Posted - October 4, 2012

Duodenal Switch and Malabsorption

Duodenal Switch and Malabsorption Risk

Duodenal Switch and Malabsorption Risk Whether you are still thinking of getting duodenal switch (DS) surgery or have recently undergone the operation, chances are you’ve run into the word “malabsorption” a few times.

Weight loss forums and surgical pamphlets throw the term “malabsorption” around to raise an eyebrow of nutritional caution among weight loss patients, and you might have even discussed malabsorption with Dr. Stewart, your bariatric surgeon. However, many people don’t have a firm understanding of what malabsorption means, and why it is so relevant in the conversation surrounding DS surgery.

Malabsorption refers to a difficulty or inability to properly absorb nutrients from food. The most typical forms of malabsorption include difficulty absorbing certain proteins, vitamins, sugars and fats that are ingested with food.  When your intestines are unable to absorb food, the nutrients that you consume will travel through your body and naturally excrete with waste, but your body will still be in need of those nutrients.

Preventing Nutrient Deficiency after DS surgery

After getting duodenal switch, malabsorption doesn’t develop as a syndrome like it might in those who haven’t pursued bariatric surgery. Duodenal switch is a malabsorptive weight loss procedure. This means that the intestine is re-routed to interfere with the natural digestion process. The gastric bypass procedure is another example of malabsorptive bariatric surgery.

Malabsorption prevents fats, proteins and other nutrients from becoming absorbed by the body. By inhibiting calorie absorption it induces weight loss, but in doing this also reduces the body’s ability to absorb beneficial nutrients.  One 2005 study revealed that DS surgery can reduce fat absorption by 81 percent, but protein absorption is also reduced by up to 40 percent, so  it is crucial that DS patients pay close attention  to their supplement use and nutrient intake and not assume that “fat” will be the only thing the body won’t absorb.

While there are proven weight loss benefits of malabsorption procedures, there are also a few risks associated with the re-routing of the intestines. While fats are being pushed straight through the digestive tract and the body isn’t able to hold onto calories from fats in the foods you eat, this also means the healthy nutrients aren’t given the same chance they once had to be properly absorbed.

Appropriate education for DS patients prevents this malabsorption factor to affect their dietary balance of vitamins, protein and other nutrients. If you don’t pay close attention to your nutrient consumption after DS surgery, then you could wind up with a vitamin deficiency.

To prevent vitamin deficiencies, Dr. Stewart will discuss the different vitamins that you are encouraged to take regularly following DS surgery. You might want to consider a number of supplements, including:

  • Vitamin A
  • Vitamin D
  • Calcium
  • Potassium

A multivitamin is also generally recommended after DS surgery, as they contain many other nutrients that your body could be deficient in due to malabsorption.

A lot of people are encouraged to start taking dietary supplements before undergoing duodenal switch surgery, but you shouldn’t add any supplements to your diet without first talking to your bariatric surgeon.