Obesity isn’t just a cosmetic issue. The consequences extend from high blood pressure and Type II diabetes to intensely damaged self-image and even biased treatment in society and the workplace. All too often, patients struggle without success to lose weight through diet and exercise interventions. In this instance, the duodenal switch provides a surgical option to help patients overcome overwhelming obesity. The procedure’s impressive results come through both limiting food intake and preventing caloric absorption.
What Is Duodenal Switch?
Duodenal switch surgery, also known as biliopancreatic diversion with duodenal switch, is a combination bariatric procedure that melds a sleeve gastrectomy with an intestinal bypass. The procedure limits food absorption by removing 60-70 percent of the stomach and bypassing at least two-thirds of the intestine. The bypass of the intestine begins at the duodenum, hence the name.
The gastric sleeve portion involves the creation of a sleeve by cleaving the stomach into two sections and removing the left portion, leaving a sleeve pouch for a stomach. This portion of the procedure limits food intake. Most patients feel full after consuming 4-6 oz. of food after having the surgery.
The bypass portion of the procedure involves sectioning the duodenum and attaching it to the lower part of the small intestine at the ileum. By eliminating a good portion of the intestine, the body can’t absorb as many nutrients or calories from food. While this process encourages weight loss, it also creates a potential for malnutrition and the requirement for lifelong vitamin and supplement intake.
This procedure can be performed either laparoscopically or via an open incision. With patients who have extreme morbid obesity, surgeons may perform the procedure in two separate stages, and for gastric sleeve patients who haven’t lost sufficient weight, the intestinal bypass may be added. Your medical team will determine the right method for you.
Side Effects to Anticipate
The duodenal switch procedure isn’t likely to cause dumping because it doesn’t affect the pylorus muscle that controls elimination from the stomach.
The greatly decreased absorption that the procedure creates results in weight loss, but it can also create frequently loose bowels and flatulence. You should eliminate greasy foods from your diet, and you might consider eliminating diary should lactose become a problem.
Patients can expect dependable, substantial, and sustained weight loss, but they’ll also need to commit to lifelong, close monitoring of vitamin and nutrient levels. A daily vitamin and supplement regimen will become as much of a part of life as eating and breathing.
The Reviews Are In
Duodenal switch reviews should largely focus on the level and length of weight loss. Patients will lose between 60 and 80 percent of their excess weight, and the weight loss phase will last around 2 years. This procedure has demonstrated the ability to help patients keep the weight off well even past the 10-year mark. Surgeons largely consider this procedure to be more effective with longer sustained results when comparing duodenal switch vs gastric bypass.
Because of the high risk for vitamin deficiency that accompanies the heightened resistance to absorption, the duodenal switch weight loss surgery shouldn’t be undergone lightly. Your medical team should weigh the potential consequences against the possible weight loss results to determine if you’re a good candidate for the procedure. This procedure is not for cosmetic purposes or patients with mild obesity.
The Right Candidate Stand to Benefit the Most
The typical candidate for loop duodenal switch is extremely obese. Patients with a BMI, or Body Mass Index, of 50 or greater or with a BMI of at least 40 with a related, serious health condition. Examples of qualifying health conditions include Type II diabetes, high blood pressure, sleep apnea, high cholesterol, lung disease, heart disease, and non-alcoholic fatty liver disease.
To evaluate the value of the duodenal switch, the before and after and potential life changes should inform the decision. This procedure can reverse the health complications that can steal your ability to thrive and even live. However, you must be able to commit to monitoring vitamin levels and taking vitamins and supplements daily. Your health will continue to be a concern, but the focus will be keeping nutrient levels high rather than trying to survive life-threatening complications from obesity.
How to Eat After the Procedure
The duodenal switch diet will by necessity be smaller and more mindful than the diet practiced by the patient before the procedure. Not only will the patient eat fewer calories, the new anatomy will also prevent absorption to create a power storm of weight loss. Patients will focus on nutrition and exercise, completely changing their outlook on food and movement.
Lean protein will comprise most of the diet after the procedure once regular food intake is re-established. This focus on protein will prevent muscle loss. Initially, however, patients will need to follow a solely liquid diet. They’ll slowly transition to thicker liquids and then pureed foods. Once acclimated to this menu, softer foods will follow, and soon, patients will return to regular food. Patients should always remember to chew thoroughly. The small stomach sleeve can experience uncomfortable blockage if food isn’t thoroughly chewed.
Patients should no longer eat between meals, and they should not drink during meals. Liquids should wait until 30 minutes post mealtime, and all fluids should be zero calories, non-caffeinated, non-carbonated, and non-alcoholic. Patients should also avoid gum, straws, and mints; they can cause gas and heartburn. Overeating and eating certain foods can create a really uncomfortable situation for patients.
If you’re a very obese patient and have comorbid health problems, you should ask your doctor about the duodenal switch with biliopancreatic diversion. It very well could be your best option for substantial and sustained weight loss. You deserve to live, move, breathe, and succeed throughout life without the health problems caused by your excess weight. Extreme circumstances call for extreme measures, and this procedure has proven to be safe and effective, although not without side effects.