Expert: John Pilcher, MD - 9/9/2010

Question
I am having a problem with hallucinations, shaking, memory loss.  Doctors have advised me that my body is not absorbing most minerals because of the Gastric Bypass surgery 6 years ago and Sigmoid Colon Resection 8 years ago.  Would you recommend me having the reversal in this case based on taking B12 and Thiamine shots for the rest of my life.  I see the benefits of the reversal.  Would you consider the operation in my case?

Answer
Tim,
There certainly are situations where gastric bypass should be reversed, and generally speaking those are situations where the surgery is working against health instead of for health.  I gather from your message that you have been found to be deficient in thiamine and B12, and possibly other nutrients that you haven't mentioned.  You have suffered neurologic problems that seem to be related to these deficiencies.

Whether or not it would best to reverse your gastric bypass depends a bit on exactly what type of gastric bypass you had done.  I get the sense that you had a "mini" Gastric Bypass or a "distal" Gastric Bypass or a "long limb" Gastric Bypass.  These types of gastric bypass cause significant absorption abnormalities and it would likely be useful to have a surgical reversal or revision.  If you had a standard gastric bypass it may be best to supplement your vitamins and see how you feel for a couple of months before making a decision.

In any case, you will be best served in making your decision if you are seen by an experienced bariatric surgeon at a Center of Excellence in your area.  You can find a Center of Excellence at on this website:
http://www.surgicalreview.org/locate.aspx

Best wishes,
Dr JP