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Wednesday, May 02, 2007

The dark side of WLS

In the 18 months that I have been writing about my decision to have bariatric surgery and my subsequent journey toward a healthy weight, I've tried to paint a clear picture of my overall experience.

But there have been some topics I've steered clear from for fear that they are too unpleasant for general consumption. The fact is that bariatric surgery is not all peaches and roses. No two patients have the same experience, because every body reacts to the anatomical changes in a different way. Some post-ops feel as if they've never had surgery, because their experience is that unremarkable. Other post-ops experience side effects so embarassing they fear leaving the house. And it's those side effects that are the topic of today's post.

There are two types of gas that bariatric patients suffer from: pouch gas and intestinal gas. Pouch gas is the easiest to deal with. Any over-the-counter gas aid with simethicone will dispel pouch gas and ease the pressure and pain.

Intestinal gas is the most painful and problematic. No over-the-counter gas aids work well in the intestinal tract. However, Digestive Advantage markets an over-the-counter pill that prevents gas in the intestines. The once-daily pill must be taken daily to work, and takes a few days to become effective, but it drastically reduces the amount of intestinal gas one experiences.

The final issue with gas is that a few patients -- particularly those who have duodenal switch -- experience flatulence with such a pungent odor that it alienates them from the world outside. They don't want to be alone with themselves, much less with anyone else. This problem can be particularly traumatizing in some patients who find their world even smaller after weight-loss surgery than it was when they were morbidly obese. For these post-ops, Devrom can be a godsend. Devrom is an internal deodorant that works to neutralize the odor in gas and excrement. It's not pretty to talk about, but it's a tool that provides post-ops in this uncomfortable situation with some measure of freedom.

Constipation is a common problem after bariatric surgery. Decreased consumption of food and fluids, combined with protein supplements, make for a situation where things don't move. Constipation may seem like no big deal, but if it goes on too long, it can lead to hemmorhoids, fistulas and obstructed bowels -- all of which are painful and can be dangerous. The best way to prevent constipation after gastric-bypass is to consume at least 64 ounces of water a day. Other post-ops advocate taking stool softeners and/or fiber supplements daily to add some bulk to the intestines and to encourage everything to keep moving. Those are great preventive measures, but what does one do if constipation is already a problem? Milk of Magnesia and Smooth Move tea are excellent solutions. They are non-stimulant laxatives that help solve the problem of constipation in relatively short order.

Though more rare than constipation, diarrhea can also be a side effect of bariatric surgery. Aside from the social discomfort of dealing with diarrhea, constant loose bowels can also cause dehydration. Depending on how long it's been since the patient had gastric-bypass, there are a few solutions. Eating bananas can firm up bowel movements. For patients at least one year out, high-fiber cereals can add much needed bulk. Another option is to use fiber supplements. Fiber supplementation is a good solution, but it takes time to kick in.


Katie Jay said...

Thanks for talking about these private matters that can drive WLS patients crazy :-) My friend who had DS says her gas problem is helped greatly by taking good quality probiotics.

There is a product for chronic constipation called Miralax, which I am taking to help avert another bowel obstruction. A doctor can prescribe it and it's worth asking about.

Love your blog, Tonya!

Tonya said...

Thank you so much for posting that information, Katie. I had totally forgotten to mention probiotics, and I've only recently heard about Miralax. Thanks for further educating my readers and me!

Tonya said...

I learned about another possible remedy for troublesome gas yesterday at The Vitamin Shoppe: digestive enzymes.

The enzymes work in the digestive tract to further break down food, which reduces the amount of gas produced.

Jane said...

Thanks for your blog! My short (I'm 6 weeks post RNY)experience with WLS "constipation" has led me to believe that this is too mild a term!!! At the very least it should be called super constipation, unbelievable constipation or even (I like this one) cementstipation!!! I am now using Benefiber daily in one of my shakes and I am really hoping this will help me get into a healthier routine. I am also taking a vitamin e capsule which someone on another blog said helped them. Thanks, Jane

Jane said...

Post WLS constipation is really more like cementstipation!! That is more descriptive! I have now started to use Benefiber daily in a shake and I'm hoping that will fix me up! Thanks for your blog, Jane

Tonya Kubo said...

Update: Digestive Advantage has changed its Gas Prevention formula and some users have found that it makes gas worse instead of better. Keep in mind that for many post-ops, the gas/constipation/diarrhea issues are related to certain foods. You may find relief if you abstain from sugar, carbs (breads, rice, pasta, etc.), and dairy.