Pouch packing and reflux? Dr. C and experienced bandsters

[S@ssen@ch 745]

Question for all you "experienced" bandsters out there, and hopefully Dr. C:

I read a post that dated back to August that was very detailed about how after time, we can possibly stretch out our pouch and by doing so the little receptors have a more difficult time telling when we're full. It even theorized that the stomach muscle tone becomes less able to move our food through efficiently. By stretching out our pouch, we also experience fewer PB's. Not that PBing is a goal or anything, it just happened to be something the poster noticed and wasn't sure if it was due to experience or this "stretching out" of the pouch/weakened receptors thing. Here's the thread: http://www.lapbandtalk.com/showthread.php?t=22437&highlight=stretch+pouch

Anyway, a thought occurred to me.......can "pouch packing"/chronic overeating and therefore dilation or stretching of the pouch have a direct link to reflux symptoms?

[Carlene 12]

Anyway, a thought occurred to me.......can "pouch packing"/chronic overeating and therefore dilation or stretching of the pouch have a direct link to reflux symptoms?

That's a good question. The only people I know who have had an actual diagnosis of "pouch packing" (esophagus dilation or stretching of the pouch) have not mentioned reflux.

Reflux, however, is definitely associated with overly tight fills.

The treatment is similar. For reflux, a slight unfill is prescribed. For dilated pouch or esophagus, a total unfill and "band rest" is advised, usually for 3 to 6 weeks.

[leatha_g 4]

Yes. A distended pouch can definitely contribute to nighttime reflux due to the fact that it often does not empty out of the esophagus correctly, thus when one lays down, there is backwash from food, etc still left in the pouch. In essence, the structure becomes a bit like a 'bowl' sitting above the band.

This does not necessarily only come from 'pouch packing', it can also happen due to being overfilled, causing the pouch to bulge above the band.

[spunkywoman 1]

A quick question......because I'm a newbie.I just had my second fill 2 weeks ago....I PBed for over 24 hours .......mostly slime. Then it happened again this week. Am I over eating? or Overfilled? 11cc band...1st fill was 5cc......second fill was 2ccs......help! I'm heading south for the winter and my doctor is in NYC....

[Trace Curry 1]

Yes anything that leads to pouch dilation could contribute to reflux. The stomach wall is normally fairly thick because of the muscles within. When the tissue becomes thinned out, it kind of gets "lazy" and doesn't act to propel things downwards anymore. So food, acid, etc, just lays there above the band and therefore can reflux into the esophagus.

Dr. C

Cincinnati, Ohio

www.TheBandDoctor.com 877.442.BAND

DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Question for all you "experienced" bandsters out there, and hopefully Dr. C:

I read a post that dated back to August that was very detailed about how after time, we can possibly stretch out our pouch and by doing so the little receptors have a more difficult time telling when we're full. It even theorized that the stomach muscle tone becomes less able to move our food through efficiently. By stretching out our pouch, we also experience fewer PB's. Not that PBing is a goal or anything, it just happened to be something the poster noticed and wasn't sure if it was due to experience or this "stretching out" of the pouch/weakened receptors thing. Here's the thread: http://www.lapbandtalk.com/showthread.php?t=22437&highlight=stretch+pouch

Anyway, a thought occurred to me.......can "pouch packing"/chronic overeating and therefore dilation or stretching of the pouch have a direct link to reflux symptoms?

[luckyme 0]

Hi, I posted this thread. I tried a number of changes in my eating to resolve my reflux without success. I finally gave in and had my last fill backed out a month after getting it as I was about to go out of town. Reflux gone. I still feel I can eat more than I should be able to on some days, but overall my pouch seems to be working much better. I'm working harder at limiting my portion size even if I don't feel "full." I still should get in for a flouro one of these days.

Right now, I'm having no problems, I've lost a a total of 10 lbs since that last fill, several after the unfill. I've decided I'm at goal as my upper body is getting too thin, guess I'll always have thick thighs. I actually PB'd for the first time in about 6 months last week after absentmindedly eating too much. I was relieved that I PB'd, but don't plan on pushing my limit again.

Reflux = unfill is now one of my rules.

Lucky

01/31/06

274/153 goal at 5'8"

[Carlene 12]

Reflux = unfill is now one of my rules.

That's such a hard rule for most of us to accept. Unfills are scary! I refused to let my GI doc do the scope thing if it meant getting my band unfilled. He said he could use a pedi tube. Good thing...

[S@ssen@ch 745]

Thanks everyone. I thought I was jumping to conclusions, but maybe there is something to this.

I'm really not sure what I should do. I was overfilled, in MAY. I got reflux. I got a slight unfill in AUGUST. I felt better. I even had an EGD and upper GI. I was told I was O.K. The symptoms were improving and I felt I was on the mend. I even felt well enough that I started being able to sleep flat again. Yeah me! That lasted only about a week or so then I started waking up choking. Now I have the reflux again. It's not as bad as before. More of an irritation in my chest and a sore throat in the morning. I'm getting darn tired of sleeping sitting up. Can we say "INSOMNIA"?

I thought may be somehow I was causing this because after the unfill I really did start feeling better. The only time I noticed the acid in my throat was when I had eaten a little too much.

For the last 2 days I've made a very serious and honest effort to stop eating when my nose runs. No more, even if I think I'm still hungry. I go to bed with my stomach absolutely growling for food. I do not eat after 7 p.m. So far, I haven't noticed any significant imrovement and I've added a new symptom-HUNGER PAINS, literal pain in my stomach which is resolved when I eat or drink. Which is something new to someone like me.

If this sounds like a rant, I'm sorry. I've just got to get it out and hope someone has an answer. I hesitate going to my doctor not because I don't want an unfill. I just switched to him and I don't want HIM thinking I'm as psychologically defective as my other doctors did. I guess I don't want to be one of "those" patients who are constantly complaining of something. So I stick it out hoping it goes away or I can treat it myself-nurse's mentality I suppose.