What's behind this mum-to-be's bowel problems?

A pregnant patient presents with chronic diarrhoea and other gastrointestinal complaints

Janine, a 34-year-old woman, was referred at 31 weeks’ gestation for review of intrapartum nutrition.

Janine underwent a Roux-en-Y gastric bypass four years ago and an emergency laparotomy for an ischaemic Roux limb at 16 week’s gestation.