Cynthia from Humble Sent us this question:
“I had Gastric Sleeve & Hiatal Hernia surgery in Nov 2017. Lots of problems afterwards with food not staying down. Food still gets stuck in a pouch/bubble & taking Dexilant/Aciphex for acid reflux. It’s recommended that I get the Gastric Bypass surgery to correct the problem… is that a good suggestion? Thank you!”
Food not going through gastric sleeve lumen is highly suggestive of gastric sleeve stricture. Gastric sleeve stricture is a narrowing in gastric sleeve lumen that leads to food regurgitation, nausea, vomiting and pain. Gastric sleeve proximal to stricture tends to dilate with time creating a pouch where food accumulates. Gastric sleeve surgery is performed using mechanical stapler. The stomach is resected and stapled over a bougie placed inside stomach lumen. If bougie size is too small a stricture may form. Some bariatric surgeons in Houston oversaw the staple line to prevent bleeding or leaks. This may narrow the lumen. Other causes of gastric sleeve stricture include adhesion formation around stomach or twisting of gastric sleeve.
Upper endoscopy and contrast study are recommended to elucidate the problem. Sometimes, balloon dilation using endoscopy or scar tissue resection is enough to resolve the problem. If the stricture is long and/or severe, conversion of gastric sleeve to gastric bypass is the only way to alleviate obstruction.
Whatever the cause, your symptoms are not normal after sleeve gastrectomy and you don’t need to suffer. Please consult with a competent bariatric surgeon to help you fix the problem and improve your quality of life.