Tag: supplements
Feeding Tube
April 20, 2015 11:43 am
Feeding tubes are catheters that are placed in the lumen of the gastrointestinal tract. They are used to provide or supplement the nutritional intake. The feeding tubes can be placed in the stomach (gastrostomy tube, G-tube) or the small bowel (jejunostomy tube J-tube). Patients who are having a revision of gastric bypass, VBG, or other weight loss surgical procedure that involves the stomach in our practice will have a feeding jejunostomy placed. The reasoning behind this is that in the unlikely event of a leak, or if the patient cannot tolerate adequate water or protein early on, this provides a way of getting hydration and nutrients. In the case of a patient with a small leak drained by the drainage tubes in place, a re-operation may be avoided if adequate nutrition can be provided to the patient by the feeding tube. Given that the J tube is placed in the small bowel, the patients usually require small, frequent feeding-hydration throughout the day.
The jejunostomy tubes are easily removed in the office.
Gastrostomy tubes are placed in the stomach. They can be placed endoscopically in an intact GI tract (they can not be placed in a gastric bypass patient without taking the patient to the operating room for a surgical approach). These tubes are easy to place, and large volumes of food and hydration can be administered simultaneously.
Additional information is also available here.
Different surgeons have different practice philosophies and approaches. After the revision of hundreds of failed gastric bypasses to the duodenal switch operation, It is my opinion that the benefits of a feeding jejunostomy far outweigh the short-term care issues associated with it.
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Vitamin D And A -Dry (Water soluble) Formulary
August 24, 2013 7:57 pm
Vitamin A and D are fat soluble vitamins. This means that in order for them to be absorbed by the GI track, them need to be absorbed by fat globules (chylomicrons). These are then taken up by the lymphatics of the GI track and taken to the blood stream. With the anatomical changes of the Duodenal Switch, the fat absorption capacity is significantly reduced. This results in excellent weight loss. It also results in much diminished absorption of the Fat soluble vitamins A, D, E and K. It is essential to use Dry Water Soluble forms of Vitamins A, D, E, and K. Bio-Tech is a brand that is formulated in this manner.
The Biotech D3-50 has 50,000IU of Vitamin D.
We recommend specific dosages of dry (water soluble) Vitamin A and D. These are not available at most pharmacies. In fact when our recommendations are presented at most pharmacies they are incorrectly dispensed with the fat soluble variety with is worth less becasue it is not absorbed by the duodenal switch patients. It is also important to not that this type of vitamin should not be taken with any dietary fat. Fat can inhibit the absorption of this type of vitamin. When ordering online, please make sure that the “Dry” or “Water Soluble” formulary is ordered.
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