Please help - Gastric Bypass vs SADI

[GigglyPuff 0]

Hi there!

Been on my surgery journey for a few years now and I'm finally coming up on my RYGB surgery date in a couple weeks. It might just be nerves but over the last couple of months I've started to rethink whether I'm making the wrong decision with the going with the bypass. I spoke to my surgeon about a week ago & expressed I might want to switch to SADI. She said it's ultimately my choice, but she feels like RYGB is a better fit for me personally as I have a history of GERD (currently mild) and that she's concerned I might lose too much weight with SADI - I need to lose 100lbs.

I've been reading & watching a lot of posts from people that have had each procedure & I'm really concerned with the idea of throwing up & having to eat a couple of bites per meal the rest of my life. The thing is, I rarely see anyone post complications with SADI. They seem to eat small meals but not as small as restrictive as RYGB patients & while they experience diarrhea - I don't see posts about vomiting. I mean, does everyone experience vomiting & dumping syndrome with RYGB? Does anyone know people that have had poor experiences with SADI?

Ultimately, am I making the wrong decision by not going with SADI?

[BlondePatriotInCDA 496]

1 hour ago, GigglyPuff said:

Hi there!

Been on my surgery journey for a few years now and I'm finally coming up on my RYGB surgery date in a couple weeks. It might just be nerves but over the last couple of months I've started to rethink whether I'm making the wrong decision with the going with the bypass. I spoke to my surgeon about a week ago & expressed I might want to switch to SADI. She said it's ultimately my choice, but she feels like RYGB is a better fit for me personally as I have a history of GERD (currently mild) and that she's concerned I might lose too much weight with SADI - I need to lose 100lbs.

I've been reading & watching a lot of posts from people that have had each procedure & I'm really concerned with the idea of throwing up & having to eat a couple of bites per meal the rest of my life. The thing is, I rarely see anyone post complications with SADI. They seem to eat small meals but not as small as restrictive as RYGB patients & while they experience diarrhea - I don't see posts about vomiting. I mean, does everyone experience vomiting & dumping syndrome with RYGB? Does anyone know people that have had poor experiences with SADI?

Ultimately, am I making the wrong decision by not going with SADI?

Your surgeon is right it is your decision, but, your surgeon also knows based on past patients experience and your health background, stats etc., what she feels based on her experience what would be the best for you. The surgery itself, the aftercare and long term outcome.

I've never had to throw up, get the runs or any issues with my bypass. I feel most ppl don't have issues, but you hear about these that do, because why post everything is great I have no issues or questions?

I chose the bypass because I have the worst luck known to mankind and I just knew I'd start getting acid refux/GERD if I didn't and I'd be back for a revision later. I've had no issues - none!

I'm not sure why you think getting a SADI wouldn't have a chance to effect you the same way a standard bypass would. There is still the possibility of nausea/vomiting etc. I think if you only have 100 lbs to lose ....I agree with your surgeon, it might be a bit much unless you have diabetes or a BMI of 50% or higher.

Just my two cents..although with todays economy..maybe its only worth a half cent! Finally, you won't spend your entire life only eating a spoonful of food at each meal, just smaller portions.

[catwoman7 11,214]

most people with bypass don't have complications- and of those who do, they are usually minor and correctable (or in the case of dumping, preventable). Major complications with bypass are pretty rare.

only about 30% of bypass patients dump. I never have, and neither do most of the other bypass patients I know. For those who do dump, it can usually be prevented by not eating a bunch of sugar or fat at one sitting (which none of us should be doing *anyway*).

I threw up occasionally the first few weeks after surgery when I ate too much, too fast, or something that my stomach wasn't going to tolerate, but now I throw up about as often as I did pre-surgery - that is, very rarely. And as for food intolerances, most of those are temporary, but some can become permanent. But you'll figure out what your body will and won't tolerate pretty quickly.

re: only eating a couple of bites of food. That's only in the first few weeks after surgery. For the last several years, no one would be able to tell I've had bypass surgery by watching me eat. They'd just assume I'm a "light eater", like many of my women friends who've never been obese. When I go to restaurants, if I'm not that hungry, I'll order something like an appetizer, Soup, or a salad. If I AM hungry, I'll order an entree, eat half of it, and box up the rest to take home. Most of my women friends do the same thing.

you're probably seeing more issues with bypass for two reasons: 1) it's a much, much more common surgery than SADI. As in a LOT more people have bypass than SADI, so of course you'll see more on it. 2). after people get over the first few weeks (which can be tough with either surgery), they usually only post when they're having some issue, because they're looking for advice or support. People who've never had issues (which would include most of us) aren't likely to post that everything is hunky-dory.

as far as which to choose, they're both good surgeries. Advantage of SADI is it's a stronger surgery, and you'll likely lose more weight with it. Disadvantage is regular doctors (as opposed to bariatric surgeons) know a lot more about bypass than they do about SADI, so your PCP may not be able to help you if you have issues - they may have to refer you to a bariatric specialist (which, of course, is fine - but just something to keep in mind). Also, if you have GERD, bypass is usually the better choice, since it tends to improve GERD, if not outright cures it. SADI involves a sleeved stomach, which can cause GERD in some people (or make it worse if they already had GERD before surgery). It doesn't happen to everyone, but it IS a risk...

good luck with your decision!

[Shanna NYC 148]

I'm obviously not a professional and can only speak on my experience as a bypass patient - I have not experienced vomiting or dumping syndrome and I'm a little over 9 months post-op. Even when meeting with my surgeon and he asked me what I was considering and why - before providing his own assessment - I said bypass as sleeve wasn't enough and SADI is too much - and he agreed. I have only experienced occasional mild acid reflux previous to surgery and did not want to put myself in a place to make it worse.

My food portions are obviously smaller than prior (that's why we have these procedures), but it is not just a spoon or two at this point. That was only closer out from surgery. I am at about a half cup to a cup depending on density of what I'm consuming and that will still evolve even more further down the line.

In my opinion, SADI is better for those who need to lose a lot more and may be diabetic as it is quick to reverse that. It may not be everyone's assessment and you have to choose what is best for you with your doctor's suggestion. I've heard and read it is difficult to revise should the need arise and it's mainly too many fats and/or sugars is what causes the diarrhea. Both require to be on vitamins/supplements for life, but it's even more important with the SADI as there is far more malabsorption.

You will know what's best for yourself and your body and I wish you much luck.

[ChunkCat 729]

If you haven't had surgery yet, you may want to join the support group "Duodenal Switch SUPPORT Group" on FB for SADI/DS patients. https://www.facebook.com/groups/1799552573392212 There are a number of patients on there who have had the RNY and done revisions to SADI or DS.

Honestly, the choice is up to you and how comfortable you are with your surgeon's opinion. There are plenty of lightweights who get SADI surgeries, especially those with pre-existing conditions. But some insurance companies still consider the SADI to be experimental, so be sure yours doesn't if you decide on it.

You can get vomiting with any bariatric surgery. You can get diarrhea with any surgery. And while RNY can be good for GERD patients, there are plenty of people with GERD who still end up with a SADI or DS. I'm one of those patients, I have had GERD issues for years, but I wanted a more robust surgery than the RNY and two surgeons both agreed the DS would be the better option for me because I'm diabetic. The surgery normalized my blood sugar within 24 hours, as well as my blood pressure, and my cholesterol and triglycerides are normal now. It packs a huge metabolic punch. but I do have to watch carbs and sugars or I get diarrhea. My starting weight at surgery was 307, my goal is 180/170. But I regularly see lighter starting weights in my FB support group... Surgery type is a really individual decision!