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Duodenal switch FAQ

Updated October 3, 2019

Table of contents

What is duodenal switch surgery?

Duodenal switch is also called gastric reduction duodenal switch (GRDS) and biliopancreatic diversion with duodenal switch (BPD-DS). It is a complex weight loss surgery which induces the loss of weight by an intestinal bypass and sleeve gastrectomy. This procedure results in a significantly decreased food absorption (up to 70% of the stomach is removed).

What happens during duodenal switch surgery?

The surgery is performed laparoscopically and only a few small incisions are made. The surgery has 2 steps. Firstly, the part of the stomach is removed and the surgeon creates a stomach pouch in a shape of a tube. Then, about ¾ of the small intestine is bypassed. As a result, the patient can eat only a restricted amount of food and the absorption of calories is reduced.

How much weight can I lose?

The majority of patients lose between 60% and 80%of the excess weight during the first 2 years after the surgery. The trials performed in the clinics have shown a long-lasting weight loss of even 70% of the excess weight beyond 10 years.

Is duodenal switch reversible?

Duodenal switch is a complex procedure consisting of gastric sleeve and gastric bypass. The digestive system is totally rearranged after the procedure and cannot be reversed.

Is duodenal switch safe?

From the medical point of view, the procedure is considered as safe. Of course, it entails some degree of risks and complications as any other weight loss surgeries. What is more, duodenal switch is one of the safest revision bariatric surgeries for patients whose gastric bypass or gastroplasty failed.

How long is the recovery after duodenal switch?

Duodenal switch is a complex procedure, so patients need time to recover. Patients spend 2-3 days in a hospital after the surgery. It is also recommended to stay at home for at least 2 weeks. Returning to work  after 2-3 weeks is considered as safe. Patients should follow the diet based on liquids and soft food. It is important to attend follow-up visits that take place every 3-4 months for the 1st year after the surgery and twice a year beginning from 2nd year.

 Is duodenal switch the same procedure as gastric bypass?

Gastric bypass is an element of duodenal switch. Duodenal switch is a combination of gastric sleeve and gastric bypass.

Will my insurance cover duodenal switch?

Yes, duodenal switch can be covered by insurance. You need to contact your insurance agency to check if you have this procedure listed in your insurance.

Should I take vitamins after duodenal switch surgery?

The vitamins and minerals deficiency is common after duodenal switch. So, it is necessary to supplement the vitamins and minerals for the rest of life after the surgery. During the first weeks, the vitamins should be in a liquid or chewable form. The surgeon will recommend the best vitamin set that will include all necessary elements. You should also perform blood tests regularly to check to monitor the level of vitamin and minerals in your body.

 Can duodenal switch patients take any painkillers?

In general, patients can take medications after duodenal switch. Nonetheless, each time, they need to consult it with their surgeon.

There is however a “no” list of medications which cannot be taken after any weight loss surgery. They include:

  • aspirin
  • celecoxib
  • diclofenac
  • ibuprofen
  • indomethacin
  • ketoprofen
  • ketorolac
  • methyl salicylate
  • nabumetone
  • naproxen
  • piroxicam
  • salsalate
  • sulindac
  • tolmetin

Does duodenal switch cause diarrhea?

Yes, diarrhea is one of the side effects that can occur after duodenal switch surgery.

What to expect after duodenal switch surgery?

After the duodenal switch surgery, you need to be prepare for the following:

  • a life-long change of your lifestyle
  • implementing daily physical activity
  • keeping a healthy diet
  • following all the surgeon’s instructions for the recovery time
  • preparing yourself for the 2-4 weeks recovery (taking time off work, help in daily duties), try to walk as much as possible at that time
  • dealing with possible side effects and pain, especially at the beginning
  • taking supplements regularly
  • finally, you need to prepare for a significant weight loss and improvement in your life quality!

What about scars after duodenal switch surgery?

During the surgery, the doctor makes a few small incisions through which the tools are inserted. So, there are scars afterwards. They should be taken care of as any other scars. Over time, the will be less and less visible of course.

What should I eat after duodenal switch surgery?

Duodenal switch is a procedure that limits the eaten food amount and decreases the amount of absorbed calories and nutrients. So, you need to take all necessary supplements for the rest of your life. The diet after surgery consists of 4 stages. At the beginning, only liquids are allowed. Over time, you add purees, soft foods and finally solid food also. The diet consists of low-fat, low-sugar small meals. The individual recommendations and instructions will be given by your surgeon and dietician after the surgery.

 How long is a duodenal switch surgery procedure?

The duodenal switch surgery lasts about 3 hours. It is a relatively long weight loss procedure, as it consists of 2 stages: sleeve gastrectomy (about 60 minutes) and gastric bypass (about 120 minutes).

How much does a duodenal switch cost?

The price for a duodenal switch varies from country to country. Please see the prices from the chosen countries below:


Average price for Duodenal switch


from 5470 GBP


from 9350 GBP


from 10 900 GBP

Costa Rica

from 10 900 GBP

United States

15 600 GBP


from 25035 GBP


from 4000 GBP


from 5400 GBP

the United Kingdom

from 11 000 GBP

Who is a candidate for duodenal switch?

The best candidates for duodenal switch surgery is a person with a morbid obesity who have tried to lose weight, but all the trials ended in failure. It is also vital that the general health condition of the patient is good enough to perform the procedure. Also, duodenal switch is a good procedure for those who tried other weight loss surgeries (e.g. gastric sleeve or bypass), but they were unsuccessful.

When can I start exercising after the surgery?

In fact, you should start physical activity a day after the procedure. Firstly, you need to only walk slowly and over time walk faster and for a longer time. You should listen to your body and gradually increase the pace and time of the activity. Any time you feel pain or discomfort, you should stop and rest for a while. After a month, you can add some more types of activity, but remember that you cannot lift heavy objects for 6 weeks.

When can I drive a car after the surgery?

It depends on how you feel and if you suffer from any complications or side effects. But if you feel good, you can drive a car about 3-4 days after the surgey.

Will I need a plastic surgery after duodenal switch?

Duodenal switch is usually recommended to heavily obese patients. If you lose much weight, you could have the excess skin later on. Some patients are able to lose weight and tighten the skin through regular exercises, only the patience is needed. So firstly, you should try exercising regularly, the best would be training with a personal trainer. You should not make the decision of plastic surgery earlier than 2 years after the surgery because you will be still in the process of losing weight.

Can I have duodenal switch after a pregnancy?

Yes, you can have duodenal switch after pregnancy. You just need to inform the doctor how long ago you gave birth to your last child, whether was is a natural childbirth or C-section and all important details in this matter.

 Can I drink alcohol after a duodenal switch?

The ideal situation would be a total withdrawal from alcohol drinking. Yet, you can drink moderate amounts from time to time. You must remember that alcohol is rich in calories and may escalate the hunger. Also, you need to observe your body reaction to alcohol as it may just tolerate it to a much lesser degree.

Will duodenal switch patients vomit?

Vomiting is a common problem among duodenal switch patients. It is important that you control the amount and pace of eating food, be aware of any food intolerances you may have, do not implement new food too quickly, drink a lot of water, avoid food that may stuck in your stomach and do not overeat. If you still experience vomiting and cannot deal with it on your own, contact your doctor to solve the problem.

Can duodenal switch cure diabetes?

Yes, duodenal switch makes that the vast majority of patients suffering from type 2 diabetes (over 90%) eliminate this problem almost immediately. It happens due to a metabolic effect from an intestine switch.

Will I lose hair after duodenal switch?

The temporary hair loss can happen between 3 and 6 months after duodenal switch. It is significant that you take the necessary supplements and take proper amounts of proteins, vitamins and minerals.

Will I have to go on a diet before the surgery?

Yes, your surgeon will give you all the details and insructions, but usually for 2-3 weeks before the surgery, you would have a special diet.

 Can I get pregnant after duodenal switch?

Of course, you can. It is recommended to wait at least a year (preferably 12-18 months) before getting pregnant. During the time of massive weight changes, the birth control pills may not be reliable and menstrual periods are usually irregular. After weight loss surgery, women find it easier to get pregnant and have more chances to give birth to a healthy baby without any complication to a mother and baby.

What kind of food should I avoid after duodenal switch?

The following foods should be avoided after duodenal switch surgery:

  • food with empty calories
  • alcohol
  • dry foods
  • pasta, rice, bread
  • fibrous fruits and vegetables
  • high-fat food
  • sugary and rich in caffeine drinks
  • tough meals

When will I back to work after duodenal switch?

The ability to go back to work is very individual and depends on each patient’s condition and mood after the surgery. Usually, the doctors recommend taking at least 2-3 week leave. However, some patients feel good enough much sooner while other need about a month before returning to the normal life.

What should I do if duodenal switch near me is too expensive?

If duodenal switch is too expensive for you, you can look for this procedure in other countries. Nowadays, medical tourism is developed to a such an extent that it is unbelievably easy to travel for the surgery to another country. In Europe, the top destinations for bariatric surgeries are Poland, Lituania or Hungary. Performing the surgery in one of these countries is even more than twice as cheap as in countries in Western Europe.

Can duodenal switch cause cancer?

There are no studies analysing whether duodenal switch may cause cancer.

Should I cease smoking before the surgery?

The reason why you have duodenal switch is improving your health. Smoking affects your health in a bad way and you should stop it as soon as possible. Also, smoking can increase the risk of post operative complications and infections. So, your doctor will strongly advise you quitting smoking before the procedure, or at least restrict it.

Can I regain weight after duodenal switch?

Yes, you can regain weight after any weight loss surgery. You need to remember that the surgery is only a first step to losing weight which makes weight loss much easier. Surgery is not a magic bullet and you will need to put great effort to lose weight after the surgery.

Will duodenal switch help PCOS?

Yes, the recent medical studies proved that duodenal switch help eliminate numerous health problems including polycystic ovarian syndrome (PCOS).

Can duodenal switch cause constipation?

Constipation happens after duodenal switch. Usually it is a result of:

  • pain medications and anaesthesia
  • much less water and fiber intake (due to smaller stomach)
  • increased intake of supplements
  • more proteins in diet
  • food sensitivity or lactose intolerances.

 Will I have problem with hemorrhoids after duodenal switch?

There are patients who complain about hemorrhoids after undergoing duodenal switch, so it might be an unpleasant side effect. Hemorrhoids result from diarrhea and constipation when patients introduce and get used to a new diet. However, this problem is easy to avoid as well as to treat.

Can duodenal switch cause bad breath?

Yes, bad breath is a common concern among any bariatric surgery patients. Usually, bad breath results from dehydration, abnormality in pouch emptying or weight loss itself. However, there are some tips that help eliminate this problem, such as:

  • drink much water
  • brush and floss the teeth (including tongue) after every meal
  • chew sugar-free gums; cinnamon-flavoured gums are also good
  • visit the dentist regularly

If you cannot eliminate the problem of bad breath for a long time, it might be a symptom of some diseases, so you should visit your GB and perform recommended medical tests.

Can I have anemia after duodenal switch?

Generally, patients of any weight loss surgery are more susceptible to iron deficiency and anemia than others. It is a consequence of nutrient deficiencies. Thus, it is important to undergo a proper nutritional evaluation and take necessary supplements, especially iron.

What stuff should I take to the hospital?

You should take personal toiletries and clothes that are easy to take off and put on.

Should the gallbladder be removed during duodenal switch?

It is your surgeon that makes the decision whether to remove the gallbladder during the procedure. Usually, if the gallbladder is in a good condition, it is left intact and you will just receive the medications to prevent any problems. Yet, it happens that removing gallbladder is necessary during the surgery.

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