Can anyone tell me exactly what is esophageal dilation and what the complications are from it? My doctor said that I was starting to dilate when he filled me up with the help of a floroscope.

Esophageal dilatation (I don't know why they couldn't just say "dilation," but they had to throw in an extra syllable) is, in my experience, pretty much as described above.

But, be careful when you "interpret" the words "overeating" or "pouch packing," or the like. It is difficult to blame overeating when not much is bieng eaten and the weight keeps coming off, as it did early on in my case. I wasn't eating more than my doctor recommended or more than I needed to eat to lose weight, I was just eating more than my esophagus could process, once its function was hampered by the presence of the band. And that "more than my esophagus could process" amount might be as little as two spoons of Soup.

So, we would go out to an early dinner (we do that on a VERY regular basis because I'm a lazy woman), order off the lunch menu, have two or three spoons of soup, and then decide to "save room" for the fish entree. When it arrived, I'd take one bite and get that deer-in-the-headlights look. More often than not, I was off to the restroom to bring UP what wouldn't go DOWN.

Turns out, I wasn't "packing" food into the esophagus as a result of eating more than my stomach could handle...what I was doing was eating food that never made it to my stomach, but bounced around--down the esophagus and then back up--because the band was keeping the esophagus from doing its job. Finally, three weeks before my band was removed, this was captured on video with two MD's witnessing it, but that was LATER.)

Then I'd get an unfill. And then a fill. And for two years this went on, until I decided I needed to do SOMETHING. And I had one band doctor who wanted me to join his support group so I could learn how life with the band was supposed to work. (I already knew...just like it HAD worked for me for eight months or so, until the band did its damage.)

After over two years of HORRID restrictions--and the weight gain that went with an emptied band and the infamous "soup and ice cream diet"--with the band, I finally decided to have a revision to the Duodenal Switch (aka Biliopancreatic Diversion with Duodenal Switch) because I wanted a stomach, not a "pouch," and I didn't want Dumping Syndrome like some of my girlfriends have, and I wanted to eat a more normal diet. I had that revision surgery a year ago.

The surgery--band out and DS performed took less than two hours--and I was in the hospital four days. It took TEN weeks before I lost all of those band-related symptoms, but once I did, my life began. (And during those ten weeks, I lost about 55 pounds, so it wasn't ALL misery.)

For some people, the dilated esophagus (picture a funnel, upsidedown) goes away once they learn to eat smaller amounts and to eat slower. For others, it may be a signal that this is not going to be an easy ride.

I hope you find the cause of your problem and are able to reverse it. It would not hurt, however, to have a Plan B in the back of your mind, because taking over two years to figure out what to do next was not my most brilliant move.

Sue

Hello Paige, Thank you very much for your answer. I came away from my meeting involving Mr Super , lasting less than 5 minutes, with no knowledge that I didn't already know and £85 poorer! I thought that he was arrogant and wasn't bothered about me because I had my band abroad. Altogether ,with his little speech and the fill,it cost me £400 and they lost the X-rays, which as a private patient, my own doctor said I was entitled to have. I got fed up phoning round and round the hospital, trying to find them.This was my only experience of private medicine in England and I didn't think much of it. I am retired so I could not afford to have the band here.

Thank you for mentioning Dr Khan, I would be grateful if you could send me details and maybe I could contact him, or my doctor could. My doctor laughed and just said Mr Super wasn't so super after all !.

Mr Kahn is at walsall mannor Hospital,

You should not feel bad about going abroad at the end of the day look at me and look at some of his other patients were not doing to great so he isnt so super AT ALL.

Your band may be placed wrong it may not be. But i think you have lost weight and has now but doubt in your head and i suspect this has given your confidence a kickin and motivation isnt as good as it was.

I cant believe he charged you £400 for a x ray fill that way above adverage at most it should have been £250 and yes you have every right to have those x rays. who's to say he just said that so he could wip you in fit a new one and charge you a fortune for it?

We only have his word there is no x ray to prove it.

i see Mr Dexter now at Leeds Nuffield my PCT pay for it, There is also Mr diggory in Telford he is lovely and its only a 30 min drive to Telford.

He's at the apley clinic Telford. Mr Dexter is at leeds Nuffield. Mr Kahn at walsall Manor Walsall. Mr Patel is at the guthrie clinic London. choose any one and see if your GP can refer you and get you sorted. I know My PCT have paid for Mr diggory and Mr Dexter and iv seen them in the private sector but NHS funded.

I have heard others say Mr Super is arrogant,

If you need any help email me ill give you some contact details but your GP should esily be able to reffer you to any one of these consultants. And they will apply for NHS funding for you. Please dont believe the band is situatied in the wrong position untill you have it from some one you trust!.

Hi Paige!, Thanks very much for your advice. I will give it a lot of thought over christmas and make a decision when everything is back to normal.

I have joined weight watchers, something which has not pleased my husband very much because he does not want to believe that there may be something wrong. This is simply because he was advised by his nephew, in Hungary, to persuade me to go there. He arranged everything and so i just went along with it. Mind You it was very clean and the whole team, some english speaking, were very kind.

Once again thank you very much for taking the trouble and I don't think that you are negative at all, just realistic!

If you look at any research there is lists of names, From EU, UK and US surgeons. In fact surgeons from all over the world while it is not ideal some one should travel out of there country for surgery i think surly they cant all be wrong. I mean if there all wrong why do they colaberate there findings and all meet up at functions and so on.

I dont think every surgeon from abroad id dodgy i am dubious about a surgeon that can reconise problems with patients who had banding abreoad but boasts a 100% sucess rate for himself.

When in reality there are many of his patients struggling. seems ironic he can spot some one elses mistake but not his own. I think the key is you have lost weight and now doubt has been set in your mind. May be you need more fills why shouldnt they work if to date you have lost weight.

Try not to worry about it like you say enjoy the christmas season. Try and remember this season has lots of temptations about for us more than normal. and it can be hard sticking to the rules while everry one else kicks back and relaxes. If you have a few classes of wine more than normal thats all calories in.

I Think we shouldnt be too hard on our selfs this time of year as we shouldnt socially exclude our selfs after all isnt that one of the reasons we all want to lose weight so we can get out and enjoy life more to the full with higher self esteem.

Esophogeal dilation can also be caused when the individual has a weak junction between the esophagus and the stomach. Even a properly placed and properly filled band exerts too much pressure. People with weak junctions should not be banded, but there is no way to know until it's too late.

my understanding is that when you eat too much, the esophagus starts to fill up and dilate. Is that correct banders??

Not quite so I have had this problem over and over again I was told it was caused by the band itself being too tight causing restriction of food not to go throught the stoma area into the stomach what it does is backs up and then begins to stretch out you might be eating like me but the food is not getting stuck nor is it going down. I am now consulting with my Dr. about doing a revision. i ahve had so much vomiting, reflux, hard swallows, fills and unfills as I call them. I had more U GI's than you can shake a stick at and most of all I stopped lowing weight over two years ago.

HI Paige,

My band is placed properly and is confirmed by endoscopy, flouroscopy and every other test known to man. I was too tight but I did not have reflux or any other problems asssociated with a too tight band, so the docs kept filling it. Yeah, I would like more restriction, but it seems that my ability to pouch pack means I need to keep the band a little looser than I would like, but it is helping me by taking the edge off the hunger and the overeating. The rest I will do for myself with diet and exercise.

The band is not rocket science. IT is either too tight, too loose or just right. I had my band accidentally unfilled when I had plastic surgery last year and gained significant weight while they tried to adjust it back to the same level of restriction that I had before. I am back on track and I have lost 20 lbs of the 38 pounds I gained over a year and a half.

It is true that I did not notice that I was slowly eating more and more, but I knew I was eating too much and didnt listen to the signals since they were not as strong as they were when I was originally banded. I lost most of my weight in the first 18 months and noticed the diminishing restriction. I kept pushing the bar just a little more everyday and pretty soon, I was eating normal portions and not getting full.

FYI: You can also pouch pack with a RNY causing the pouch to enlarge and no longer be effective in creating satiety. You can sabotage any WLS if you really put your mind to it.

You keep saying that you dont mean to be negative, but you are and I find it disturbing.

Babs in TX

334/190 ish

Babs in TX,

Hopefully, you are still coming around from time to time to see how things are on this site.

I am much in the same situation you described above. I'm too tight and I knew it, but I got a barium swallow ($175 self pay) to confirm and I'm now trying to get a Gastroendologist (sp) to take a look at me. Please note that I was banded in '04, in Mx, my port floats as it was not attached and I have a MIDband that no one wants to touch with a ten foot pole and gloves because it's not US FDA approved. I've phoned numerous Drs. in several states and even the Fill Center who informed me there are actually 6 US FDA unapproved bands and they could only reccommend this site to me as an aftermath.

I do have a WONDERFUL Dr. in OH that, but with this weather being what it is (winter and GA is gonna get slamed with ice and snow), a 7 hr. drive one way and any emergency that might arise, I'm trying to find something more local. He and the NP have commented when I told them of this that a port is a port and it shouldn't make any difference (he and his NP access the port w/o any problems or floro)...I know they are right, but it's not reality. My daughter is an RN, but she lives about as far away as the Dr. and the weather there is just as bad if not worse because of the mountains.

I must say I did find one Dr. in AL that would take me for a fee + adjustment + floroscopy (if needed at a tune of $400.00) = $$$$$$. I've even been quoted an amount of $2,000.00. The amount some doctors want to soak you for is OUTRAGEOUS!! It makes me wonder if they remember the Hypocratic Oath.

I was wondering if you'd be so kind as to contact me so we could discuss the options, life changes and any advise you might have? I would really appreciate it!!

Tacy

There is also another VERY RARE cause, that unfortutenly I experienced. Everytime they filled my band and got to a place of good restriction (about 8cc out of 10cc band) I would experience nighttime vomiting and although I was restricted I could still eat WAY more then I should have been able to and gaining fast.. Each time they took an esphogram and it showed massive dilation. After 6 months of going through the fill/unill cycle they realized there had 2 be something wrong and when they did a revision surgery turns out scar tissue had formed and pulled the band into a malposition. Essentially everytime they filled to a point it would kink off my espogus so all the food would just sit there.

Cort

http://thebandit1.blogspot.com/

Babs in TX,

Hopefully, you are still coming around from time to time to see how things are on this site.

I am much in the same situation you described above. I'm too tight and I knew it, but I got a barium swallow ($175 self pay) to confirm and I'm now trying to get a Gastroendologist (sp) to take a look at me. Please note that I was banded in '04, in Mx, my port floats as it was not attached and I have a MIDband that no one wants to touch with a ten foot pole and gloves because it's not US FDA approved. I've phoned numerous Drs. in several states and even the Fill Center who informed me there are actually 6 US FDA unapproved bands and they could only reccommend this site to me as an aftermath.

I do have a WONDERFUL Dr. in OH that, but with this weather being what it is (winter and GA is gonna get slamed with ice and snow), a 7 hr. drive one way and any emergency that might arise, I'm trying to find something more local. He and the NP have commented when I told them of this that a port is a port and it shouldn't make any difference (he and his NP access the port w/o any problems or floro)...I know they are right, but it's not reality. My daughter is an RN, but she lives about as far away as the Dr. and the weather there is just as bad if not worse because of the mountains.

I must say I did find one Dr. in AL that would take me for a fee + adjustment + floroscopy (if needed at a tune of $400.00) = $$$$$$. I've even been quoted an amount of $2,000.00. The amount some doctors want to soak you for is OUTRAGEOUS!! It makes me wonder if they remember the Hypocratic Oath.

I was wondering if you'd be so kind as to contact me so we could discuss the options, life changes and any advise you might have? I would really appreciate it!!

Tacy

Hey Tracy! I find myself in quite a quandry myself. I had the band in Mexico in 2008 and have lost 90 pounds with about 50 to go, but my weight loss has slowed to a crawl and I have bad reflux again (have had it for years but it subsided for a while after teh band and has returned with a vengeance!).. I would really be interested in any docs you have found that will take on patients banded in Mexico. I have gone back to liquids only in hopes it is only a concentric pouch and will correct itself, but I need to start thinking about what will happen if it is actually a slip! I asked the question BEFORE I had surgery in Mexico "What if I have probelms" and was told that my insurance would kick in and cover problems.. but now, I hear otherwise. I am self pay and in this day and time, getting sick, having medical probs, or an accident, is NOT something I want to think about! Would appreciate any info you can give me!

my understanding is that when you eat too much, the esophagus starts to fill up and dilate. Is that correct banders??

I have had esophageal dialation called a mega esophagus and not from over eating either, you can develope this from having a too tight band when food does not pass through the esophagus to the stomach due to a narrow esophagus measuring about 2.3 mm in diameter means that the foods and possible liquids you take in cannot pass and there for it in my terms just sits and backs up, causing vomiting,reflux and a real bad time of it. My most current UGI showed that my esophagus had narrowed, nothing passing through it, reflux in the esophagus just sitting there no place to go. It was also diagnosed that I ahve a hiatal hernia and as long as the hernia is there I will always have problems and possible esophagus problems for the rest of my life. If you have a hiatal hernia then your not supposed to be banded until after it is fixed, I was told none was found during my surgery but now it surfaced, so did the hernia happen due to all the vomiting? and pressure I had? I can't say I am not a Dr.

However my Surgeon had his office person send ina pre-determination letter to ahve the band removed and convert me to the RNY. I am still waiting for an answer. My Band has been completely emptied, placed on 2 weeks of liquids and 4 weeks pured foods and anopther UGI to follow. This is not my first time around with this same problem, for it has persisted now 2 years and enough is enough in my book. The Hiatal hernia was actually seen on my UGI from June 2010 and we are now just being told of this. What took so long? got me I was not the one reading the scan results, you cannot go by paper documentaion from the radiologist for they might not report it.

Babs was your esophageal dilation caused by overeating?

Matzatl,

Chronic pouch dilation is the most likely culprit of esophageal dilation because once someone chronically overeats, the pouch fills up and the food has no where else to go but the esophagus. Essentially you would be using your esophagus as a third pouch. Esophagus, upper pouch/ lower stomach.

Other causes of esophageal dilation could be esophageal dysmotility (which means that your esophagus is not pushing food through properly), too tight band, band placement (which is not the likely cause but it could happen).

Most docs will do a complete unfill and let the esophagus and pouch go back to normal size. Chronic pouch packing/dilation can cause a slip, esophagus problems etc. THe best thing you can do to prevent these problems is to watch your food portions and keep them to 3-4 oz of solid Protein and a few ounces of veggies/carbs per meal.

I speak from experience. I had my band emptied in August and refilled in mid September due to esophagus dilation and pouch dilation. I am much more aware of quantities now.

Babs in TX

334/190 ish