Texas Janice / Common Channel Length (Long)

[Guest guest]

Hi Janice,

Here is my take on the channel length subject. I posted most of this

a few weeks ago; it seemed to become clearer in my own mind as I

wrote it. Forgive the duplication if you have already read it.

The way I understand it, the overall success of this surgery is a

matter of trying to achieve balance. From what I have heard, there

is around an 18 month window where patients will achieve the greatest

degree of weight loss and then it will taper off. I think this is

the period of time it takes what is left of the stomach to stretch to

" normal " size. Once the stomach stretches and a slightly larger

quantity of food is eaten regularly, weight is maintained by the

malabsorption component of the intestinal bypass.

So, it seems, here is the tightrope walk; and everyone is different.

How much weight is lost and how quickly (and how COMFORTABLY) it is

lost depends upon BOTH the size of the stomach and the length of the

common channel. The longer a patient eats smaller quantities, the

more rigorous one adheres to smart food choices, the more weight will

be lost even with a longer (100 cm or more) common channel. The

shorter the channel length, the less nutrients and calories that will

be absorbed before and after the 18 month window, and the GREATER the

chance of serious malnutrition issues lifelong. I think shorter

channel lengths also contribute to possible bowel/gas difficulties -

on account of foods passing through that are less broken down and

less absorbed.

I see it as everything being inter-related. Channel length, stomach

size, food choices/quantities, inherent metabolism, pre-disposition

to bowel/gas problems, exercise and vitamin & mineral supplementation.

Good surgeons work with their patients to find this balance. They

determine channel length based on the doctors' experience and perhaps

the patient's metabolic history. They structure their aftercare

programs to maximize the peak post-surgery weightloss window for each

patient while minimizing long-term malnutrition risks. The patient

needs to be observant of what food/drink combinations work well with

their bodies and which do not; all WITHIN the parameters of their

doctor's aftercare program.

Common channel length is one component we (or, actually, our

SURGEONs) control. But, because of the balance of everything,

deficiencies in one can be compensated (to some extent) by some of

the other components. For example, a patient who, pre-op, may

already have sensitive bowels, may be better served with a longer

channel length and/or more conscientious food choices. While someone

who has never had bowel issues may experience uncomfortable symptoms

due to their shorter channel length but may be able to control it

with smart food choices. This might be why some surgeons say they do

not see major variations in outcome with slight to moderate

differences in common channel length (25-50 cm).

Hopefully, this helps somewhat. For me and my metabolism, I

personally would lean towards a *slightly* shorter channel length (75-

80 cm) because I haven't had bowel issues regularly as a pre-op. I

also know I will be vigilant about taking my supplements and getting

in my protein. But if, for whatever reason, my surgeon said he could

only give me a 100cm length, I don't believe I would be doomed; not

in the least.

Terri Hassiak

BMI 60

http://www.obesityhelp.com/morbidobesity/profile.phtml?N=H980366398

email(no spaces): bunsofluff @ hotmail.com

> Thank you Kate for responding to my post about common channel

length and its

> possible correlation to bowel patterns and gas. I was worried it

was too

> enmeshed with intake, etc. to be a viable parameter but it was

" worth a

> shot " . I hate to give up on the idea quite yet so if anyone else

would love

> to talk about their take on the subject I know I would be

interested and

> hope others would be too.

>

> Janice in Texas

> Fighting my way out of the Insurance Jungle