Ulcers

[tinamichele 1]

Anyone else dealing with ulcers? I am 5 weeks out and started having problems with food right after i was advanced to food that can be cut with fork. Had an EGD today and my poor little pouch is a big ol ulcer. So i am back to liquid diet for a week and 2 new ulcer meds.

I have been on the struggle bus since day one and I am starting to get depressed with each set back. I know i am not getting enough Protein. Some days, i just struggle with Water.

I need help. Not sure what to do...i just know i want to be back to normal and not have all this pain and extreme fatigue.

[soccerkaty 50]

I don’t have an ulcer but I understand your frustration as I have been sick (shortness of breath) since surgery and all I want is to feel better. If I go back to the doctor they will give me steroids which may or may not help but I’m afraid I’ll stop losing weight if I take the steroids. It sucks.

Also if it makes you feel at all better I got the OK to have soft foods so I had tuna today for dinner and thought I might die in the process. I swear it got stuck in my throat and you know no mixing Water at the same time so I suffered while my tuna digested in my throat.

I’m only two weeks out today but this is not what I anticipated to say the least.

[James Marusek 5,244]

According to the internet:

Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.

So generally what this is saying is

1) stay off all NSAIDs such as aspirin and excedrin that contains aspirin.

2) use a proton pump inhibitor such as prilosec (omeprazole). My surgeon recommended I take this daily for the first year so that my stomach would heal properly. At the end of my first year I discontinued it. I am now 5 years post-op.

3) make sure you were tested for Helicobacter pylori infection. This is a very common infection, one that is somewhat hidden because of a lack of symptoms.

The three most important elements after RNY gastric bypass surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. So my first concerns are not focused on food but rather to make sure you are meeting your daily protein and fluid requirements.

[tinamichele 1]

According to the internet:
Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.
So generally what this is saying is
1) stay off all NSAIDs such as aspirin and excedrin that contains aspirin.
2) use a proton pump inhibitor such as prilosec (omeprazole). My surgeon recommended I take this daily for the first year so that my stomach would heal properly. At the end of my first year I discontinued it. I am now 5 years post-op.
3) make sure you were tested for Helicobacter pylori infection. This is a very common infection, one that is somewhat hidden because of a lack of symptoms.
The three most important elements after RNY gastric bypass surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. So my first concerns are not focused on food but rather to make sure you are meeting your daily Protein and Fluid requirements.

Dr has changed my meds to 2 new ulcer meds. I never take NSAIDS or drink or smoke. I have been doing what the doctor ordered. I have not had the symptoms mentioned for ulcers. All i ever felt was that i was so full and it felt like a knot below breast bone. Hoping my meds kick in soon. Back to focusing strictly on protein (Fairlife milk) and Water. Hoping I can get back on track.

Oh and they tested me for that bacteria and I didnt have it. Here is what my stomach looks like

[tinamichele 1]