BPD/DS anyone?

[Karenish 1]

Has anyone else chosen this surgery? It's actually the only one I'm interested in, but there seems to be so little post op info on it. Everything I read deals with RNY. Does anyone have decent books or sites they can recommend for more education?

[CelticBeautyEvolving 23]

I've been doing some reading about the DS procedure, so I'll be able to discuss my options with my surgeon next week - with my BMI and the weight I need to lose, the DS seems like it would be the first choice, BUT some of the potential side effects concern me. I have seen many posts about gas, and diarrhea being side effects that you just have to deal with - very high percentages of DS patients have significant gas and odor problems. I am not sure that is a side effect that I could live with ... I read several articles about it -- since my insurance does cover it, and it is very effective for those with large amounts to lose, but...I just can't imagine living with that issue for the rest of my life.

[Karenish 1]

13 hours ago, CelticBeautyEvolving said:

very high percentages of DS patients have significant gas and odor problems.

From what I'm reading, those problems are related to diet. If you keep a good food log, you can usually figure out which foods are causing the odor and bathroom issues. There are a couple of groups on FB dedicated to DS that I belong to and that is what I'm finding there.

[Poppyseed28 115]

I chose the DS. From the start it is what I wanted. There are more risks of nutritional deficiencies so you have to make sure you are taking all your Vitamins each day. The smelly gas is associated with eating more fat. My surgeon is very pro DS for those with very high BMI. I’m not even 2 weeks out and I have already lost 14 pounds and wouldn’t change my decision.

[CelticBeautyEvolving 23]

2 minutes ago, Poppyseed28 said:

. The smelly gas is associated with eating more fat.

My surgeon is very pro DS for those with very high BMI. I’m not even 2 weeks out and I have already lost 14 pounds and wouldn’t change my decision.

So two questions - did your team give you food suggestions NOT to eat, in order to avoid the gas? Or are you figuring it out on your own?

And would you mind sharing your starting BMI?

[Poppyseed28 115]

They haven’t given me any foods to avoid just to eat low fat. I am still doing full liquids at the moment and I haven’t gotten any smelly gas. I’ve past gas and there wasn’t a smell. My first 2 bm after surgery smelt pretty bad haven’t since. I’ll find out once I move to soft foods of certain foods cause it.

My hightes BMI when I met my surgeon was 59

[RickM 1,747]

My wife had a BPD/DS about fourteen years ago, plus a couple of years of unsuccessful insurance games beforehand (insurance considered it to be "investigational/experimental" at the time despite ASBS acceptance) so I guess you can say that we have been in the DS culture for a while, lol.

A couple of good resources to learn more about it would be:

https://www.dsfacts.com/ and

https://www.dssurgery.com/resources/videos/

On the gas/odor/diarrhea issue, it is a potential DS thing, but tends to be overblown by some surgeons who don't perform the procedure working to sell potential patients on those that they do perform. What they conveniently fail to mention is that the RNY is subject to the same problems for the same reasons - incomplete digestion and disrupted gut biome, particularly in the early days. "Never trust a fart" is a well ingrained part of RNY culture, and one can also do a net search for the Al Roker White House Shart story. Often, in both the DS and RNY worlds, patients report that this aspect is particularly sensitive to refined white flour products (which we shouldn't be eating anyway).

Diarrhea should never be a problem with any of these procedures as that reflects some kind of bacterial problem, and can yield dehydration problems but stool consistency can be variable. The DS specifically malabsorbs fats, so many go whole hog, or more on "full fat everything" and bacon with everything, etc. which can yield loose stools if the diet is overly fat. One doesn't normally need to go overboard with low fat products with the DS, but the normal balance point between Constipation and overly sloppy stool is shifted more toward the fat side than with the normal anatomy.

We have a dinner support group most every month with primarily 10-20 year post ops in the back room of a local restaurant, and have never gotten "gassed out" of the place, but it can be smellier at times than we normal folks (not that we are never sweet smelling ourselves!) but it was worthwhile to install a higher capacity exhaust fan in the bathroom!

In short, yes -this can be an "issue" but not an insurmountable one, and not one that is all that unusual compared to other malabsorbing procedures.

The other main compromise with the DS is that it is more demanding of the patient to be compliant with supplementing and lab follow ups. As I noted above, we are in regular contact with numerous long term post-ops and all are overall doing well Healthwise (considering that all are fifteen years older, give or take, than they were when they had surgery - that always takes a toll!) but warnings are brought up from time to time by the docs that they just saw a patient who they haven't seen in some years having some odd problem that nobody seems to be able to diagnose. Yes, it is usually some odd nutritional deficiency or imbalance that should have been picked up if they had done their labs regularly! If that type of responsibility is a potential problem then it would be better to go with a less altering procedure that is not as demanding - we did have one gal in our group who needed to have her DS backed out to fundamentally a VSG because she was unable to adequately keep on top of things and was suffering as a result (something that probably should have been picked up in the psyche review....)

The good side (really good side) is that the DS has much better regain resistance than the other mainstream procedures, so if one has a long history of yo-yo dieting, or substantial metabolic problems, then it is a better procedure than most others if one can live with the more demanding follow up needs. I went with the VSG instead because I had lost about a third of my excess weight while getting my wife on the table and kept that off for several years, so it didn't seem that I needed the extra power that the DS offered (still maintaining that after eight years) -different procedures for different needs.

[Fazzini Bee 76]

16 hours ago, RickM said:

My wife had a BPD/DS about fourteen years ago, plus a couple of years of unsuccessful insurance games beforehand (insurance considered it to be "investigational/experimental" at the time despite ASBS acceptance) so I guess you can say that we have been in the DS culture for a while, lol.

A couple of good resources to learn more about it would be:

https://www.dsfacts.com/ and

https://www.dssurgery.com/resources/videos/

On the gas/odor/diarrhea issue, it is a potential DS thing, but tends to be overblown by some surgeons who don't perform the procedure working to sell potential patients on those that they do perform. What they conveniently fail to mention is that the RNY is subject to the same problems for the same reasons - incomplete digestion and disrupted gut biome, particularly in the early days. "Never trust a fart" is a well ingrained part of RNY culture, and one can also do a net search for the Al Roker White House Shart story. Often, in both the DS and RNY worlds, patients report that this aspect is particularly sensitive to refined white flour products (which we shouldn't be eating anyway).

Diarrhea should never be a problem with any of these procedures as that reflects some kind of bacterial problem, and can yield dehydration problems but stool consistency can be variable. The DS specifically malabsorbs fats, so many go whole hog, or more on "full fat everything" and bacon with everything, etc. which can yield loose stools if the diet is overly fat. One doesn't normally need to go overboard with low fat products with the DS, but the normal balance point between Constipation and overly sloppy stool is shifted more toward the fat side than with the normal anatomy.

We have a dinner support group most every month with primarily 10-20 year post ops in the back room of a local restaurant, and have never gotten "gassed out" of the place, but it can be smellier at times than we normal folks (not that we are never sweet smelling ourselves!) but it was worthwhile to install a higher capacity exhaust fan in the bathroom!

In short, yes -this can be an "issue" but not an insurmountable one, and not one that is all that unusual compared to other malabsorbing procedures.

The other main compromise with the DS is that it is more demanding of the patient to be compliant with supplementing and lab follow ups. As I noted above, we are in regular contact with numerous long term post-ops and all are overall doing well Healthwise (considering that all are fifteen years older, give or take, than they were when they had surgery - that always takes a toll!) but warnings are brought up from time to time by the docs that they just saw a patient who they haven't seen in some years having some odd problem that nobody seems to be able to diagnose. Yes, it is usually some odd nutritional deficiency or imbalance that should have been picked up if they had done their labs regularly! If that type of responsibility is a potential problem then it would be better to go with a less altering procedure that is not as demanding - we did have one gal in our group who needed to have her DS backed out to fundamentally a VSG because she was unable to adequately keep on top of things and was suffering as a result (something that probably should have been picked up in the psyche review....)

The good side (really good side) is that the DS has much better regain resistance than the other mainstream procedures, so if one has a long history of yo-yo dieting, or substantial metabolic problems, then it is a better procedure than most others if one can live with the more demanding follow up needs. I went with the VSG instead because I had lost about a third of my excess weight while getting my wife on the table and kept that off for several years, so it didn't seem that I needed the extra power that the DS offered (still maintaining that after eight years) -different procedures for different needs.

Thank you, that was very informative.

[CelticBeautyEvolving 23]

RickM - thank you so much! That is all very helpful info!