Following the Duodenal Switch operation, patients will have more frequent flatulence. The problem can get worse with specific dietary choices. A very simple way of looking at this would be that, in general, Carbohydrates contribute to gas and the fat contributes to causing loose bowel movements. Carbohydrate or gluten sensitivity can also increase stool production.There is a significant overlap of the effects of carbohydrates and fat intake and one has to remember that the symptoms of gas and loose stool can often accompany each other.
In the majority of cases, when a patient is having a significant “gas problem,” a close investigation of the diet usually identifies the condition. The most frequent culprit is carbohydrates (breads, pasta, etc.). Special attention should also be given to Gluten in other food products, as these can cause gas, bloating and stool changes. Carbonation and diet soda should also be avoided. Other less obvious contributing factors may include artificial sweeteners (Splenda). Articifical Sweeteners may change the gut micro biome and increase gas produced by the gut bacteria. Milk Lactose can also cause significant gas. If the dietary sources of the “gas problem” have been eliminated, probiotics should then be considered. Additional information on probiotics can be found here. A list of probiotics that have historically helped patients is found listed on our supplements list here.
There is very little published scientific data on the actual bowel habits of Duodenal Switch patients, that I am aware of. Wasserberg et.al, from The University of Southern California in 2008, published “Bowel Habits after Gastric Bypass Versus the Duodenal Switch Operation”.
They concluded: “…Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.” Therefore, increased diarrhea or number of stools per day, following Duodenal Switch, should be investigated for a reason whether food, medical or pathological.Past blog post on Gas and Bloating.
Then, look at your diet or supplements and read your ingredients. How your body reacts to these items is very individualized and each person may have a different culprit. The best way to proceed is to eliminate all possible causes for a few weeks, then slowly add back in one item as a time to find the exact culprit. Once the gas producing culprit is identified it can be avoided.
Gas and GI Upset Causes:
- Magnesium citrate or Magnesium Oxide can cause loose stool, gas bloating for some. Check your supplement labels for these types of Magnesium. Magnesium Citrate is very common in Calcium supplements.
Magnesium Glycinate is a more absorbable form of magnesium. Magnesium Information here. - Too high of dietary fat intake. Fat Intake after Duodenal Switch here.
- Lactose (Milk Sugars)
- Milk or Milk products
- Artificial Sweeteners (Splenda, Aspartame (Equal), Acesulfame potassium (also known as Acesulfame K)),
- Sugar Alcohols (Usually found in sugar free items. List: https://www.diabetes.org/food-and-fi…)
- Sugar
- RTD shakes (many are whey concentrate which contains lactose)
- Preservatives
- Nitrates/Nitrites
- Additives
- Fruit
- Gluten from Bread products
- Flour (breading)
- Refried Beans
- Seasonings these may contain hidden or unknown gluten, MSG, etc.
- Meats (example: Pork causes some DSrs gas issues),
- Blend Protein Powders/Drinks (not whey isolate only, milk protein concentrate contains lactose)
- Cruciferous vegetables
- Legumes (Beans/peas/lentils)
- Refined or processed oils
- MSG
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