Gurgling, Swelling, Stenosis/Stricture?

[Taylor5 98]

Happy Sunday & Happy New Year's Eve Folks!!

Got sleeved on 12/27 {finally} and just returned from MX today. All in all feeling pretty good. Little itching/tenderness at one incision site. No nausea until my 1st Protein Shake today. Worst pain was actually from the constantly full bladder caused by the non-stop IV drip all night post-op. Once they took that out, oh sweet relief...!

But, I digress...On Friday I went back for my leak test. It showed no leaks but they said there were two small areas that looked a little more narrow than the rest. I could see the screen, and yes, I could see what they meant. Below the esophagus, leading to the stomach, were two small areas that were more "gray" than "black" as the rest of the barium filled areas were coming up black.

They asked if I was having difficulty taking fluids? I said no, I was taking 2 c of chicken broth per day, almost 2 sugar free popsicles, 1-2 bottles of Water, and a bottle of electrolytes (also a small cup of watered down apple juice, at the nurse's recommendation). So yeah, Obviously I was getting my fluids! So he said, no issues at all? Oh, well then I told him I was experiencing gurgling when I swallowed - not severe - not exactly painful, just uncomfortable and a little annoying. He showed me the screen again and said that gurgling was the esophagus trying to push what I consumed down into the pouch and it was gurgling bc it was taking longer than it should, causing some back-up. He showed me on the screen where some of the barium was still sitting in my esophagus and I could see it and also feel the gurgling in my throat a little.

He said the area around the stomach/diaphragm was just swollen still and that's what caused the narrowing. He said sometimes they do a steroid injection to help bring the swelling down, but they don't like to do steroids if they don't have to. So, the question was, did I really need the shot or would this get better on its own? I said I would defer to his expertise since I wasn't really sure what to do...I have plenty of experience w/steroids for back pain, but not applied to this situation. So he said they would give me a small dose of the steroid and he felt that should reduce the swelling and open the area up for normal passage.

The shot was in the bum (they never tell you that til right before it goes in...), and it did sting for a while. I didn't notice any huge improvement in gurgling right away, but now, two days later, I guess I would say I feel about how I would expect to. There may be a small amount of gurgling if I swallow too much at once, and then too some slight discomfort (or if I have to swallow a pill, bc a few of my meds are time released and can't be crushed, so they said to just take as usual as long as I am able to). I think I'm feeling how I should be feeling at this point, 4 days post-op, but how do I know for sure? I'm back home in PA now, so I hope it's all good..

Just wondering if this is considered stenosis or a stricture, or if those are different things that would happen down the line? Also, has anyone else experienced this and does it sound like this was handled in the proper way and would you feel comfortable at this point if you were me? Just want to check in with some of the vets...

[AZLoser 103]

I've never heard of a routine leak test. Leaks shouldn't happen and are not common. Gurgling is very common. Your stomach is now empty most of the time and you'll hear a lot more gurgling than ever before. You shouldn't swallow anything bigger than a small pea at this point. You shouldn't need to worry about your Vitamins now. Focus on liquids the first few weeks. It sounds like you're fine if you can get your fluids down.Add your vitamins in a few weeks. Do you have a local doctor for any follow up? You can always YouTube 'AskDrA' with Dr Alvarez. Those video clips will answer everything you need to know about post surg experiences.

[Taylor5 98]

Thanks for responding @AZLoser,

Every program that I researched, even the ones here in PA/NJ/NY/FL/VA did a leak test as part of the process. Some did it right after surgery when you are still sedated - inject some barium and check the screen for leaks. Others would do it the next day before discharging you or have you come back in a day or two and drink a very small amount of barium (a tiny medicine cup full, about 2 swallows). Thankfully you are right, leaks are not common, but I believe they are still a concern in the field of bariatrics (one reason for all the caution w/what to eat & drink & how soon), and that the test is a common part of making sure the patient is ready for discharge or is recovering as expected.

That said, the gurgling I'm describing isn't the "Hello Down There!!", Standing at the top of the Grand Canyon, massive echoing gurgle from the empty tummy, it is the little foam- feeling gurgle sometimes felt within a few seconds after drinking something (especially if you accidentally take too much at once or it is a new experience (cold/hot, etc.). It's further up in the esophagus - actually feels near the back of the throat, but from watching on the film I could see it was a little further down than that.

A couple of my meds I have been on for many years and cannot just stop taking. They do not come in a liquid form, and a few are extended release. For this reason I cannot crush them as I do my other maintenance medications. The one is a decent sized capsule a little smaller than a kidney bean, and the other is a tablet about one and a half times the size of a pencil eraser. I know this is not ideal, nor is it fun to do, but unfortunately is necessary to my overall health. So hopefully, no issues will come from that. Also, I know every program is different in pre-op/post-op programs, but I was told to resume Vitamins on Day 7, which is tomorrow.

I do not have a follow-up physician at home yet. I had planned to see my PCP until I was able to look up a Dr/Facility on the ASMBS website who states they are willing to follow other surgeons' patients. Most are not until about 3 mos post-op, but a few are. Unfortunately, we are self employed and also moved to a new county recently, so our health insurance changed in December and all my regular doctors except 1 are not on my new plan. I have to see brand new docs in my new county. So that's fun, and a lot to take on while in the early days of recovery. But it's one of the things I will be working on this week, and in the meantime I can go to the ER if anything happens to warrant that. So far I don't think it has, thank goodness.

I appreciate your response/feedback and the tip on Dr. Alvarez. Have a great day!