Hi

[Craftwork]

I am 8 years on from RNY. Just had 2 iron infusions for iron deficiency anaemia. Ferritin levels low for 4 years, before became very anaemic. Dr said levels normal for me! Referred to gastro who sorted it out. Also had diarrhoea since RNY but much worse since gall bladder removed 15 months ago. Gastro trying me on Creon.

 

[southernlady]

Welcome Craftwork
Anemia after RNY (and the DS) is pretty normal since most of where we absorb iron is out of the picture.

As far as diarrhea, what are you eating daily? First, clean up your diet if carbs have made a re entry into your eating habits. Go to water and plain meat for a couple of days. You should clear up and two days will not make a large impact on vitamins ect levels. Then start reintroducing foods slowly and keep track of how your system responds. Something is giving you fits and the only way to find it is an elimination diet.

It could be lactose, an artificial sweetener, some react to things like onions, type of fat, eggs, just about anything which is why water and one plain meat for a day or so helps clean you out.

Also if you aren't on a probiotic, try it. It may actually make it worse for a week or so but keep at it. Just means your gut had bad bugs in it.

 

[Craftwork]

Welcome Craftwork
Anemia after RNY (and the DS) is pretty normal since most of where we absorb iron is out of the picture.

As far as diarrhea, what are you eating daily? First, clean up your diet if carbs have made a re entry into your eating habits. Go to water and plain meat for a couple of days. You should clear up and two days will not make a large impact on vitamins ect levels. Then start reintroducing foods slowly and keep track of how your system responds. Something is giving you fits and the only way to find it is an elimination diet.

It could be lactose, an artificial sweetener, some react to things like onions, type of fat, eggs, just about anything which is why water and one plain meat for a day or so helps clean you out.

Also if you aren't on a probiotic, try it. It may actually make it worse for a week or so but keep at it. Just means your gut had bad bugs in it.

Hi,
Carbs have reappeared in my diet. I am also having problems with glucose control and have recently developed diabetes ( had impaired glucose for 16 years). I have ongoing issues with dumping syndrome, often 2-3 hours after eating when the only treatment is fast glucose in the form of orange juice or dextrose tablets. I do not drink alcohol, A tot of wine makes me feel drunk. I have recently purchased some chewable multivitamin and mineral supplement as my previous one was unpalatable. I have high dose vitamin D, B12 injections, extra folic acid and iron will be monitored and infusions given when necessary. I live in England and very few RNY or carried out now and most surgeries are gastric band or sleeve neither of which cause malabsorption. There is very little nutritional follow up. I have been to see 2 nutritionists but their advice was not suitable for a gastric bypass person.

 

[southernlady]

Hi,
Carbs have reappeared in my diet. I am also having problems with glucose control and have recently developed diabetes ( had impaired glucose for 16 years). I have ongoing issues with dumping syndrome, often 2-3 hours after eating when the only treatment is fast glucose in the form of orange juice or dextrose tablets. I do not drink alcohol, A tot of wine makes me feel drunk. I have recently purchased some chewable multivitamin and mineral supplement as my previous one was unpalatable. I have high dose vitamin D, B12 injections, extra folic acid and iron will be monitored and infusions given when necessary. I live in England and very few RNY or carried out now and most surgeries are gastric band or sleeve neither of which cause malabsorption. There is very little nutritional follow up. I have been to see 2 nutritionists but their advice was not suitable for a gastric bypass person.

I understand the return of diabetes as I have been in the 2-5% of DS'ers who do not stay resolved.

Orange juice...no, pure sugar and probably partially responsible for the diarrhea.
Dextrose tablets, just enough to get you OUT of danger and then follow up with protein and a bit of fat. Peanut butter eaten off a spoon is an awesome option.

High dose D? What amount and brand?
RNY'ers and DS'ers need a dry form of vitamin D. Not sure what UK'ers can get but here in the US, we suggest the BioTech Dry D3 50,000 a day. Other brand options are Nivegan and BioPhix. All are dry (as in capsule form that can be pulled apart), all come in 50,000 IU and all need to be taken daily. (OR more).

Need to rein in the carbs. I know they taste good but focus on protein and good fats. You need about 30-40 grams of fat per day for brain health as a normal person. I doon't know how much extra a RNY'er might need.

 

[hilary1617]

Craftwork, Creon can do great things for increasing absorption of nutrients, but it can be very difficult to take. You didn't mention it, but many of us who have taken Creon experience burning tailfeathers from acidic diarrhea; bile salt diarrhea is also a known complication of gall bladder removal. If you have this burning effect, you should speak to your doctor about adding Welchol (colesevelam) or a similar bile acid sequestrant. It works wonders. Best wishes and sorry you are going through this.

 

[Craftwork]

Thank you for your replies. I saw a diabetologist/endocrinologist yesterday. Referring me to diabetes specialist nurse and bariatric/diabetic dietician. The gastroenterologist gave me a course of Rivaximin, a very strong antibiotic to kill off any bugs in the colon, which is apparently a major cause of diarrhoea post op. The condition is called small bowel bacterial overgrowth. Creon is definitely helping, only beentaking it 3 weeks and I agree with ‘burning tailfeathers’!. Gastro did suggest bile salt sequestration might be useful, but one stage at a time. I feel much better after iron infusion. I take Vit D in form of Pro D3. 10,000units weekly and adcal D3 chewable twice a day. It was the dietician who suggested a small orange juice daily, to keep up Vit C and add the horrible force all to. I was 125 kg before my surgery with a bmi of 48.7. I’d had a stroke, sleep apnoea. Following my RNY, I lost weight rapidly for 6 months, then it stopped. It took a further 12 months to lose 1 stone(14 pounds). Over 3 years I went down to 76 kg, still in the obese range, but healthy. The bariatric nurses said my progress was similar to a gastric band rather than bypass! Machine for sleep apnoea no longer needed, yeeeay. Unfortunately, I have regained 2 stone which I seem unable to shift. I have recently retired from work and my activity levels have reduced, perhaps part of the problem.i had a fleur De lys abdominoplasty 3 years ago, so my massive ‘apron’ has now gone, no infections any more, brill. Thank you for allowing me to join this group. I think you’re further on in bariatric Care in USA. It’s very much still a novelty here, gastro said most family practices have only 2 patients post bariatric surgery.
Also advised monitoring of blood sugars, due to frequent meals and dumping, suggested a continuous glucose monitor. Can’t prescribe as only available on prescription for type 1 diabetes. I have tried to purchase a Freestyle Libre and sesnsors but they’ve stopped all sales to new customers, unless nhs prescription. None available until July. Just had a thought. I wonder if I could get one through a private prescription. This would enable me to continuously monitor my glucose and see what my sugar levels are doing and how often it’s spiking and dipping. The information can be downloaded for the doctor.

 

[Spiky Bugger]

Craftwork,

Have you tried this guy? http://www.ameetpatel.co.uk

He performs the DS as well as other bariatric surgeries, so he may be more informed about malabsorption issues than the average bear.

Good luck,

Sue

Also, his patients almost always mention that Mr. Patel is HOT.