2001 Lap. Roux en Y bypass-reversal?

Question
Dear Doctor,
I had this surgery in 2001.  Around 2008 I developed iron deficiency anemia, which ranges at times from mild to severe.  This past October I ended up in the ER for a blood transfusion, which was unsuccessful.  I have been taking 3X the normal dose of iron as per my Hematologist, who tells me that it will take 6 mos for my iron to reach a normal range, due to my weight loss surgeries removal of the segment of small intestine that absorbs iron, that I will always have to monitor my anemia, and that at the rate I am absorbing now, I will feel better in six months.  
My question is:  can a partial reversal of the roux en y be safely performed to reconnect more small intestine?  2nd, can the roux en y in total be reversed, with a gastric band be put in place.  Does gastric banding also limit absorption of vitamins and minerals?
Thank you,

Lisa

Answer
Lisa,
I regret your problem with Iron absorption.  The hematology doc typically needs to give the Iron replacement IV - it does not sound like that is what is happening.  Patients who become very deficient might need several doses of IV Iron to get them back up to speed, but generally the the IV route is fully successful.

There is not really a way to revise the gastric bypass to facilitate more Iron absorption, without reversing it completely.  Complete reversal is technically possible but it is challenging and therefore risky.  In my opinion, placing a Band on the stomach after gastric bypass reversal would be a bad idea because the surgical changes would make a slip or erosion fairly likely.

Basically, I would suggest the use of IV iron and close follow up.

Best wishes!

Dr JP

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