Do I need to have an endoscope yearly to check for erosion?

What are the signs and symptoms of erosion?

I have read that sometimes there are no signs or symptoms and that is why we need a scope annually.

What are your thoughts?

I know two people that went in for fills, and the doctor noticed the barium wasn't flowing through the pouch correctly. They'll notice the barium sort of flows around the outside of the band, which indicates potential erosion. That's the first sign that a doctor can see. Once they detect what looks like potential erosion from the fluoscopy, they'll schedule you for an endoscopy to confirm erosion.

However, my doctor believes annual endoscopies are good band maintenance. But you must get the scope done by a Band surgeon. If a regular gastroenterologist does the study, he can completely miss the erosion and tell you you're healthy. They have to know specifically what erosion is and what it looks like.

One friend said she had more PBs, while other people lose all restriction. But most people don't even have any symptoms. The sudden loss of restriction is because food isn't passing through the band any more, but instead it passes around the outside (hey experts, am I explaining this right?)

We talk about this in our support group from time to time. My doctors' practice doesn't recommend endoscopy testing unless there's some other indication of a problem. They do fills under fluoroscopy with a barium swallow, though, so they always have a very good idea of how things are with our bands. Erosion is very uncommon, goes the thinking, so having a relatively invasive and expensive test annually for something that happens to only 3% of patients is not good use of medical resources.

But it's ALWAYS a good idea to stay in close touch with your aftercare doc even after you're through the first year (during which you will presumably have regular post-op checkups, fills, and so on). As time goes on you'll learn how your band feels, its patterns with regard to your bodily functions (does it get tighter during that time of the month? the day after a very salty meal?), and how you can eat/tolerate what sorts of foods. If you're paying close attention if/when there are any changes you'll be that much more aware of them. And IF there are any changes you should get in touch with your doctor for testing.

If I didn't have the barium test done each time I had a fill, I'd probably want one annually or so. Looking at the band via fluoro can tell the doctor a lot about its condition, and yours.

I should have made myself more clear that "my" doc wants me to have an annual endoscopy, but that's probably because I've had so many problems with infected ports. But I think what Alexandra said is more accurate - that they'll only schedule one if they see problems with the fluoro or if they have other reasons to believe you need one.

No, Lisa, your doc tells ALL of his patients that, not just you.

My last fill was my 4th (always done under fluoro), and that was October 2003 - no problems noted. At my endoscopy June 19, 2004 I was at 40% erosion.

Donali, I do recall Lopez saying we should have annual endoscopies, but then another doctor told me they won't do them unless they are suspicious. I prefer the "better safe than sorry" rule of thumb myself, though it's difficult convincing doctors to schedule the endo since they are so expensive. I'm still waiting for them to come out with a pee stick that will show erosion!