Pouch Dialation? Slippage??

[Sultana 0]

Hi All,

I just read Leatha's intro on roll call, and she says that she is currently unfilled because she was diagnosed with band slippage which they also called "Pouch dialation". Are they the same? It makes sense to me, because why would the pouch be too big unless the band slipped? I just had an upper GI, and that is what my Dr. is checking for--pouch dialation because I seem to be able to eat so much even with four fills. She also said that the treatment would be to unfill to let the pouch recede to where it should be?? I am now at 3.0, and I do eat less, but I have no trouble eating. Anyone knowledgeable? This makes me nervous.

Sultana

[donali 57]

In my mind, slippage and dilation are two different issues. In usual terms, slippage means that the bottom part of the stomach has come up through the band. Another less common form of slippage is when the band itself moves down further on the stomach, which does make for a larger pouch.

Dilation is more generally used to describe a band that is in the correct position, still, but that the pouch itself has been stretched enough to accommodate more food.

I could be wrong, but that's how I understand those terms. Anyone else have better info?

[Penni60 45]

I agree Donali with your analogy. I will make one observation though. The slippage can also be up toward the esophagus as well as down. The up slippage is more emergent than the down would be.

Pouch dilatation in my book is when it stretches or the band slipped down, in both instances the stomach pouch is bigger and allows more food to accumulate or to be ingested.

If the doc is calling dilatation the band opening itself that is an unfilling situation.

You should get the doc to clarify what he is checking for. Make him get specific with exactly what he is looking at.

Hope this clarifies this.

[donali 57]

Oh, I should have added: When the slippage is cause by the lower stomach coming up through the band, it can sometimes be treated by removing the fill, making the band looser and allowing the lower stomach to move back down through the band.

In my understanding.

[dishdiva 5]

To the best of my understanding from what my doctor told me last week, the pouch can be dialated alone or can be dialated with a slip. He called mine an "anterior slippage" and in my case, yes, it makes for a larger pouch, sort of. (Anyone heard of anterior slip?)

Judging by the picture he drew, it's kind of like a bone that's popped out of its joint (sorry, but that's the best analogy I can think of!) What was happening is food would go in the pouch which is kind of off to the side -- so the food wouldn't slide on down vertically... which is why I always felt so miserable...again, sorry for my bad description!

Elizabeth

8/03

[donali 57]

Anterior would be in the front - posterior would be in the back.

[Sultana 0]

Hi,

Whew! This is confusing. I hope I don't have ANY of these scenarios. I had an upper GI today, and the Dr. was freaked--never even heard of a Lapband! I was like a living advertisement; he was intrigued. I have the films because I need to take them to my Dr. on my next visit. I see my little pouch, but is it in the right place?? too big?? Who knows.

I ordered the new book on Lapbanding. I sure hope it arrives soon. It is about time! Thanks for the info guys. U rock!

Sultana:D

[leatha_g 4]

Hi ya'll! Yes. Pouch dilation and slippage are definitely two different things. Pouch dilation would concern the actual esophagus, which would be above the stomach. Slippage occurs when the stomach bulges through the band or the band moves downward. In my case, the pouch is fine, but the stomach has bulged up over the band sorta of creating a bowl type effect above the band. I have a scan of my film, if you want to see.

Leatha

There are 4 views, all with barium. The upper is with only one swallow but the lower is with more barium. You can see how there is more liquid sitting ABOVE the band, sort of spilling over the sides.

[leatha_g 4]

Yikes!! That's huge. LOL. So now you know me up close and personal.

Sorry it's so big.

Leatha

[donali 57]

Here you go, Leatha!

Thanks for sharing. You might want to delete the larger pic from your original post.

[leatha_g 4]

Oh, Thank you Donali! LOL that was huge.

Anyway. Thought some of the folks might like to see a film of what they are calling slippage from the 'old' technique. (Not being stitched around the band.

Just as a note, the very dark areas are the actual barium coming down the esophagus, then into the stomach. The bowl-like stomach is ABOVE the band.