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Duodenal Switch and Distal Gastric Bypass (ERNY)

Posted On : December 04, 2009

On 10/28/2009 I had a variation of the RNY gastric bypass (Distal Gastric Bypass) known as the Fobi pouch. I lost over 270 pounds, but I had debilitating complications of dumping syndrome, reactive hypoglycemia, acid reflux and vomiting.

My entire day was pretty much controlled by dumping syndrome. Due to the hypoglycemic episodes that resulted from dumping syndrome, I was constantly in a binge cycle, because I constantly needed to stabilize my blood sugar. I would eat breakfast and need to lay down. Once I started having hypoglycemia, I would get up and splurge on carbohydrates.

Note that my dumping syndrome was not caused by poor food choices. I only splurged off carbohydrates in a desperate attempt to quickly get my glucose levels up. This did work, but it lead me to dumping syndrome again. I then had another episode of hypoglycemia, which lead to more binging which resulted in more dumping, more binging and weight gain. Here is a diagram of the cycle I was constantly in:

Eat –> dump –>hypoglycemia –> binge –>redump –> more hypoglycemia –> binge –> dump

This was a constant cycle I was in, and as you can see here, my entire life became controlled by dumping syndrome, and it eventually caused me to become disabled. I am a full time student and was not able to go to school in this state. I would eat lunch and then go to class only to start dumping ten minutes into lecture, and I ended up dropping my classes for the semester.

I went to my bypass surgeon and told him of the problems I was having, and he told me that I was anorexic. I was also told that it was “…all in my head.”

After doing much research, I consulted with Dr. Keshishian. I handed him a list with the problems I was having and asked if revision to the duodenal switch would resolve these problems. Dr. Keshishian drew out a diagram of the anatomy of my surgery and showed me exactly why I was having these complications. I remember him saying, “There is a physiological explanation for why you are having these problems. It is not in your head. Yes, revision will resolve these complications.”

I had my revision on 4/11/2011, and all the complications I had with my bypass have been resolved, and I have had no complications with my duodenal switch. Now that my pylorus is working again, I can eat without becoming ill. I have now gone back to school, work, and have resumed back to a normal life.


7 responses to “Duodenal Switch and Distal Gastric Bypass (ERNY)”

  1. Hello….I am curious as to why you say you had a distal gastric bypass and that it is also called a Fobi Pouch? These are two different procedures. The distal gastric bypass generally staples off a portion of your stomach to create a pouch….the Fobi is a plastic band placed between the stomach and the small intestine that keeps the opening standardized for life, unlike the distal which can stretch over time…

    • I apologize….I just re-read your comments where you do state that you had a variation of the distal gastric…. So my new question is this – because of the Fobi ring, is that what was determined to be causing all the issues you were experiencing because it was not allowing the food to pass more naturally?

    • Hello the terms Fobi pouch refers to the stomach component. The term distal bypass refers to the small bowel component. In the scientific literature it has been shown that distal gastric bypass does not solve the problem of weight regain, commonly seen after the RNY-Gastric bypass.

      • why are surgeons so reluctant to perform the surgery. I live on the east coast, Maryland, and the dr.’s that I have heard of that did perform the DS have stopped and the ones that do perform it make you pay out of pocket – they won’t accept insurance.

        • Yasmeen, there is a list of surgeons who will revise RNY patients to Traditional DS, including some on the east coast. If you are still looking email me. I also Admin a Facebook group for revision patients revising from RNY to Traditional Duodenal Switch and Distal Bypass.

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