Is duodenal switch surgery suitable for me?
The criteria used by the National Institute of Health and Clinical Excellence (NICE) to determine whether you are eligible for surgical intervention are:
Are you classified as obese?
Does your obesity cause you problems?
Have you tried hard to lose weight using conventional treatments?
The most suitable type of surgery depends on several factors, including your body mass index (BMI). Duodenal switch surgery is generally used in people with a BMI of more than 50 kg/m2.
The surgical team will also take other factors into account, including:
Your age/gender/ethnic background.
Your history of weight gain/weight loss.
Whether you have other illnesses such as type II diabetes, hypertension, sleep apnoea, arthritis, and asthma.
If you have medical/genetic reasons that make you gain weight.
If you are taking any medication.
How is duodenal switch surgery performed?
The first part of duodenal switch surgery, known as a sleeve gastrectomy, involves removing ¾ of the stomach. The stomach that is left is made into a narrow tube. The second part , the distal bypass, rearranges the small intestine so that calories and some nutrients can’t be absorbed as well After around 12 to 18 months, your stomach will expand to hold a small to near-normal sized meal, but the changes to the intestines will remain intact so that you can maintain your new, lower weight.
You will usually need to stay in hospital for 4 to 6 days following duodenal switch surgery.
What are the risks with duodenal switch surgery?
Duodenal switch surgery may cause slightly more of the side effects commonly affect all distal bypass patients - including smelly wind, diarrhoea, vitamin/mineral deficiencies or protein-calorie malnutrition. These problems generally clear up within six months of surgery and you can manage them by being careful about what you eat and by taking activated charcoal tablets.
After duodenal switch surgery, there is usually a period of ‘intestinal adaptation’, during which there may be frequent loose bowel motions (up to 10 to 15 times a day). This may persist for several months and in some case, you might find this carries on permanently.
Lifestyle changes following duodenal switch surgery
You will definitely need to adjust your diet following surgery but not quite so much as with gastric bypass surgery. You will need to eat far less fat - because fat absorption does not start until later in your new digestive tract, eating high fat foods causes undigested fat to pass through – making the usual side effects much worse. The poor food absorption that follows duodenal switch surgery also means that you take in less protein and less of the important vitamins and minerals such as vitamins A, D E and K, iron and zinc. You therefore also need to eat a diet that is high in protein, as well as taking vitamin and mineral supplements for the rest of your life.