Gastric bypass surgery is the most popular weight loss surgery but doesn’t provide the highest expected weight loss. Duodenal Switch provides the highest average expected weight loss available but comes with more risks and complications.
Acid Reflux and GERD (Pyloric Valve Regulating Food)
In the duodenal switch, the stomach size is reduced and the pyloric valve, or pylorus, stays untouched. Restriction in the stomach increases gastric pressure and reduces gastric emptying. In gastric bypass, the pyloric valve stays connected to the separated stomach, and the new pouch redirects most of the stomach acid to stay out of the esophagus. Therefore, Roux-en-Y gastric bypass is best for patients with acid reflux or gastroesophageal reflux disease.
Dumping syndrome is an abdominal discomfort accompanied by rapid heart rate, palpitation, nausea, vomiting, and explosive bowel evacuation. It is estimated that over 50% of gastric bypass patients experience dumping syndrome due to the unregulated flow of food from the stomach to the small bowel.
- Early Dumping Syndrome – Instantly after eating food. Symptoms include abdominal pain, cramping, nausea, and light-headed.
- Late Dumping Syndrome – 1 to 2 hours after eating food. Symptoms include lack of energy, exhaustion, perspiration, and feeling “out of it.”
Staying on the post-op diet usually fixes this problem and patients usually outgrow symptoms.
If the patient has had or currently has ulcers, the duodenal switch is recommended over gastric bypass surgery. The pouch that is formed with bypass surgery is so small, it is referred to as the “blind” stomach. It is nearly impossible for ulcers to be detected without a doctor laparoscopically scoping the stomach under anesthesia. Taking Aspirin or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) increases the risk of ulcers.
Curing Obesity-Related Health Problems
Both procedures cure comorbidities like Types II Diabetes and hypertension, however, duodenal switch surgery is much more effective with remission of obesity-related diseases. The duodenal switch also shows much quicker results in its metabolic effect.