Protein malabsorption?

[snowkitten 371]

I had the VSG in 2014 and lost 110lbs. Unfortunately a mix of sleeve failure (after an egd my gastroenterologist said if he hadn't known I had the surgery he never would have guessed, my stomach was normal sized) and emotional eating cause me to gain back about half.

My surgeon offered a revision with option to do resleeve, RNY, or DS. I don't wanna do an RNY because I need frequent EGD'S. I've always wanted the DS so that seems most logical.

Vitamins and bowel movements don't worry me. What worries me is the amount of Protein malabsorption. Has anyone had issues with this?

I already have a protein losing enteropathy so this is a concern.

On one hand adding the DS could exacerbate the issue since it's not certain where the protein loss is located .

On the other hand, it could help. My last biopsy showed the small intestine villi were enlarged. Which could be (and most likely is) the reason for the protein loss. If the diseased part is bypassed with the DS then it could potentially give me a better shot at protein absorption.

Now people say eat 80-100g of protein a day and no worries. Has this amount ever given u an issue?

Thanks in advance!

[James Marusek 5,244]

According to the internet

Malabsorption syndrome occurs when something prevents the bowel from absorbing important nutrients and fluids, including Proteins, fats, and Vitamins. Malabsorption can be caused by conditions such as celiac disease, Crohn's disease, lactose intolerance, and intestinal damage.

So I don't think sleeve, RNY or duodenal surgery impacts Protein absorption. (I am 3 1/2 years post-op RNY gastric bypass surgery and I currently obtain all my Protein from food alone. I no longer take protein supplements and my blood work shows my protein levels are fine.) It sounds like another underlying condition (My last biopsy showed the small intestine villi were enlarged.) is at the root of the problem.

I am not a doctor and I suspect most individuals on this site cannot offer you the medical advice that you are seeking. So I would recommend that you work this very specific problem with your surgeons office.

[snowkitten 371]

According to the internet
Malabsorption syndrome occurs when something prevents the bowel from absorbing important nutrients and fluids, including Proteins, fats, and Vitamins. Malabsorption can be caused by conditions such as celiac disease, Crohn's disease, lactose intolerance, and intestinal damage.
So I don't think sleeve, RNY or duodenal surgery impacts Protein absorption. (I am 3 1/2 years post-op RNY gastric bypass surgery and I currently obtain all my Protein from food alone. I no longer take protein supplements and my blood work shows my protein levels are fine.) It sounds like another underlying condition (My last biopsy showed the small intestine villi were enlarged.) is at the root of the problem.
I am not a doctor and I suspect most individuals on this site cannot offer you the medical advice that you are seeking. So I would recommend that you work this very specific problem with your surgeons office.

Sorry for any confusions. I'm not asking for medical advice. Just giving some background info. My question is if any DS'ers have difficulty with protein malabsorption despite hitting the 80-100g. In the DS surgery the intestines are rerouted and you absorb less fat, protein and complex carb. That's the "magic" of it.

[Postop 411]

If you have a full DS it's more like 125+ grams per day. I probably eat around 150 a lot of days.

Edited March 2, 2017 by Postop

[Berry78 4,261]

DS patients do require Protein above the level of sleevers, so there is definitely some malabsorption going on for the typical patient. It's impossible to say where along your intestines your malabsorption is taking place, but it seems logical that by bypassing any of your intestines, you might be bypassing some of the healthier parts, thereby worsening your condition.

However, the actual biology may defy logic, (as your postulation suggests) so your doctor would know the answer better than I.

[snowkitten 371]

If you have a full DS it's more like 125+ grams per day. I probably eat around 150 a lot of days.

OK that sounds better. All the info I've read said 80-100. Which didn't seem right to me since that's what I was told with my sleeve. Has that amount kept your lab Lvls good?

[janedoe92 260]

OK that sounds better. All the info I've read said 80-100. Which didn't seem right to me since that's what I was told with my sleeve. Has that amount kept your lab Lvls good?

80 to 100 is usually if you get SIPS, where your common channel is 250+ which allows more absorption than regular DS where your cc is way smaller therefore less absorption and more Protein needed.

[snowkitten 371]

80 to 100 is usually if you get SIPS, where your common channel is 250+ which allows more absorption than regular DS where your cc is way smaller therefore less absorption and more Protein needed.

Oh! That totally makes sense. I've heard alot of people don't realize their SIPS arent the real DS and thus call it DS. Explains why they said 80-100. Thanks for that insight. [emoji4]

Do you all find it hard to get in 120+ Protein?

[janedoe92 260]

Oh! That totally makes sense. I've heard alot of people don't realize their SIPS arent the real DS and thus call it DS. Explains why they said 80-100. Thanks for that insight. [emoji4]

Do you all find it hard to get in 120+ Protein?

No problem, and I've had SIPS surgery, and I find it hard to get my 80, but I'm also only about 6 weeks out, so hopefully that'll get easier.

[snowkitten 371]

No problem, and I've had SIPS surgery, and I find it hard to get my 80, but I'm also only about 6 weeks out, so hopefully that'll get easier.

Oh wow your doing really good to get 80 and only 6 weeks out. How do u like the sips? Have u noticed alot of bathroom visits? Did ur surgeon tell u how much u malabsorb? I can't seem to find that online. It's only the DS stats.

[janedoe92 260]

I'm happy with my surgery so far. I had bowel problems before and would make frequent stops to the bathroom and ever since surgery I only go once a day, so I was happy about that. I'm actually not sure I malabsorb, but I don't have a problem with it being less than traditional DS I'm just happy I'm finally losing weight. Are you going to be having traditional DS or SIPS?

[snowkitten 371]

I'm happy with my surgery so far. I had bowel problems before and would make frequent stops to the bathroom and ever since surgery I only go once a day, so I was happy about that. I'm actually not sure I malabsorb, but I don't have a problem with it being less than traditional DS I'm just happy I'm finally losing weight. Are you going to be having traditional DS or SIPS?

I'm really not sure. I talk to my surgeon on wensday so I'll ask him all my questions then. I'm leaning towards the traditional DS only because there isn't long term data on the SIPS. I don't wanna fail again u know?
How much have u lost?

[janedoe92 260]

I'm really not sure. I talk to my surgeon on wensday so I'll ask him all my questions then. I'm leaning towards the traditional DS only because there isn't long term data on the SIPS. I don't wanna fail again u know?
How much have u lost?

Yeah I know what you mean, and I've lost 28 lbs since surgery 41 since preop.

[snowkitten 371]

Yeah I know what you mean, and I've lost 28 lbs since surgery 41 since preop.

I'm really not sure. I talk to my surgeon on wensday so I'll ask him all my questions then. I'm leaning towards the traditional DS only because there isn't long term data on the SIPS. I don't wanna fail again u know?
How much have u lost?

Awesome! Congrats!!

[janedoe92 260]

Thank you!