Malabsorption after Gastric Bypass Surgery and Gallbladder Removal

I had gastric bypass in 2005. Yes I have malabsorption syndrome diagnosis. Here is what I was told Of course This comment assumes you had a Roux-N-Y gastric bypass rather than staples.
2 of the reasons people achieve dramatic weight loss with this surgery is that you can only eat small amounts and another is the malabsorption of calories and such. The duodenum is the part of the intestine that "grabs" most all of the stuff the body needs(and the bads like fats etc) Since this part is not attached to the pouch moderate malabsorption is normal and expected. This is because they cut the duodenum away from the created pouch and instead bring the jejunum, which is much less able to absorb nutrients, up and attach it to your pouch then the duodenum is reconnected to the side of the jejunum effectively creating the "Y" My husband and I had the surgery 1 day apart. He was told that he was not allowed to die on our 8th wedding anniversary! He weighed 397 before now 150. I was 234 with comorbidities that made me elegibile but I now only weigh 82 at 5ft 2. When others ask us if we knew then what we know now would we still have the surgery my answer is NO. His answer is: YES ABSOLUTELY! Funniest thing after surgery was the nurse that didnt realize we were husband and wife. She was MORTIFIED that someone put a man and a woman in rooms that shared a bathroom and kept apologizing to me. LOL

@hbm82
Welcome to Mayo Connect. After my Roux-N-Y gastric bypass many years ago, I had problems maintaining my ferritin (Iron) levels. I have also had my gallbladder removed. The symptoms were fatigue, but so many things cause fatigue, it is hard to know what is causing. The first year after surgery, I had blood tests that identified low ferritin (iron). I was encouraged to make sure I took vitamins, and when my iron dropped low, I was given iron infusions. After that, I was fine for a few years. And then, after routine CBC tests, my hemoglobin was low again, and my iron levels were also low. Again, IV infusions.

For me, the most important thing is to have yearly rechecks to see how I am doing. I had my surgery at Mayo, and every year I meet with providers in Endocrinology and have blood and urine tests to check vitamin levels. If something is outside the normal range, they order additional tests or make suggestions for food intake or vitamins.

Do you keep track of the amount of protein you take every day? A provider should be able to give you information on what you need. I have a hard time getting enough protein from my normal diet, so I add protein shakes.

What are your symptoms of malabsorption?

I have had an iron infusion as well. My symptoms are muscle burning, fatigue and numbness and tingling. I also have autoimmune issues. They have done multiple tests to figure out the problem and haven’t come up with anything yet. I was getting treated for Rheumatoid Arthritis. Now they are treating me for Myasthenia Gravis. I have a skin biopsy in November. I have my labs checked yearly and that appointment is also coming up in November. I’m just trying to figure out what is going on and start feeling back to normal.

I had bariatric surgery back in 2005. I started later on with digestive issues, including on set diarrhea. I found an incredible Gasto dr., who knew, right of way what was going on. He diagnosed me with BAM (Bile acid malabsorption). It’s common with Bariatric Surgery and much more if you had your gallbladder out. He put me on Colestipol, 1/2 times a day, and boy, does it help. It’s a Cholesterol Drug (which I didn’t need) but, it takes care of the bile acid. Good luck.

@roch
I lost about 10 pounds last year, and 5 pounds this year without trying and despite eating everything. My surgery was over 20 years ago. The last 3 weeks, I have diarrhea . I’m wondering if this is malabsorption.

@upmary
There are many reasons you may have diarrhea, and it may not be related to your previous surgery.

Have you discussed it with your primary care provider?

@roch
Yes, I met with my Doctor after1 week of diarrhea and he prescribed Lomotil which took 5 days before my insurance company approved. After 10 days of the meds, I am just now seeing some results. However this, with negative fecal tests, and the unexplained weight loss, and continuing weight loss from the diarrhea, he yesterday referred me to a gastroenterologist for follow-up.

@roch I have my labs checked yearly as well my next appointment is coming up in November. I’m having unexplained weight loss, diarrhea, fatigue, muscle burning and very bad acid reflux. I’m taking Pepcid twice a day and Protonix twice a day my PCP just put me on Carafate 4 times a day. I take a chewable multivitamin with iron daily and a Protein shake a few times a week.

@upmary
The referral to a GI provider sounds like the next step for you. Make sure you come prepared.

This discussion has a short, simple video with suggestions:
https://connect.mayoclinic.org/discussion/your-tips-on-how-to-get-off-to-the-best-start-with-a-new-specialist/
Hopefully, you will not have to wait long for a GI appointment.