What is better for Irritable Bowel Syndrome, Gastric Sleeve or Gastric Bypass?

Question Below Submitted By:  

Roxanne (a patient from Birmingham, AL)

Hi,

I’m 33 and want weight loss surgery and I’m about 80 pounds overweight. I either want gastric sleeve or gastric bypass. My concern is I have irritable bowel syndrome (IBS) and I’m scared that modifications to my body and organs will make my digestion even worse.

I know that gastric sleeve removes part of your stomach and you need to supplement with vitamins and minerals the rest of your life. I currently take fiber for my diarrhea, so will I need to take more fiber now if my body isn’t absorbing nutrients? I read someone even got IBS after gastric sleeve… can gastric sleeve cause IBS?

If I already have IBS, is gastric sleeve too risky for me? I’d honestly prefer to get this procedure because my friend had good results and I read the weight loss results are better, but I don’t want my IBS to get worse.

Another question – it might sound ridiculous – does gastric bypass cure IBS? I’ve read enough people say that their gastric bypass made IBS a non-issue. What is happening here? If I already have IBS, should I just get the bypass over the sleeve?

Thanks,

Roxanne the Lioness

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01.

Expert Responses to the Question Above

Surgeon Response to "What is Better for Irritable Bowel Syndrome, Gastric Sleeve or Gastric Bypass?"

by: John Rabkin, M.D., Pacific Laparoscopy

Roxanne,

The Gastric Sleeve (SG/VG/VSG) bariatric procedure has rapidly become the most commonly performed weight loss procedure today. It is a very straightforward and relatively low risk surgical procedure that routinely can be performed in under two hours and often requires only an overnight hospitalization. It doesn't alter your intestines and, consequently, doesn't involve any anastomoses (new connections), unlike the Roux-en-Y Gastric Bypass (RYGB) procedure.

Consequently, the risks of surgery are significantly less for the VG than for the RYGB. Furthermore, especially for patients who have inflammatory bowel disease (IBD), the VG may be a safer alternative than the RYGB due to the absence of any intestinal component to the surgery; irritable bowel syndrome (IBS) patients may (or may not) be similar in that respect.

Unlike the RYGB, the VG procedure doesn't involve creating any malabsorption: not of vitamins, minerals, and/or calories. This means that you would need LESS supplementation with the VG versus the RYGB. However, as your overall consumption of food with the associated necessary vitamins and minerals would be decreased after undergoing the VG versus before undergoing the VG, post bariatric surgery vitamin and mineral supplementation would be recommended in most patients cases nonetheless.

Many (if not most) patients with IBS symptoms experience significant relief of those symptoms once they lose weight after undergoing Weight Loss Surgery (WLS) of any type. I would predict that you would have an improvement in your IBS symptoms as well if you proceed with either of the two WLS procedures that you are considering.

The durability of the weight loss, as well as the reversal of any obesity related medical morbidities such as diabetes mellitus, MAY not be as robust with the VG compared to the RYGB: the studies to date aren't conclusive in my opinion. However, from what you've shared with your questions, in your specific situation you may be better served with the VG than with the RYGB.

John M. Rabkin, M.D.
Pacific Laparoscopy

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02.

Patient Responses to the Question Above

Does age play a factor in getting Gastric Sleeve

by: Donna

Hi, I am 61 years old. I am 100 lbs overweight and suffer from ibs d and ibs c. How risky is this surgery at my age??

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