If you are concerned about malabsorption after surgery and you are considering Duodenal Switch or Gastric Bypass surgeries, we encourage you to read on, because, unless otherwise indicated by our experts, malabsorption should not undermine your determination for this life-changing experience.
Although there are some factors to think about when making this decision, keep in mind that as a bariatric candidate, your most important priority is losing the excess weight and taking action for the sake of your physical and overall health.
As you already know, adequate absorption of vitamins and minerals (the substances in food the body requires for proper functioning) is necessary for good health.
Gastric Bypass and Duodenal Switch surgeries involve malabsorptive procedures. This is why the term may lead to some confusion.
So, first, what does malabsorption really mean?
Malabsorption, in the bariatric surgery context, means the restriction of the absorption of the components in the food you eat, including calories! It aids in weight-loss, it’s safe, and controlled with supplements.
Let’s recall what the procedures for Gastric Bypass and Duodenal Switch surgeries entail.
In Gastric Bypass surgery, first, the stomach is stapled forming a small pouch in the upper section. This makes the stomach much smaller, which makes you eat less and feel satiated sooner. Second, the surgeon cuts the small intestine. Then, he attaches the lower part of the small intestine to the small pouch. Now, what will happen when you eat food is that it will bypass the stomach and the upper part of the small intestine. This means your body absorbs fewer calories. Next, your surgeon will connect this bypassed section to the lower part of the small intestine. The digestive juices or bile will move from the stomach and the upper part of the small intestine into the lower part of the small intestine.
Duodenal Switch surgery requires two separate surgeries. It combines restriction (how much you can eat), and malabsorption (how much your body absorbs the nutrients in the food you eat).
On the first surgery, your surgeon will divide the stomach vertically and remove around 85% of it. The remaining portion of the stomach is stapled acquiring the shape of a banana. The valve that regulates the release of food from the stomach into the small intestine is left intact.
On the second surgery, the surgeon divides the upper part of the small intestine, just past the stomach, and attaches it to a loop of the lower part of the small intestine. This means that around two-thirds of the small intestine is bypassed.
Because of this loop attachment, the channel through which the digestive juices flow and connect to the small intestine is also altered.
Before, the digestive juices would connect and mix with food at the duodenum (the upper part of the small intestine) whereas, after the switch, they now mix at the lower part of the small intestine in a common short channel (around 3ft. long).
Digestive juices are needed to absorb food, they mix with food and that’s how absorption occurs!
Duodenal Switch surgery is the most effective weight loss surgery, it shows the best durability and the least dietary restriction. The stomach empties fairly normally (minimal dumping syndrome) and even triglyceride levels are improved.
Ordinarily, nutrients are absorbed along different and specific parts of the small intestine. Therefore, because the distance between the stomach and the small intestine is undersized, some nutrient (chiefly vitamins and minerals) malabsorption is expected both with Duodenal Switch and Gastric Bypass surgeries.
However, absorption of prescription drugs is NOT affected.
There is NO change whatsoever in how our bodies absorb medicine than before surgery. The reason for this is that the body does not need digestive juices to process drugs.
So, if you normally follow a treatment for diabetes, high pressure, etc., it will not be a problem, and your body will process it as usual.
Vitamins and minerals, however, are a different story.
In general, liposoluble vitamins, such as Vitamin A, K, and E, do require digestive juices for their absorption. Remember, because absorption occurs at different and precise sections of the small intestine, after surgery some vitamin intake may be insufficient. This is the main reason why your surgeon may instruct you to take supplements.
For example, it’s very likely he will indicate a calcium supplement, as it is a common nutrient the body does not absorb well after surgery.
Losing weight is a common side-effect with malabsorption; the worst consequence being anemia. But don’t worry, we are aiming for health and at Mexicali Bariatric Center we will provide you the best follow-up treatment to avoid negative side-effects.
This is also why we encourage you to be persistent with your treatment and endure with a positive attitude. You will find that new habits will become normal in no-time. And remember, by leaning on our professional health experts, you will be grateful you made this decision.
Your life is important in countless ways, we know this is true and we’re here to remind you of it.