Duodenal Switch vs Gastric BypassIt has been quite a while since the procedure of gastric bypass has been taken up by the doctors, as well as by the patients as a very effective tool to treat obesity. Though the advantages of this mode of treatment are undeniable, it is however, never devoid of certain obvious side effects. There is another widely performed weight reduction surgery called duodenal switch or gastric reduction duodenal switch (GRDS) which can be more efficient in effecting overall weight loss. So those who have decided to undergo a weight reduction program can be in a dilemma about choosing the right procedure to get rid of those unwanted pounds permanently. If you are one among them, then instead of troubling yourself with unnecessary confusions, you can go through this comprehensive and comparative study on Duodenal Switch vs Gastric Bypass.
The Basic Of Basics
First of all, you should know what do these two modes of treatment are all about. Gastric bypass is basically a type of Bariatric surgical process where the stomach of the patient is divided into an upper pouch and a lower pouch. Thereafter, surgeons set up the small intestine and connect it to both the pouches. It helps to cut down the size of your stomach and thus, lowers down the amount of food you can eat at one time.
On the other hand, duodenal switch is actually a combination of two operative procedures: restrictive and malabsorptive. By performing the restrictive process, the bariatric surgeon vertically divides the stomach and removes 85% of it. The residual part is given a banana-like shape and measures about 100 to 150 millimeters and weighs about 6 ounces. However, the pyloric valve is kept intact, which regularizes the release of stomach contents into the small intestine. The malabsorptive component of the surgery includes rearrangement of the small intestine to separate the food flow from the pancreatic juices and bile. The food, as well as the digestive juices can interact only in the final 18 to 24 inches of the intestine, and thus, it leads to malabsorption. With DS, you start consuming less food than what you used to, and a large amount of food you consume passes undigested through the truncated intestines.
Doctors prescribe both the DS and GP to highly obese people whose BMI (that is body mass index) is more than 40.
Both Duodenal Switch and Gastric Bypass have some clear advantages on those who have undergone any one of the surgeries. They can be mentioned as the following:
Benefits Of Gastric Bypass
- Generally, people have reported that they have started losing weight right after the operation, and have continued to lose so for about two years after the procedure.
- Typically, the patients lose 65%-80% of excess body weight. However, though in some cases, they have regained 5-10% of the weight they lost, the process allows the patients to maintain the weight loss for a long time.
- It also helps to eliminate, or at least improve the complications which are generally attributed to obesity. Such symptoms include adult diabetes, hypertension, sleep apnea, gynecological complications and the like.
- Increased energy level, higher self esteem.
- GERD (Gastro Esophageal Reflux Disease) is cured in almost every case.
- Lower back pain, joint pain, venous thromboembolic disease signs such as leg swelling are typically improved or relieved in almost all patients.
Benefits Of Duodenal Switch
- The Duodenal Switch has been proved to be the most effective overall long-term weight loss procedure among the different weight loss surgeries.
- Type 2 diabetics get immediately cured after the surgery. In fact, in many of the European nations, surgeons perform the switch procedure to cure diabetics.
- Since the pyloric valve that lies between the stomach and small intestine is preserved in DS, people who have undergone this procedure do not suffer from the dumping syndrome, which is very common with people who have gone for gastric bypass.
- It also helps to alleviate complications like arthritis, snoring, sleep apnea, hypertension, high cholesterol and high triglycerides, gastro esophageal reflux disease, asthma, and urinary stress incontinence.
- Finally, the diet following the DS is more normal and endurable than with any other surgeries.
Though the health benefits of both of the procedures are obvious, none of them are absolutely free from certain disadvantages and fallout. Let us have a look at the downsides of these surgeries.
Disfavors Of Gastric Bypass
- Infection inside the stomach is likely to take place owing to the release of bacteria from bowel during the surgery.
- After the operation, the patient may suffer from internal hernia for the rearrangement of the intestine. This can cause a serious bowel obstruction. In fact, an incisional hernia can take place if the surgical incision does not heal optimally.
- Anastomotic leakage in the stomach-intestine connection.
- Anastomotic stricture.
- Anastomotic ulcer.
- Dumping syndrome is likely to take place after a gastric bypass surgery. It is a condition where consumed foods bypass the stomach too quickly and thus, enter the small intestine in largely undigested form.
- Gastric bypass patients can also suffer from certain nutritional deficiencies after the operation, such as deficiency in calcium, zinc, iron, vitaminB12, vitamin A and protein.
Disfavors Of Duodenal Switch
- If the patient starts eating too much carbohydrate after the surgery, he can suffer from excess gas.
- Deficiency in fat soluble vitamins (A, D, E, and K) is possible.
- Patients are likely to develop osteoporosis like the gastric bypass.
- Patients can suffer from diarrhea if he/ she starts to eat too much fat.
- Gall stones.
What Do The Experts Say?
- The researchers, of Cornell Medical Center in New York have claimed in one of their study reports that gastric bypass may not be the most effective surgery to lose weight.
- After another study in 2006, researchers from the University of Chicago have observed similar result with the morbidly obese people, who had a minimum body mass index (BMI) of 50. The researchers, after investigating the cases of the patients, it was concluded that those who had undergone DS could lose more weight than the patients who opted for Gastric bypass.
A study, which was based on about 350 post surgery morbidly obese patients, showed some interesting results:
- Till date, each of the diabetic patients who have undergone DS could completely cease their medication for diabetes. In this occasion, DS boasts of a sweeping win over Gastric bypass surgery, undergoing which only 60% of the patients could fully recover from diabetes.
- A whooping 68% of the patients, who opted for duodenal switch, could stop taking their medicines for hypertension, contrasted to 38% of gastric bypass patients.
- Finally, 72% of DS patients have absolutely stopped taking high cholesterol related curatives in comparison to 26% of gastric bypass patients.
If a debate on Duodenal Switch vs Gastric Bypass is ever raised, the former appears to have a clear win. However, you should always keep it in mind that whatever surgery you go for, it involves some risk. Post surgery, you may suffer from some immediate complains. What is more, some long term risks like hernia and bowel obstruction can also await you sometime. Thankfully, each of the complications can be well taken care of. So whichever weight reduction surgery you go for, make sure that you have consulted the matter well with your physician.
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