Duodenal Switch post-op eating plan

In many respects, the advice for duodenal switch patients is similar to that for gastric bypass patients. One advantage of a duodenal switch is that in the longer term, you will be less restricted in the foods you can eat, and because of the re-configuration of your intestines, you will have a greater degree of malabsorption after a duodenal switch – so you will absorb fewer calories from your food and lose more weight.

However, because fat absorption does not start until later in your new digestive tract, eating high fat foods can lead to more undigested fat passing through – offensive (very smelly) wind and loose stools are the main indicators of this. Reducing your fat intake should solve this problem.

The other major area to watch with your diet is the protein intake. Because of the degree of malabsorption, your protein absorption is reduced, together with the absorption of important vitamins and minerals such as Vitamins A, D E and K, iron and zinc. A diet high in protein, double the normal amount, is required to prevent protein deficiency as well as taking vitamin and mineral supplements for the rest of your life. Having double the normal protein intake is not quite as easy as it sounds, especially as you initially have a reduced capacity for food anyway and it is very important that you develop a good relationship with your dietitian/nutritionist to work out an eating plan to meet your needs.

Vitamin Supplements Required After DS Surgery.

  • Vitamins: Take one multivitamin tablet each day. This will cover many of the essential vitamins and minerals but there are others which you need to pay special attention to in addition to this. A and D are very important fat soluble vitamins, and because you are not absorbing fats you will need to take a water soluble version - many people take ADEK vitamins – (produced by Scandipharm and available in the UK on a named patient basis from SHS International Ltd, Wavertree Technical Park, 100 Wavertree Boulevard, Liverpool L7 9PT (0151 228 8161)) generally three per day to maintain a proper level of these vitamins. If you need to take blood thinning medications (anticoagulants) you must watch your vitamin K level, and your doctor needs to know that you will be very sensitive to anticoagulants.
  • Calcium: Calcium is the most important mineral for you to take after DS surgery. Most of the body’s calcium is stored in bones, which are very important to your strength, function, and body stability. Calcium plays a vital role in many basic physiological processes, including blood coagulation, the sending of messages along nerves, maintenance of muscle tone, preservation of cell membrane integrity and permeability, and certain glandular functions. Less than 1% of your calcium is available in extracellular fluid (body fluid outside cells) for these important functions, the rest being found in bone. If your serum (blood) calcium is low, your body will take the calcium that it needs from your bones and over a long time will make the bones soft and easier to break (osteoporosis, especially in pst0menopausal women). Thus, it is important to take the proper calcium supplementation. Since you have the first 60% of your small bowel bypassed, you will not absorb enough calcium. You must take calcium supplements, about 1,500 – 2,000mg per day. “Tums” will work well in the first few weeks, are easy to take, help settle your stomach, and reduce gastric irritation. Later, when you are able to take pills more easily, your doctor may prescribe Citracal which is a form of calcium citrate, or Cal Apatite, which is a form of microcrystalline hydroxyaptite, the most readily absorbed form of calcium (followed by calcium citrate, and then calcium carbonate which is least easily absorbed because it requires acid to dissolve it in the stomach). Any type of liquid minerals or vitamins will be absorbed better than tablets will. If you can drink skimmed milk, it is a good source of calcium (300 mg. per cup) and is absorbed well.
  • Potassium: Most DS patients are prescribed potassium supplements straight after their surgery, but do not need them as time progresses.
  • Iron: About 10% of DS patients will need to take iron as the small bowel is sbsorbs iron from food and your stomach reduction also increases your likelihood of developing iron deficiency anaemia.