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My Theory on Pouch Dilation - Babs, Shelly, Dr. C
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This is my theory based on the problems I've seen others have and some issues(reflux) after my most recent fill. I've been banded about a year and a half and I've noticed that my band doesn't work the same way it did before.
Even with a tighter fill, I cannot depend on stop signals anymore, and I can definately eat more that I could earlier in my banding. I do plan to make an appointment with my doctor to discuss and to request an upper GI, and possible decrease in fill.
Based on my experience, I think that when the pouch is stretched for a period of time, it becomes less able to contract and move food through the stoma. It becomes more likely to stretch with a tight fill and too large serving sizes. I used to consistenly be able to feel the very subtle peristaltic contraction and the slight "gurgle" of food going through my stoma. I lost that after my last fill (and intermittanly before). I was having non-acid reflux at night. I believe this was because my pouch wasn't contracting to squeeze the last of the food sludge and Water that gravity didn't take care of through the stoma.
I backed off to fluids for a couple of days till I got my gurgle back, then started adding in 1/2 cup servings of solids. As long as I stick to small portions, I keep my "gurgle" and NO REFLUX. Yesterday, I had a couple of larger meals and lost the gurgle and had reflux again.
What is different about this from earlier fills is that I couldn't eat more than 1/2 cup of food after earlier fills untill the fill loosened up. I expected to get back to more noticible "stop" signs after this fill, but I didn't. I just noticed that food seems to stay in my pouch longer. I do think that my pouch stretches more easily now and when it is stretched, it doesn't move food through effectively. Because I was able to eat more before this fill, I thought my band had loosened, it may be that I'd gradually stretched my pouch. I suspect that once it stretches, it will stretch more easily in the future.
Another intersting aspect to this is that my last fill was 8 months before this one. I haven't PB'd in about 5 months. I'ts not that I'm trying to PB, just one of those things that would happen about once a month after a lapse in chewing or judgement. It was about the same time that I noticed I could start eating more.
For me, it looks like I will have to stay with strictly measured portions and/or back off on the fill to prevent future problems. I'm down 120 lbs, at a normal BMI and only 10 lbs from my personal skinny goal. I don't want to risk long term problems with my band. BTW, my doc does fills without floro unless he has a problem accessing the port.
Lucky (and I plan to stay that way)