Duodenal Switch is a malabsorptive operation which produces weight loss by having much of the food you eat pass through you without being absorbed. Although this results in very effective weight loss, as a result of the malabsorption there is a high incidence of protein and fat-soluble vitamin deficiencies. As well, excessive flatulence and chronic malodorous diarrhea can be a big social problem. Lifelong high doses of vitamin and protein supplements are required, and even then there is a 5% risk of serious complications of malnutrition or calcium deficiency and bone loss. If protein and vitamin supplement guidelines are not followed, as many as 25% of patients will develop significant nutritional and metabolic problems requiring intravenous feedings. 

We don't recommend Duodenal Switch or any other malabsoptive operation because of:

• the risks of significant metabolic and nutritional consequences and 

• the social problems associated with chronic diarrhea and bad gas

• nearly equivalent weight loss with other operations

We generally recommend that patients who have had previous malabsorptive operations such as Duodenal Switch, BPD, or distal gastric bypass should be converted to either Proximal Gastric Bypass or Sleeve Gastrectomy to maintain their weight loss while addressing the complications associated with malabsorption.

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