My Gastric Bypass Complications (1-2 months post-op)

[kukuiokalani 99]

Hi all,

I am writing this for the >1% of gastric bypass patients who have the unusual complications that I had and, like me, couldn't find any information about it online to ease your mind.

I had my gastric bypass surgery on September 7, 2022. I chose gastric bypass over the gastric sleeve specifically after months of research because of the higher rate of successful weight loss, particularly in women. My first week post-op went great, but after day 8 or 9 when I tried progressing my food intake from full-liquids to pureed foods I began vomiting and feeling really nauseous at every meal. I let my surgeon and dietitian know immediately and stepped my food intake back down to full-liquids. Pretty soon, I couldn't even take in full-liquids and was limited to hydrating fluids and chicken broth. I could keep down hydrating fluids and broth about 80% of the time, full-liquids 50% of the time, and everything else came back up.

My surgeon was very responsive and had me get an endoscopy. Under general anesthesia, the endoscopy explored my new stomach pouch and roux limb connections that make up my new tummy system. Typically, gastric bypasses can result in constriction of the connection between the stomach pouch and roux limb, and my gastroenterologist was prepared to use a balloon to inflate the area to ease that restriction. In my case, however, that area looked fine, but further down the roux limb there was a stricture that was almost impassable for the narrow scope. This is what was causing my problem.

I had an external compression on my roux limb that was making it impossible for anything more viscous than Water to pass through. My layman's understanding of what had happened is that my surgeon brought my small intestine / roux limb up to meet my new stomach pouch through the transverse mesocolon. This involved cutting a hole through the transverse mesocolon to put the roux limb through and then stitching it up a little on either side to make sure nothing else will slip through the hole and cause a hernia. Apparently, this is typically sufficient and there is space enough in the hole in the mesocolon for scar tissue to form but still allow the roux limb to operate appropriately. Not in my case! xD

My body and over-active immune system saw a hole and decided that hole must. be. fixed! The scar tissue that formed to close the hole closed tight enough on the roux limb and it was tight enough that barely anything could get through. I had a second laparoscopic surgery on October 12, 2022 to remove the scar tissue and loosen the compression on the roux limb. My surgeon decided to remove the small stitches on either side of the hole in the transverse mesocolon to reduce the chance that any new scar tissue will close the hole up as completely again. Immediately after this second laparoscopic surgery, I felt tons better! I stayed overnight in the hospital and was put straight on full-liquids, which I was barely tolerating before!

The reason I am writing all of this out is because, in the month-long interim between surgeries, I couldn't find anything in my online research to figure out what was wrong, or what I could try, or what the next steps looked like, or how long, or why this was happening. I went for more than a month on little to no substantial nutrition, and I found so little information on what to expect or how long I would have to live like this. I even looked in these forums to see if anyone had asked about symptoms that are similar to mine and I didn't find very much information. So, I'm writing about my experience and using as many of the keywords I can think of that I've been searching for over the past two months!

So! If you had gastric bypass and you start experiencing nausea and vomiting after what seems like typical food progression, please speak to your surgeon. It could be an internal stricture of the roux limb or the connecting bits, or in my case an external compression of some sort. From the very few resources I could find online, my type of external compression of transverse mesocolon on the roux limb seemed to occur in 0.9% of gastric bypass patients and it seems to happen within the first month. My surgeon pretty much immediately knew what was wrong, and her PA said she had seen it before, but not often, and it was new for my insurance caseworker. The inability to eat made it very difficult to complete normal daily tasks like my job, housework, walking the dog, etc. I wasn't in pain, I just couldn't get enough energy to do anything! My doctors moved quickly to get me back in for surgery, but it still took 4-5 weeks from starting to vomit at each meal to waking up from my second surgery feeling much better. I am so thankful that my surgeon was able to fix what was wrong with the scar tissue compressing around the roux limb; it made a world of difference!

I'm not out of the woods quite yet, however. Six days after the surgery to repair the hole in the transverse mesocolon, I had a bad food day and nothing stayed down. I immediately reached out to my surgeon's office and today went in for an upper GI in which I intake contrast dye while a doctor observes how it flows through my new gastrointestinal system with an X-ray. That doctor said it looks like the connection between my stomach pouch and roux limb looks stenosed now. I am grateful that they found something and that there is an explanation for why everything I put in my mouth makes me nauseous and that there's a reason why I don't want to eat anything.

I will be having another endoscopy in the following couple of weeks and, as ever, I am hopeful that this will be the last surgery that I need for my gastric bypass.

[St77 87]

Oh that sounds rough! I hope you continue to feel better and don't need any other surgeries.

I've had some minor issues since my bypass, mostly a stuck feeling in my throat that never goes away and it doesn't matter if I've eaten or not. I have a twisted esophagus, but GI explained at this point there's nothing to worry about since I can get food down.

That leads to the 2nd problem, I am never hungry. I know that can happen and usually goes away, but my nutritionist and even neurologist are concerned that I'm losing weight too quickly. I'm also getting so full after taking my necessary medications in the morning (not counting supplements and vitamins) that I don't get to Breakfast until 11 AM or so.

[kcuster83 1,504]

I am glad it was resolved and you are feeling better.

I have heard of this happening, scary.

[catwoman7 11,212]

regular strictures occur in about 5% of bypass patients, and they're an easy fix. I've never heard of the issue you had before - but I'm glad they fixed it!

[TerryCieniewicz 7]

Thank you for sharing your story. I hope it helps someone.

[SilentMoon 8]

Thank you for sharing. I’m just dealing with discomfort. Stomach noises, the gurgling, and moving through my system where I can hear everything! Also, I have pain in my shoulder and neck. Surgery date 12/22/22

[Tomo 1,191]

I am so glad you are better now. Your explanation was very clear, and I think it will help those in the future to act quickly if they get similar symptoms.

[Mychelle D 8]

I did not have the same issue but I did get a stricture. I also had to wait to be scheduled and ended up eating no solid foods from 4weeks-8weeks post op. I hope you feel better ASAP.

[SleeveToBypass2023 2,598]

How are things going now? Did you get everything resolved?

[CarainCali 4]

Thank you for sharing! I'm dealing with a stricture now. I've had 3 bsloon procedures but the camera still won't go all the way through. My surgeon described it as a funnel where he has been able to open some at the top but not go through. I've been trying to transition from a feeding tube to eating but can't keep Water or food down and everything makes me nauseous.

This is my story so far:

I had surgery 6/13/24 for revision to RNY. I had 2 emergency surgeries 3 days later. I had a leak and had 7liters of toxic fluids cleaned out of me then ICU 6 days and hospital until the end of July. It has been 10 months + with wound vac, Gtube, and now a stricture that I've had 3 balloon procedures and still not halfway there. Total of 6 hospital stays, 4 ER visits, 7 surgeries since June 2023.

I'm getting better. Feeding tube helps but also causes alot of pain and granulated tissue which has to be burned off.

I have found 4 people who have talked about the same issues. A leak like this and a stricture is very uncommon.

Most people with leaks end up dying. It's why you don't hear about them.

I'm not sure why anyone would require a feeding tube other than a major stricture or leak. Maybe due to already having so much scar tissue. They think that is why I had a leak but nobody knows.

For reference. I had lapband 2008. Lapband Removal 2019 due to Gerd. RNY 2023. I was 238lbs 5'6 at the time. I'm 170 now.