Ileal Interposition and Absorption

Ileal Interposition and Absorption: What is the Difference of Ileal Interposition from Other Metabolic Surgeries?

Ileal Interposition is not an obesity surgery as point of origin. i This surgery aims to treat all health conditions included in Metabolic Syndrome and Type 2 Diabetes in particular.  So, obesity is not a must in criteria for Ileal Interposition operation.  However, Ileal Interposition can not be compared with operations which is applied for obesity and morbid obesity treatment which create severe malabsorption such as Single Anastomosis Gastric Bypass (Mini-Gastric Bypass), BPD (Biliopancreatic Diversion)  ± DS (Duodenal Switch), DJB (Duodenojejunal Bypass).  These surgeries applied for Morbid Obesity treatment prevent food passage from very long small intestine parts.  Severe fat and carbohydrate malabsorption appears in patients after these operations.  They provide a strong weight loss and patients may preserve these weight losses for a long period.  However, vital vitamins and minerals which are absorbed from small intestines by dissolving in the fat are not absorbed as well as fat absorption which is seriously restricted after these surgeries.  Vitamin and mineral deficiencies rapidly appear after a short period following the surgery.  Patients who will have these operations are analyzed in terms of these vitamin and mineral levels and supplementation of some is started before the surgery.  These patients should be followed strictly and their blood levels should be monitored closely.  Osteoporosis due to calcium deficiency is one of the most important problems that these operations create during mid-term.  Since calcium supplements and eating foods rich in calcium are not enough, intravascular hormone and calcium supports may be necessary in time.

Ileal Interposition operation does not cause malabsorption.  Patients who have ileal interposition, start to live without need of any vitamin or mineral with a completely free diet within 6 months to 1 year.  Patients who have ileal interposition, start to eat liquid foods from 3rd day following the operation.  When they start to intake food orally, one calcium tablet and two scales of vitamin syrup are started.  Patients quit all Diabetes, Hypertension, Hyperlipidemia drugs that they were using before Ileal Interposition surgery. They are monitored for progress of these diseases during their hospitalization period after Ileal Interposition operation.  Majority of patients who have Ileal Interposition surgery are discharged without any medication.  Less than 15 % of patients, need some medications to be  continued for several weeks to several months until metabolic effects settles.  When blood sugar measurements reduce to normal levels, all of these drugs are discontinued.  By this means, metabolic effect of Ileal Interposition operation is significantly superior than other surgeries especially in low BMI type 2 diabetes patients.  Patients do not use any vitamin and mineral support after one year.  They discontinue hypertension and cholesterol drugs that they take for metabolic syndrome.