eudys3

I have had multiple complications since my RYGB on 7/18/16. I have had emergency kidney stone surgery, multiple hospitalizations for what was finally determined to be a marginal ulcer, and dysautonomia which is uncontrolled low blood pressure (60/40 or less). In addition I still have to vomit 2-3 times a month or more after a meal when I hurt for 2 hours & know whatever I ate won't go down. I am not complaining, but also I rarely (once every 3 months or so) have upper abdominal pain that is so intense that I can't breathe, let alone drive, walk, speak. It puts me down for 5-10 minutes and scares the hell out of my family, my patients, and my staff. The intense pain usually subsides after a few minutes of lying on my right side. The chief of the Bariatric Surgery dep't here thinks I'm having temporary small bowel intussusception. I know I don't have an internal hernia as my RYGB surgeon was very careful about that. Usually intussusception advances to bowel death requiring surgery, but mine resolves after a few minutes in the right position. Has anyone else experienced this?

I had RNYGB on 7/19/16. I still say it is the greatest surgery I have ever had. My BMI is down from 37 to 21. I had no problems until I had to go to the ER on 4/10/18 with horrific abdominal pain, nausea, and vomiting. My surgeon put me on Prilosec and Carafate for 6 weeks, but I found out later the Prilosec caps were not bioavailable and just went through without being effective. So on Mother's Day I went back to the hospital for pain control and an upper scope to look for a marginal ulcer. Unfortunately the GI MD had no expertise in looking for marginal ulcers and said my scope was normal. So, I had 6 more weeks of unbelievable pain. My surgeon said maybe I had gallbladder disease so I had my gallbladder removed on 5/29/18. Did not help my pain at all. Finally, my surgeon referred me to a bariatric subspecialist who repeated my upper scope, and he found my marginal/anastomotic ulcer. This is potentially very serious in that the ulcer could perforate and require emergency surgery. I am concerned because I was pain-free after starting Prilosec liquid for the first four weeks, but the crippling pain has returned. My patients compliment me on my weight loss, but nausea and pain is a horrible way to do it! Does anyone else have experience with having a marginal ulcer?

BTW my RYGB was on 7/18/16.

I am curious how common post-bariatric surgery hypotension is. 18 months after my bypass I was admitted to the hospital for pain that was later determined to be from a marginal ulcer. My blood pressure at that time was 78/45 after 4 liters of IV fluids even though I was in terrible pain. For the next 6 months my pressure rarely exceeded 85/55 and was as low as 61/45 one morning-I had to stay home from work, couldn't stand up. I went through a million tests, echocardiogram, EKG, endocrine testing, etc-all negative. No cause was found. I am told I have dysautonomia which is a nerve dysfunction, in this case of the blood pressure-regulating mechanism. This happens after gastric bypass sometimes. I am taking midodrine which is a medication that raises blood pressure so now my BP is usually 95/65 or so-no more passing out! Has anyone else heard of this?

Just a quick update, possibly to give hope for healing- Had my repeat EGD on 11/16, 5 months after my marginal ulcer was found so that I had to take that yucky compounded immediate-release omeprazole w/ sodium bicarbonate & Pepcid & Carafate. I still have gastritis (stomach pouch irritation) but my ulcer has healed! I was really afraid I would need a revision or worse, a reversal. I am able to eat now without pain-yea! I have stopped losing weight which has been a huge concern for my family & friends; my mother says I look "gaunt." I am so glad I did all the online research I did on marginal ulcer healing; Bariatric Times is a great resource, geared to the medical profession so the terminology might be a bit difficult. Keep the faith, everyone. You could be as fortunate as I have been. Good luck to all.

Just an update: still having intermittent severe abdominal pain in spite of 5 months of compounded Prilosec twice a day, max Pepcid, and Carafate. My surgeon said I should have healed after two months so I got another scope today (my 3rd since May). My ulcer has healed on the inside. He said I may have an ulcer on the outside of the cuff which would need a revision=big darn deal. I could have an abscess touching the liver which has a lot of pain receptors. Or I could have a stricture (scarring) which would be an easy fix. I am hoping for easy. He said to switch to Dexilant and continue Pepcid and just see how I do.

I have been taking prebiotics with an antifungal agent as well as probiotics for the past year, so no, they did not help after my GB surgery in 5/18. Post-op diarrhea just happens to some folks. Mine stopped after a month. I have an unlucky friend who STILL has it almost 3 yrs after her RNY.

I was 51 when I had my RNY, and although I have had some significant complications (marginal ulcer & marked hypotension,) I still think it is the best of all my 14 surgeries. (Yes, 14-cosmetic, orthopedic, female, etc.) I just wish I had my RNY 25 years ago! All that wasted time being unhappy about my body!

I had a cholecystectomy in May, 22 months after my RNY, mistakenly to cure my abdominal pain which was actually due to a marginal ulcer. So a totally unnecessary surgery. I had 1 small stone that was soft & would have passed. BTW, nobody told me about the uncontrollable, explosive diarrhea I would have after my GB surgery. I would have to go home and change my clothes in the middle of work. I still carry a spare pair of underwear in my purse. Very embarrassing when they fall out of my purse when I remove my wallet!

I have done a bunch of research into what causes ulcers. Gastrin is a hormone that is released by eating protein which causes the parietal cells in the stomach to release acid. Well, can't stop eating protein. Alcohol and caffeine directly stimulate parietal cells without affecting gastrin. So all alcohol & caffeine of any amount are out. I have cut out my morning coffee and sometime 1 glass of wine after work & feel a lot better.

PLEASE don't hate me. I am not bragging. I have a very legitimate concern. I am 2 yrs out from RYGB and have lost 98 lbs. (Can't figure out how to update my stats.) My BMI is a very healthy 21. No, I am not emaciated. However, I started losing again, about 1.5 lbs/week. I have NO appetite and have to force myself to eat. I keep track of my nutrition on My Fitness Pal, and I typically get between 650-800 calories a day. I know I can't continue like this. I can't stand protein shakes/bars. I even tried eating Dorito's, my old favorite, pre-surgery, and wondered why in the hell I ever liked those nasty chips. My surgeon says I'll gain wt back soon "once everything settles down" after my gallbladder surgery (in late May). This problem began in Feb after my weight loss had been steady at 70 lbs for 15 months. My husband is worried about my health. I am worried that I might require a reversal if this continues. Has anyone else experienced this?

I had the exact same symptoms/excruciating pain starting at 21 months post-op. I went to the ER twice, hospitalized twice, had a CT, an upper scope, multiple lab tests-all negative. I even had my gallbladder removed as a last-ditch effort, to no avail. My bariatric surgeon said he was "all tapped out" & had nothing else to offer me surgically. Fortunately, my surgeon referred me to a bariatric subspecialist who said he did not believe the upper scope results since a GI doc did it & not a bariatric specialist like him. Sure enough, my marginal ulcer was hiding beneath the cuff/anastamosis; the first doctor did not go far enough down & retroflex the scope. Read about marginal ulcers. Up to 26% of RYBG patients get one, usually in the first yr post-op. There is a very informative story in Bariatric Times regarding the healing of marginal ulcers which my surgeon did not know. You need immediate-release liquid omeprazole w/ sodium bicarb, not the sustained-release caps. If you have a marginal ulcer, I feel for you. I am still struggling with it 4 months later. Hope you are feeling better soon. Keep us posted re: your diagnosis & progress.

Just an update- The pain has improved since resuming Carafate. I am continuing omeprazole 40mg twice daily & famotidine 40mg at bedtime. Marginal ulcer healing takes about 3-6 months with immediate-release omeprazole (Zegerid or compounded omeprazole w/ sodium bicarbonate) versus 11 months or more with the timed-released/extended-released capsules or tabs that are available over the counter. Perhaps those of you that have not found relief w/ rx have not been given the correct meds.

Had my RNY on Monday at 1 pm and went home Tuesday at 10 am. I drank 80 oz of water overnight and did 30 laps around the entire floor. I was motivated to go home!

I had my RNY in 7/16 at age 51. I have lost almost 100 lbs and continue to lose about 5 lbs a month (primarily due to an ulcer). I am down to a size 4-never before. Just wish I had this surgery 25 yrs ago!

I make smoothies from baby spinach, plain non-fat Greek yogurt, crushed pineapple in its own juice, banana, almond milk, & a little protein powder. YUM!

I took off only 8 days after RNY on 7/18 since I don't have PTO in my job. I went home on post-op day 1. I went back to work for 3 days at half time after my 8 days off. I started back full time this week & have twice the normal amount of work, having been out for so long. (I own my business & no one else can do my particular job.) I sit a fair amount at work but walk often between exam rooms. I manage to drink 2 ounces about every 15 minutes. Although I am still very tired, I feel pretty good. That said, it might have been better to take the full two weeks off.

Finally made it. I have only lost 6 lbs since surgery 10 days ago but have lost 22 in the past 4 weeks since starting the liquid diet. Other people have said that weight loss is slower when starting BMI is lower, but it is frustrating to hear other people losing 20lbs a week!

I recommend ProtiDiet, a liquid flavoring to put in water. Each packet flavors 16-24 oz of water & has 15 g of protein. The flavors are very good, especially kiwi melon-available from Amazon. I also recommend getting a mug warmer. It'll keep your soup/broth/decaf coffee warm while it takes you 30 minutes or more to consume it. You can get them at Walmart or Target. I also got a timer to remind me when to drink, walk, etc. You might want to get some liquid Tylenol just in case.

@MsMiniMe I see that Dr Weiner is your surgeon. That is so cool. I have seen all his videos on YouTube & will be starting the Pound of Cure diet when my surgeon gives me the green light. (I'm only POD #9.) I like what Djmohr says about fruits & vegetables, not to forget about beans!

Consider yourselves lucky! I am in the 3rd week of liquid diet out of 5 total, pre- & post-op. I am able to have soup & nonfat Greek yogurt in addition to shakes & clears, which is a blessing. I will say I am really looking forward to Aug. 8th when I advance to pureed foods. Will make spinach, yogurt, banana green smoothies.

I agree w/ James. If you walk regularly after surgery, you'll recover faster. I went home the day after surgery. My surgeon gave me the post-op rx's before my surgery so I could have them filled & ready for my arrival home. I needed help getting in/out of the shower for a couple of days after I got home but was able to do everything else. I had prepared weell so I had everything I needed.

To supplement my daily protein intake, I use ProtiDiet flavor packets. I mix 2 packets in 32 oz of water & it's 30 g of protein. Tastes great. I especially like the honeydew melon flavor, but all 6 different flavors I got are good. I got these from Amazon.

I went home on post-op day 1; now POD 5. The first couple of nights at home, I slept (poorly) very upright using a triangular wedge daybed pillow. After that, I am able to sleep on my side if I bring my legs up to my chest. Still can't really lie flat on my back comfortably.

My nutritionist said as long as it's pourable, sf yogurt or pudding is okay. Just add some milk.