a bit graphic but important info needed please

[jpeo1990]

hi folks, I am currently waiting a date for my operation and have gone through all the stages. my question is I'm down for a gastric bypass however I have a condition called bile salt malabsorption which can cause loose stools or the dreaded runs as people like to technically call it.

I'm aware that WLS can cause issues with the likes of IBS etc has anyone got any personal experience of the surgery causing bowel conditions to become worse? I know it is a risk that is mentioned a lot but my condition is quite uncommon and my consultant cant say that it wont aggravate my condition.

thanks in advance all

J x

 

[SAM55]

I had a similar problem a few years ago and they thought it was bile salt malabsorption caused by gall bladder surgery, so I can understand why you are worried about it getting worse. (In fact they were wrong in the end and I sorted it with a very high grade pro-biotic that I got on prescription). I and most other people find constipation is more likely, due to the high protein and trouble getting enough liquid in.

Bowel habits are a common topic on here so don't worry about being graphic.

 

[jpeo1990]

thanks very much for your reply. this may sound strange but I'm pleased you have actually heard of this before because none of the doctors in my GP practice or a number of consultants ive seen for various things have even heard of it. quite frustrating to be honest! I have never really thought about it from the other perspective of the limitation of fluid and high protein diet could have on it as I have always thought about the fact I'm having a bypass and that causes malabsorption that putting 2 malabsorptions together would equal not a very nice time for me haha!

this is the only thing that has been worrying me about having the operation and I know right up until I'm getting put to sleep for the op I will be panicking about it!

 

[SAM55]

thanks very much for your reply. this may sound strange but I'm pleased you have actually heard of this before because none of the doctors in my GP practice or a number of consultants ive seen for various things have even heard of it. quite frustrating to be honest! I have never really thought about it from the other perspective of the limitation of fluid and high protein diet could have on it as I have always thought about the fact I'm having a bypass and that causes malabsorption that putting 2 malabsorptions together would equal not a very nice time for me haha!

this is the only thing that has been worrying me about having the operation and I know right up until I'm getting put to sleep for the op I will be panicking about it!

It is always good to feel you are not alone. Do you know what the cause of yours is?

Why have you/your consultant chosen the bypass rather than the sleeve?

 

[jpeo1990]

I have always been told by my consultant that the bile salt malabsorption is just down to my liver excreting too much bile meaning it cant all be absorbed back naturally meaning I have more fluid in my bowels and thus causing loose stools. I am on a binder that I take upto 6 times a day depending on flare ups but I am only on 1 sachet 90% of the time.

my gastro consultant has said only the bypass would work for me due to having severe reflux along with barretts oesophagus. he said the sleeve is not an option as this can cause more reflux and due to my oesophagus already being damaged they cannot risk it getting any worse especially considering I am on the strongest ppi at the highest dose they prescribe and I am still having really bad reflux.

 

[TiaLi]

That sounds sensible, if your reflux has already resulted in Barrett's you really don't want to risk it. Many gastric bypass patients will experience an improvement in their reflux issues after surgery since the removal of the pyloric valve will reduce the pressure. Personally I haven't noticed THAT much difference though to be honest, I still have to take PPIs, but I know of others who have seen a significant improvement.

I don't have any experience of bile salt malabsorption so can't really comment on that, but I did experience changes in bowel habits and developed issues I've never had before after my bypass surgery - primarily pretty bad constipation. Things started normalising at around 7 months out though, so if your symptoms do get worse afterwards it is quite possible that that is just temporary. And who knows - perhaps things even get better, given that constipation tends to be a common side effect instead? Even if your condition was more common, I think it would be difficult for anyone to predict how your body will react, because bypass patients seem to have quite different experiences. Some people develop food intolerances post surgery, some don't. Some people will get dumping syndrome, some don't, some become lactose intolerant, some don't - and so forth.

I hope it all goes well for you, good luck with everything x