Pouch Dilation Discovered from Fluoroscope Fill

[TexasRose 0]

I went for a fluoroscope fill this morning and discovered that I had pouch dilation with being too tight. My other fills have been without fluoroscope...based on how much chicken I could eat and how hungry I was getting over time. I had some reflux after my last fill but quit eating past 5PM and that seems to resolve. I just felt like my last fill, which was 5 weeks ago, did not take and that was why I was back in for another fill.

Well, seems that 2.4/4.0 for me was too much because I basically had nothing going through the stoma according to the barium. So, now I am unfilled to 1.0/4.0 for 2 weeks....3 days liquid/the rest of the time soft food. The PA said that she had seen much worse and that I was not slipped - but that we needed to unfill and let the pouch unswell - then re-evaluate in 2 weeks.

Any suggestions on what do to help the dilation reduce?

What soft foods would be best?

Have a terrific day!!

[TexasTerry 0]

I don't have an answer for you. I don't even have a fill yet. But WOW, you have lost 91 lbs since Sept. 95!!! That is fantastic!!!!!!!! I am only dreaming of having that kind of success.

You Rock!

Terry :confused:

[TexasRose 0]

Terry,

You are doing great too! I think my personal loss has been due to keeping on top of exercising. I try *sometimes it is extremely difficult* to do 5 hours per week through Curves and treadmill. I'm certainly not perfect with my eating but I do stay under my BMR requirements. I just hope that this hurdle does not cause me to gain weight or send me back in for surgery. Congrats on your recent banding!!! Tiffany

[barbara465 2]

I would just eat soft foods and things that won't stay in the pouch long. that way, the pouch won't get overworked or too full. You may try very small meals more than 3 times a day until you get this resolved. Just my opinion. :confused:

[the best me 6]

T, check out the food Forum. There's a Sticky there (uhhh...used to be...I hope it's still there!) called food Stages. Look for great ideas under the Mushies Stage. Just keep it super soft. Guacamole is a fave of mine. Good luck! You'll do fine!

OH! Aloe Vera juice is very healing. You might consider drinking 2-3 ounces of that at bedtime, and even 2-3 times a day. It's good for the stomach tissues around the band area. That might help you, too.

[giveyouthemoon 4]

I have this as well....think SMALL. Super small. Little bitty tiny small portions. Even if you are eating mushies. I mean REALLY adhere to the half cup guideline. I know it's hard to make this revision...but my dr calls pouch dialation a "prelude to a slip" and neither of us wants a slip, right?

I'm all about tiny amounts spread throughout the day rather than eating meals.

Small! Tiny! Little bitty!

Luck!!! :confused:

[TexasRose 0]

Thanks Ladies!!!

I think these next two weeks are going to be extremely difficult with controlling the hunger and getting enough calories in to not go in to starvation mode.

Karen - they did not give me any quantity or size guidelines....just liquids and soft foods for next 2 weeks. The PA also said that I should not slip at all - maybe she was just being kind. She said that it was definitely because I was too tight for 5 weeks. Let's hope neither of us ever slip!!!

Cannot wait until this barium gets out of my system!!!

Have a terrific day....Tiffany

[babyjessica 0]

Make sure you continue the Protein Shakes. That will help with the hunger. Also don't let them do a fill without fluro next time. My potential surgeon says he only do fills under fluro and he go really slow with fills. He even showed me the fluro room.

[TexasRose 0]

BabyJessica,

My surgeon just only started offering the fluoroscope fill outside of his office as an option - unless you had specific problems where he needed to utilize the technology. I will definitely only have it done this way from this point on - and would have done it early had it been available.

Have a great day! Tiffany

[giveyouthemoon 4]

Karen - they did not give me any quantity or size guidelines....just liquids and soft foods for next 2 weeks.

The quantity guideline isn't about the dialation, it's the general band rules. When you had your surgery, what portion sizes did your dr recommend? Stick strictly to that is my main point. My dialation is from going past that and eating too much.

[the best me 6]

My dialation is from going past that and eating too much.

Yes, eating too fast, too much, too quickly, PBing, getting stuck, being overfilled, will all cause swelling which makes the stomach around the band irritated and swollen and cause that "hole" to close up. This can lead to slippage.

I'm a little confused because, the pouch is dilated? Because the opening through the band is too tight? Is this right? Dilated means "open" and it seems as though the problem here is being NOT open...help me understand!

Wait, there's a medical term "dilitation" (sp?) but it's not in my dictionary...Bueller? Anyone? Anyone?

[giveyouthemoon 4]

I think I was spelling wrong...it's dilation (like getting your eyes dilated means the pupil is WAY open)

Dilation...it means both my pouch and my esphagus have widened above the band. It is caused primarily by overstuffing the pouch (eating too fast and too much).

The pouch will naturally dilate a bit after a year (the main problem that RNY patients have, the pouch "relaxes" and gets a bit bigger) but mine is beyond the normal aspect. It's not to the extreme, but enough that my dr is concerned and I have to be super careful about eating. And if I keep stuffing the pouch, it could cause a slip in the band.

The good news is the tissue is pretty resiliant and should, if I care for it well, go back a bit.

The main problem I have with the dilation is I feel hungry A LOT and like I can eat A LOT. It feels like I need a fill...but that would just make it worse.

So my regimen is to eat little tiny bits throughout the day. Like a handful of nuts. One egg. Stuff like that. Stick to the half cup of food at a time which I've fought against this whole year. And my fighting against the rules bought me this...not a problem yet, but a potential.

So I'm pretty diligent now. I want to keep my band for a VERY long time!

[leatha_g 4]

See attached: 1st xray showing how the band is TOO tight and the pouch bulging above the band in a 'bowl-like' structure. Because the band is too tight below the pouch, the pouch can become distended and stretched due to no food being able to move through adequately. Hope this helps to visualize what can happen if you become too tight.

The second xray shows that the pouch can be returned to normal.

[giveyouthemoon 4]

Wow lethea, your pouch was REALLY dilated! Mine isn't that distended...in an odd way seeing your xrays make me feel better.

So tell me....you were able to get your pouch back to right size? How? Did you take out all your fill? Or did you eat small? Just curious?

[leatha_g 4]

my band was actually slipped and had to be replaced.. this due to the overfill..