Bile after surgery

[sarah50 10]

Hi all, im new to this site but open to suggestions ,

So my story is , i had a gastric bypass in April 2017, weight loss great, all my medical conditions settled , but i had pain in the insides of the left rib area from quite early on, i couldn't get to the pain by touch, i had the camera and CT scans , i was later informed i had ulcers in the new pouch, i was relieved to find out i did have something wrong and this pain would go away , so in 2018 i had a bypass revision to have the ulcers removed , my new pouch had lengthened (stretched due to acide reflux) , so i had further surgery to shorten this and the ulcers were taken out.

Further complications arose, as they removed the ulcers they caught my bowel , more surgery was needed and i lost 5 pints of blood, recovering from the surgery , 5 months later I'm still in excruciating pain on the left side, pain killers don't help at all, and my GP said it was my 'Back' i knew this wasn't what was wrong with me and i felt i had no support or getting anywhere with my condition. The hospital were also at a loss what was happening with me, and tried to diagnose me as depressed, the only depression i had was pain and not been believed.

i took it upon myself to do my own research and i have came up with Bile reflux, not acid, the GP listened to me and agreed to try me on some medication, as i wa passed myslef by this time, after 5 days of been on the medication , at last i'm getting some relief ,i cant explain the pain i have been in, i thought i was going insane at one point as all the tests were negative, scans all clear , pain that i couldn't get too, yet it had me drinking bottles of strong pain relief to literally put me in bed .

My question is ? has anyone else had this complaint of BILE REFLUX and if so what was the outcome as i understand the medication can only be take short term?

[CindeeAT 19]

I'm shocked that your surgeon can't get this under control for you! Maybe a second opinion from another bariatric surgeon? My GP admits that she has very little knowledge about bariatric issues and she sent me right back to my surgeon when things were going off of the rails with my band and sleeve.

[Orchids&Dragons 9,046]

I'm so sorry you've had to deal with so much pain. I don't know anything about bile reflux but I hope they find some answers for you. (hugs)

[sarah50 10]

Hi thanks for replying , im back to see the surgeon in April I def want answers , really feel fed up, thankyou for Dr google lol , Ive read that this isn’t that common and can be mistaken for acid , I guess I will be an expert by the end if it all lol.

[DanaC84 1,116]

I hope you get answers Sarah! I’ve never heard of it either. I can only imagine how bad it is based on what GERD feels like (and this definitely sounds worse). Keep us posted !!

[Frustr8 7,886]

If you have Wikipedia on your computer or phone you can look it up. I wonder if your rny was faulty, I always was told the reconnection was far enough " downstream" that such a thing was pretty impossible and DS were more likely to exhibit it. And Wikipedia does admit it is not a "fun thing" to have happen to you.

[sarah50 10]

Hi, I’ve looked everywhere I was hoping some one else may have experienced what I’m going through. I’ve had 2 lots of surgery now basically my surgeon said I’ve had 2 rny , I was unique the first time round now this , my story continues lol. But it’s not a nice experience to have constant pain and I’m not one that anything pushes me down but this has done , I wouldn’t want my worst enemy to have the pain. Thanks for trying x

[Frustr8 7,886]

And Sarah I do hope and pray you do get better!😪

[FluffyChix 17,409]

Ouch! So sorry for your crappy journey and struggles. Hope you are able to get to the bottom of it and feel relief!!! Which med is working for you? ((hugs))

[sarah50 10]

Sorry it’s taking me a king time for updates. I’m struggling with this site. Another update.
The meds they gave me gave me really bad side effects. The doc described it as Parkinson’s symptoms, I was a mess, I’m now on dorperidome which is helping a little bit but not taking the pain away , Just moving the food quicker out of the stomach, ive also got a brown/yellow tongue which is like sandpaper and a croaky voice, no matter what I do it didn’t go away, it’s vile. I have also seen a psychologist who said it was all in my head and had to learn to live with the pain or control it, I’m so mad, no one wants this type of pain.
Roll on next week when I see my surgeon, this is not normal 😢x

[Frustr8 7,886]

@Sarah50, if you are still active,could we hear from you damn

[Frustr8 7,886]

Oops was trying to talk to Google, thought I was backed out and the word I said was determination, Ooh this phone is going to give me major trouble, I can just see Bad things ahead. I think this phone needs replaced badly.

[sarah50 10]

Hi. I’m still active but not sure how to get back on this site unless I’m sent a message. I’m still having issues and under a new consultant, so more tests are needed

9 hours ago, Frustr8 said:

@Sarah50, if you are still active,could we hear from you damn

[sarah50 10]

Another update. I’ve been put on domperidone meds which is to help push food through the stomach ( in my case) they are helping but the pain is still there especially after food, I also keep having really bad indigestion too which takes ages to settle. I can’t lay flat anymore and have to stay on my right side, roll on the 2nd opinion x

[RickM 1,747]

On 3/24/2019 at 12:17 PM, Frustr8 said:

If you have Wikipedia on your computer or phone you can look it up. I wonder if your rny was faulty, I always was told the reconnection was far enough " downstream" that such a thing was pretty impossible and DS were more likely to exhibit it. And Wikipedia does admit it is not a "fun thing" to have happen to you.

Actually, with the DS (at least the "traditional" bileopancreatic diversion (BPD) DS. bile reflux is near impossibility, as the duodenum is split between the bile ducts and stomach, forcing the bile and pancreatic enzymes to flow downstream some ten feet or so (depending on individual variations) until it hits the common channel where it meets the food flow and actual digestion can occur; for it to reflux into the stomach, it would then have to flow back upstream some 4-5 feet or more (again, depending upon individual variations) before it could get to the pyloric valve and reflux into the stomach.

The newer "simplified" SIPS/SADI/Loop DS is more of a classic Billroth II configuration (cousin to the RNY) where bile reflux may be possible, depending upon how the surgeon sets up the limb lengths.

With the RNY, like any Billroth II based procedures, bile flows downstream from the bile ducts and can reflux into the stomach pouch. The main counters to this is neutralizing the bile with stomach acid from the remnant stomach, and limb length between the bile ducts and pouch. Bile reflux is not uncommon amongst cancer patients who have had a gastrectomy, where the basic layout is an RNY without the remnant stomach, The surgeon that I worked with when I was considering this told me that he has never had any bile reflux problems if he keeps that limb length at 60cm or above; presumably, some of these cancer patients received a shorter limb in an effort to minimize malabsorption and weight loss. As with many things in life (and medicine in particular here,) there is a balance between the therapeutic and objectionable side effects - and people will vary as to where that balance may be in their particular case.

Perhaps the OP experienced classic RNY marginal ulcers from the acid incompatibility with the intestine and anastomosis, and in the process of these serial revisions, wound up with an overly short jejunum?

Hopefully she can get this sorted out, but the DS does provide something of a last ditch option of other avenues don't resolve the problem; unfortunately, such revisions are very complex, and there are only a half dozen or so surgeons in the country with the skills and experience to perform it. Perhaps a distal RNY, where they move the pouch waaaayyy down the intestines toward the colon may be a middle ground that might do the job.