JRL1989

I had an esophageal manometry test (which I don't know the results for, will get next week when I see WLS surgeon), but regardless - I am in Canada. LINX is not approved for use here in Canada. I asked him at 3 months post-op where he told me LINX isn't approved, and that he thinks in 15 years - LINX will be the new gastric band story - lots of erosion etc. So, LINX isn't an option for me, really. I'm going to explore alternative options with him to see what he thinks. I'll be bringing the Ligamentum Teres paper, and also the BARF paper showing hiatal hernia repair works for these symptoms too. It's not that I absolutely won't agree to getting RNY, but I really truly feel like RNY should be a last resort. Not the first-line response to non-PPI responsive GERD after sleeve.

How did your appointments go? I had a scope, showed HH (recurrent, as it was apparently fixed during my sleeve) and a "patulous LES" (wide open lower esophageal sphincter), so I guess that explains my regurgitation. I see my WLS surgeon again for follow-up next Thursday. I am pretty sure he's going to try to strong-arm me into converting to RNY.

I was assigned 6 weeks as well (BMI starting was over 60), and they ended up moving my date and I had to shakes for 9 weeks. Each week got easier. Hang in there!

There's a really interesting paper published on this topic, it is currently in press. I can send you the full paper PDF if you'd like. You can see abstract etc here: https://pubmed.ncbi.nlm.nih.gov/33483233/ I have been having "BARF Syndrome" as they describe in the paper, and my 1-month post-sleeve barium swallow showed a recurrence of my hiatal hernia (it was repaired during sleeve). My surgeon also wants to convert to bypass. This paper shows improvement of symptoms with even just HH repair.

GIRL - I'm in the same boat!!! I am almost 32, and never pregnant. I want to get pregnant as soon as possible, but if I have the RNY then our fertility doc still wants to wait 18mo after surgery. SO frustrating.

Exact same case as me. Monitor until 6 months, but only real solution is convert to bypass. An hour for meals sounds INSANE, doesn't it? I hope your dysmotility can go away on it's own.

Thanks for your reply! You are very knowledgeable and great to chat with. I will post an update after I finally get my manometry and scope, and see what surgeon says we're gonna do. Thanks!!

Has anyone had an "early" revision? I see most sleeve to RNY's happen at 2+years out from sleeve. I had no GERD at all before I got sleeve on October 15/20. I literally felt the acid as soon as I woke up in recovery. My program has us switch to soft foods at 2 weeks post-op. As soon as I switched from liquid to softs, I felt food rise in my esophagus after eating (regurgitation, but not full on puking - it rises, and then goes down again). At 1 month post-op, surgeon did a barium swallow and noted that I was regurgitating the barium and also that my esophagus was showing dysmotility and tertiary contractions. I've been on 60mg Pantoprazole 2X daily - then switched to 60mg Dexilant 2X daily, in combo with 1g of Sulcrate 4X daily now. I don't feel these meds help the regurgitation at all. I experience regurgitation (the acid reflux movement feeling up and down in my esophagus) after eating solid food. Almost every single food I try. Because of this, I eat very little. Also, I have to wait around 90 minutes after eating to try to drink water, or else the regurgitation is worse. Because of this, I also struggle to get in more then 30oz of water a day. There is a fine balance between food and water for me, and if I go too much on one - the other one suffers. My dietician says she wants me at 1200 calories (seems really high, I'm in Canada and I notice they do things differently here), and at least 64oz of water. I'm at max 500 calories and 30oz water. My low food intake and water intake is now causing me to have internal hemorrhoids and now I bleed every time I have a bowel movement (which to be honest, is once every 4-5 days. It's not often). I've lost over 130lbs and I'm just over 4 months post-op. My surgeon says I need the revision to RNY and wants to do it at around the 6-month mark (so April 2021), but I have not heard of anyone getting a revision this early due to GERD. Has anyone here got a revision from sleeve to RNY due to GERD, less than 1 year out from sleeve? How did it work out for you?

Thanks Rick! I too, also thought it was a stricture. I was convinced. But nope, on my barium swallow it showed my sleeve looking like a nice fat little sausage. The surgeon is who said it must be GERD-related, as the barium swallowed showed me regurgitating the barium. When I don't take the PPI, I get heartburn AND regurgitation - but if I take the PPI I only get regurgitation. He said something about "refractory GERD". I wish my province offered the DS. I'm in Alberta, they don't cover it and the surgeon isn't trained in it (I asked). He's actually the most experienced sleeve surgeon in the province (Which is why I'm a bit worried about doing RNY with him, hah. He IS experienced in both, but there are more experienced RNY surgeons in terms of total numbers of procedures completed, but to switch surgeons at this point would put me back months). Did you have a revision from sleeve to RNY? I guess part of my worries is that I'm playing with fire and possibly creating more problems. OR, that I will lose all the restriction my sleeve affords me (colloquially, I have seen RNY patients post food photos and they can eat more at 1 month post-op than I can eat now at 4 months post-op). I want to get pregnant, so the surgeon said that I need to do RNY so that I'm able to eat enough food to sustain a pregnancy. It's a bit of a mind trip. Surgeon ordered an esophageal manometry test and an endoscope. Manometry is next week, still waiting on scope booking.

How did your appointment go? Wishing you well!!

Yup sounds exactly like me too! I also had a hiatal hernia discovered during surgery and then repaired. Barium swallow isn’t diagnostic for dysmotility - ask if he’ll send you for an esophageal manometry test. Have you also been having GERD/acid reflux/food regurgitation? I also struggle with things feeling stuck. I have been not able to drink much water so I have fainted several times in my 4 months since surgery :( good luck with your appointment - let me know how it goes for you !

I got sleeve Oct 15/20, and developed GERD almost immediately after. I have trouble swallowing things now too - my surgeon thinks its because of the GERD and acid and irritating my esophagus. At 1 month post-op, I had a barium swallow done, and the report indicated esophageal dysmotility and "tertiary contractions". My surgeon is sending me for an esophageal motility test (esophageal manometry) next week. He wants to convert me to bypass at the 6 month mark because of this.