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12 years post RNY---3 years post emergency revision---new complications?



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Looking for advice, will try to be brief. Thank you for allowing me to join your community! As the title explains, I have had two operations in the last 12 years. I have had issues with alcohol in the past which led to my revision. Anyway, I will complete a 'my story' post soon. Today I am trying to determine if what I am experiencing is normal or not. Thank you, in advance, for your candid advice.

I developed GERD-like symptoms about nine months ago. I tried to moderate it with diet (less spicy / tomato), a few rounds of Prilosec. About seven months ago I gave up all alcohol in-part due to the painful symptoms. I had greatly moderated from my two bottle a day heyday, but I still drank. I am proud of my progress, but meetings may be in my future. At three months, Dr. ordered an endoscopy. I had the procedure October 30, 2021. Results showed that I was inflamed, but no ulcers. 'Just stay on Prilosec, forever if you have to' is the advice I received. After endoscopy, I decided to give up all carbonated drinks (I was hooked on about 100+ ounces a day of Diet Dr. Pepper). My go-to drink is now Water. Also have added a lot of unsweetened iced tea and some coffee.

A few days after New Year, my appetite started to decline. Just the thought of food was making me not feel well. I work from home and I fell into a habit of: one yogurt in the AM, Protein Drink at noon if hunger strikes, then just maybe 10 bites of anything around 4pm. dinner at 7, maybe 20 bites over two hours. Hunger pains come on strong at times, but go away fast with 2-4 bites of anything.. As of today, Jan 23, my appetite is still just about 30% / 40% of what it was. I still find myself feeling like I have to 'force' myself to eat sometimes. Nothing sounds or tastes very good. I had a colonoscopy in December. Came back normal with one non-issue polyup (sp).

Last week, I ran out of Prilosec. I decided to see if maybe I could get away with an as-needed solution. Big mistake. For the last three nights I have been awakened with extreme pain in my stomach. I have been taking Pepcid and Rolaids / Tums as needed. I plan to restart Prilosec tomorrow. Not sure why my stomach is still on fire??? I have a rather bland meat and potato diet. I quit alcohol and all carbonated drinks. Maybe a liquid fast and 100 Hail Mary's?

This is my theory about my appetite issue: I think giving up the pop has resulted in far less bloating in my small stomach. Perhaps this has allowed it to heal back to a normal, or less inflamed, size. I cannot eat as much, but if I space out my eating, I'm sort of fine. I'm not sure about the mental aspects of this situation or how they corollate in parallel to the physical issues. However, the last time I felt this way (loss of appetite, could barely eat) was just before my emergency revision. Thankfully I have not developed the abdominal pains of that episode, just the eating issue.

Just for context: I am a 47 year old male, about 260 pounds. I worry about constriction due to scar tissue, I was warned to look out for this.

Thank you for any thoughts or advice!

Matt

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I am 5 1/2 years out from RNY. Had consistent sore throat pain in spite of being on Omeprazole. Dr explained that I had small hiatal hernia which allowed stomach acid to seep into esophagus. Last endoscopy must have pushed stomach Bach down below diaphragm because pain substantially reduced. Best of luck to you.

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Do you think you're due an appointment with your WLS surgeon to discuss what's going on with you?

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Was it your family doctor or bariatric surgeon who ordered the endoscopy? If family doc, was your bariatric surgeon in the loop on it! My thoughts is that there are a lot of things (potentially) going on in the blind look of the RNY (remnant stomach, duodenum, bile and pancreatic ducts, etc.) that aren't covered by an endoscopy as with the normal anatomy. So for instance, you may not be seeing any ulcers in your pouch, but there may be one in the remnant stomach. I would want to make sure that someone intimately familiar with your altered anatomy is in the loop on this.

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For ages I used to suffer from very sharp cutting like pains across my tummy. Ultrasound, barium meal & endoscopy & they found slight reflux, no ulcer & a little scaring. What they did discover was I overproduced acid. No food in my tummy - pain. Not from hunger but from too much acid. The pain & the acidic tummy often made me not want to eat but, you know, vicious circle. The easiest & quickest way to stop the pain was to eat. (Carbs like bread, cracker breads, Pasta, rice, etc. worked best - more absorptive I guess.) Because much of this is like what you’re experiencing I wonder if that is your problem too. Certainly worth asking your doctors.

I take Nexium every day now. I say it’s for my increased but different reflux but I also think a lot of it is still too much acid in my tummy. And it’s likely why, & with no gall either, I have random attacks of diarrhoea a couple of times a month - acid irritating my bowel.

Changing your diet is a great start I managed my reflux that way after it was diagnosed. Only took esomeprazole occasionally then. No carbonated drinks (terrible hiccups if I indulged in more than 2 glasses of champagne or G&Ts), no spicy food, nothing too fatty, no rich or creamy foods (watch cheese too), reduced caffeine (single large mug of green tea a day).

Maybe try eating more regularly & more dense food (not advocating lots of simple carbs but maybe some good complex whole or multi grains).

I hope they can find an answer for you soon. All the best.

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I had a gastroscopy yesterday 27th January 2022, with my bariatric surgeon. I have been experiencing awful acid reflux, regain, lack of fullness and occasionally vomiting. He informed me I have candy cane syndrome. Which means there there is a part of the anomostosis which goes from the pouch to the intestine which basically shouldn't be there. It's filling with food and causing too much acid. Also the hole from the pouch that connects to this anomostosis is too big. Letting food through too fast. My pouch is 6cm which he said was good but had stetched a little. I had my RNY 21 years ago and this is apparently rare. But I'm sure in those who had surgery that long ago may well have it and not know. So have to have it rejected. Surgery planned for 17.2.22.

I would hope you get your surgeon to take a look, he knows what he's looking for. I've had a couple of gastroscopys via the NHS and they said nothing was wrong!

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