption. It might give post ops who have not met goal more time to lose the weight easier. I would think it would be a better option than revising to a DS. Am I way off base here or does it seem viable? Do you know of any studies or information about it. Just wondering.

julie

If you destroy some of the villi that are absorbing calories, you would also be destroying the mechanism for vitamins to be absorbed in that part of the intestine. People can control their weight loss (within limits) by changing their eating and exercise habits. They cannot, however, control their body absorbing (or not absorbing) vitamins, and the last thing we need is yet an additional area of the intestine that is unable to absorb vitamins.

Lora

I am also an RN but I feel like this is so new and so different from what I normally do.  When you are the patient, its so much different. I always worry about taking in to many calories.  My RD said to focus on protein intake and to not worry about caloric intake at this point. Is it because I won't absorb all of the calories I take in?

It is partly because you are not absorbing about 30% of your calories (which means that 600 is more like 400), partly because counting calories reinforces the diet mentality (and this is not a diet, but a lifestyle change), and partly because if you are focused on protein first, that alone will keep your calories in check for the first 6-9 months ****il you can eat a greater amount of food).

Lora

malabsorption does change.  I absorb nutrients at a different level than I did when I first had the surgery.  I also absorb calories at a different rate.  I have to be as diligent as ever not to gain weight. 

 

Steve