Regurgitation and Choking at Night

Just wondering if anyone has any insight on this problem I am having...

I just got a small fill .5cc about two weeks ago and I am able to eat just fine during the day, but at night I violently choke and regurgitate stomach acid pretty much every half hour (as soon as I fall asleep) for the entire night. It lasts until the morning when it's time to get up and I am exhausted. I am not eating past 7:30 pm, sometimes I try to eat before 7pm and I go to bed around midnight or later, so I wait long enough to lay down. I also take a prescription stomach acid reducer and ratitidine for GERD, but it doesn't help with the choking. I am wondering if I need to get a little bit of fluid taken out so that I can sleep. I haven't slept through the night since I got the fill almost two weeks ago. I thought it might just be swelling so I have stuck it out this long, but it's not getting any better.

I also was wondering if maybe I am eating too much and this is why I am having this problem, as I said, I am able to eat a pretty good amount of food. It's weird, I would think if the band was too tight, I wouldn't be able to eat like I have been able to during the day. but as soon as I go to lay down to sleep, I am choking and throwing up stomach acid. So wierd and frustrating. I got this fill because I haven't lost weight in a long while, but I am also not loosing weight right now either, even with this fill. Any thoughts would be great!

 

Hey...this is common when you either have pouch dilation or a hiatal hernia, it happens A LOT to lap banders over 1 year post op. I had this same problem in my 2nd year of being banded, luckily I had gotten most of my weight off before this started to happen, and I just "accepted" that I could no longer keep a GREEN ZONE fill for long periods of time, but turns out this problem got worse over the years and the hernia started to cause other issues, and 3 weeks ago after being banded over 7 years, I got a new band and the old one replaced and my new surgeon mentioned that I had a large hiatal hernia which caused the reflux and prevented me from reaching the GREEN ZONE without waking up choking on "stuff" coming up through my nose and mouth.

Reflux at night is a sign of pouch dilation (small slippage), could be the reason for your hunger, despite being tight, and or an undiagnosed hiatal hernia that many people don't know they have. Also many small slippages DO NOT SHOW UP ON UPPER GI's...mine did not, nor did not a hiatal hernia; the hiatal hernia finally showed up when I got an endoscopy done. Bottom line I am not here to give you a diagnosis, but something is wrong and with a healthy band you should not be choking at night with good restriction.

You can try to work around this issue like MANY DO, by sleeping in a recliner, taking PPi's and don't eat close to bedtime, but this is only a band-aid approach to a potential problem that will need surgical intervention to fix. Also another tip is to chew papaya enzymes close to bedtime to help digest the food with a chewable Pepcid, that did help me for a few yrs.

I had to get a new band and a hernia repaired to get fixed, I hope this band journey will be a lot more "peaceful" than my old one.

Good luck.

Thank you so much for your reply to my post! I was just going to add that I actually just had an upper GI done prior to this fill because I was having daily Reflux and Heartburn, and results showed a small pouch dilation, but after a lengthy conversation, my doctor said everything looked good and gave me a small fill. That is also when he put me on the medicine to reduce the stomach acid, and funny because I haven't had heartburn at all, just the regurgitation and choking, but not the normal Heartburn pain that I used to get is gone. I also was told right after surgery for the lap band that my doctor repaired a hiatal hernia while he was in there inserting the lapband. So I find it interesting about what your post said about pouch dilation and Hiatal hernia. I do agree with you, it makes sense. I am just really frustrated and I am not sure what to do, all I know is that I can't live like this with waking up choking every half hour with stomach acid coming up out of my mouth and nose. It is terrible. I would take PBing all day over this nighttime thing. I haven't lost weight in a very long time, and I work out regularly and run 5k's! I am going to see the doctor tomorrow, but I am guessing to get some fluid out, and hoping it will get better, but i guess I just wont be hitting that green zone anytime soon. It is frustrating! Thanks so much for sharing with me your story though!! I really appreciate it!!

Ok, that is what I thought this was pouch dilation. If I were you, I would go back to my surgeon IMMEDIATELY and ask for a TOTAL UNFILL, I know..I know...that is hard to swallow, but that was the only thing that helped my pouch dilation to heal and stop the reflux. And after 6 weeks, my surgeon slowly started to fill my band again.

BUT....this STILL MAY NOT WORK, I have to tell you that in MOST CASES POUCH DILATION NEEDS TO BE SURGICALLY FIXED to STOP THE REFLUX, in my case even after the total unfill I COULD NEVER GET THE GREEN ZONE AGAIN WITHOUT REFLUX ISSUES...believe me I tried and tried, I went through the drill of unfill/refill several times and I could never get my band to work properly again, IT WAS A WASTE OF MONEY TIME AND EFFORT for FILLS.

FOR ME, I struggled with hunger continually after pouch dilation because I could never ever get the GREEN ZONE without ISSUESs...MANY LONG TERM BANDSTERS CAN NO LONGER GET THE GREEN ZONE AGAIN DUE TO THIS REASON.

If it were ME, I honestly would not waste my time with UNFILLING AND REFILLING, if you have GOOD INSURANCE OR MONEY, I would ask the surgeon to surgically fix my pouch....If you have insurance coverage, it SHOULD cover this, the surgeon can just go in and unbuckle the band and fix your pouch (if he can't get a second opinion) , sometimes they may let the pouch heal for a while and then go back in and resize the pouch, or you may want a revision surgery because once this happens your chances of getting the green zone again is very slim.

But in the MEANTIME, PLEASE GET SOME SALINE REMOVED IMMEDIATELY, TO TAKE PRESSURE OFF OF YOUR POUCH BEFORE YOUR POUCH DILATION TURNS INTO A SEVERE BAND SLIP and if you suffer a REAL BAD slippage, YOUR CHANCES OF FIXING YOUR POUCH WILL BECOME SLIM IF THERE IS TOO MUCH DAMAGE AND IF THERE IS TOO MUCH DAMAGE DONE FROM A BAD SLIP, YOU WILL NOT BE ABLE TO GET A NEW BAND OR GET YOUR POUCH FIXED THEY WILL HAVE TO TAKE THE BAND OUT AND YOU CAN'T GET ANOTHER ONE IF THERE IS TOO MUCH DAMAGE TO YOUR BODY...

Good luck

 

Wheeler!
I noticed on your profile you have no information, how long ago where you banded? Do you attend your doctors support group meetings?

See your doctor! Reflux is never good news. I went through this and the hard reality is that I was relying on my Band to stop me. I would get a FILL and be too tight resulting in reflux. But the Reflux was not immediate, a few weeks would go by after a Fill then a few weeks later reflux! So I was doing this yoyo thing of FILL & UNFILL!
I remember Star telling me I was too tight, and I honestly thought, no I am not, I can eat fine, but it was what was occurring at night with the reflux which was a sign to a bigger problem. My doctor had an intern in his office for a while, and I was seeing her, she would give me the FILL & UNFILL. I strongly believe that my doctor would have notice the pattern and we could have addressed the issue of me relying on my Band sooo much. I also had a wretched episode with a freakin carrot! And we believe this also contributed to my slip. I am fine now, it got me a low profile port too!

I remember my doctors wife saying, "its ok to get a little hungry. Normal people get hungry," and WLS patients are afraid of getting that feeling. But looking back, I have a better understanding of what she was saying. Try to determine if your hunger is true hunger. Is it in your mouth that you feel hungry or your stomach?
And with so many of us being emotional eaters, we don't know what that feels like. If its coming from Your mouth? It is Probably a craving. Because you can eat something healthy and that should take care of your hunger . But usually we resort to eating for comfort.

Remember, we are suppose to eat only to the point of satisfied, not to the point of uncomfortable or till our band has to stop us. I believe that so many of "us" don't recognize our contribution to this problem and then end up with problems further into our journeys , some times resulting in surgery repairs. it becomes such a "head" thing!!! So many of us dont understand eating until we are satisfied, as we are part of the clean Plate club!

Anyway I am not saying you are imagining the hunger, my little rant is for any one, especially newbies ! With that being said I will post the "8 signs of emotional eating" from my doctors office support group.

KeeP us posted
Prek3

Thank you so much for your reply, I just joined this forum and I didn't know how to enter my information about my surgery etc.... I have been banded since April 2011. I do go to the support groups, but a lot of people in our support class are gastric sleeve or  bypass patients and we don't really seem to talk about issues, more support for other issues, like plastic surgery and other things,  but I do go.

I am going to see my doctor tomorrow, and I am sure to get a slight unfill, just like you were saying, I feel the same way, fill & small unfill.....almost  everytime. I was having very bad Heartburn right before this fill and had a upper GI done to check for slippage or dilation. My doctor said there was a small amount of dilation but he really didn't think it was a problem, and that I could probably benefit from a small fill. I actually went on the stomach acid reducer meds also, and haven't had the heartburn that I used to get, just the regurgitation and Choking at night, but no heartburn like I used to get all day and night. I agree, reflux and this choking is terrible, and I certainly can't live this way any longer. I am just frustrated. as I said in an above post, I would take PBing all day over this regurgitation at night thing. It is really terrible!

As far as the hunger and eating goes, I know what you are saying about head hunger or real hunger. When I think about it at first I am pretty sure that I am feeling real hunger, because most of time my stomach is growling and I feel hungry, but I suppose that maybe it's in my head that I should be able to eat, and I keep eating just because I don't feel full. This is something that I do struggle with I guess. I just feel that in a day I may eat tuna fish for lunch and then when it's time to eat dinner, a big salad with chicken isn't a lot to eat, but when the salad is big and I can eat the whole thing, then I wonder why I am able to eat the whole thing and if that means I need a fill. Not trying to get all confusing, I guess I just don't feel that 4 oz of food is enough for me, because I think I am still hungry, at least in my mind I think I am. For instance today I had 1 cup coffee in the morning, half a can of soup for lunch, and for dinner we are having chicken with rice and vegetables, but I could eat one or two pieces of chicken, a good amount of rice, and all the vegetables with no problem. I usually stop when I feel satisfied, but that could mean a whole plate full of food. If I only ate 4 oz, I would be really hungry around 9 or 10 pm and look for sweet foods. I guess I thought that when your band is right, that you don't have that feeling of being hungry 1 or 2 hours later after eating a big plate of dinner. Either way, I totally understand what you were saying about emotional eating, and maybe in my head is that I need to eat more, and that I am not truely hungry and just a habit. I just wish i had the restriction that I did when I first got my fill, and then didn't have this terrible regurgitation and choking!

Hey wheeler,

Its soooo frustrating when as a Vet you want to hit the hard hitting topics, but there will be newbie or people there inquiring about surgery! Our support group use to be the "BOMB" separate meetings for newbie & Vets / and specific meetings for LApBander (as some of the people who have the "other" surgeries, dont understand that our needing a FILL or an UNFILL are not complications just fine tuning our Bands) and special cooking classes at least once a month. This was constant!!!! Even at one point weekly Band meetings!!! The doctors wife held them, and she could dissect our "obese" mind! She would really challenge us and keep us on our toes. But unfortunately now we get just 1 meeting a week, and that is with a shrink a dink!

I am not being mean, but just noticed what you were eating. It could very well be in part what you are eating that is leaving you hungry. I am writing this for you but also incase a newbie is reading it, maybe it could assist them too. My comments are in blue to what  you wrote: again, maybe tweaking a few things could help address that (feeling hungry soon issue). You still gotta get that that UNFILL, or you will be jepordizing your health and Band.

You wrote:::

For instance today I had 1 cup coffee in the morning*** is there Protien in your coffee???,

half a can of soup for lunch,**soup is not dense protein, liquid goes right through fast

 and for dinner we are having chicken *** how many ounces of chicken? 2 or 3 oz.? Aim for 3 oz. as DENSE IS GOOD with rice ***I am assuming a very itty bit  of rice due to carbs

 and vegetables, but I could eat one or two pieces of chicken, a good amount of rice, and all the vegetables with no problem ***you heard this one before "just because we can, doesn't mean we should."

 I usually stop when I feel satisfied, but that could mean a whole plate full of food. If I only ate 4 oz, I would be really hungry around 9 or 10 pm and look for sweet foods  ***go to bed you could just be honestly tired, or drink water first, looking for sweets is looking for energy have an apple with a piece of cheese (***the protein from the cheese neutralizes your taste buds from having had a fruit (glycemic index can be higher in certain fruits)

 I guess I thought that when your band is right, that you don't have that feeling of being hungry 1 or 2 hours later after eating a big plate of dinner. ***are you remembering to drink water  an hour later and through out the day?I personally don't know that satisfied feeling, I am trying to still get my head around that, but I do find I am not satisfied until I get to have my water an hour after my meal. also certain carbs ( the white stuff with no substance of fiber) will set you up for cravings. Nutritionist from Dr. Office recommended these 2 books Mindless Eating by Brain Wansink PHD & The End Of Over Eating By David Kessler, MD Interesting reading that is NOT BORING!!!!! Talks also about salt & fat resulting in cravings besides the sugar. Again, I am no expert, but these are some of the things that my doctors wife would challenge us on to re-evaluate ex. I have to eat my almonds raw,without the salt, or I will keep at it and we know that its definitely higher in calories

 Either way, I totally understand what you were saying about emotional eating, and maybe in my head is that I need to eat more, and that I am not truly hungry and just a habit. I just wish i had the restriction that I did when I first got my fill, and then didn't have this terrible regurgitation and choking! *** your body is going through lots of changes, besides changing physically outside, don't forget the physical changes inside too. With each FILL I have always found there to be a new learning curb to go with it.

I see an eating disorder doctor who has a Doctorate  in Addiction Psychology, is a Clinical Psychotherapist, Certified Eating Disorder Specialist, Certified Addiction Professional, and Licensed National Board Certified Clinical Hypnotherapist.She use to be a WW leader who would binge on food on the weekends. Counseling is so important too as we are going through so many changes.

Anyway, get in to see the doctor, and journal your foods see if it helps.

keep us posted, or message me I would like to know how everything goes, we have so much to learn from each others experiences,

Prek3

 

Thanks Prek-3, it makes a lot of sense. It was nice of you to break it all down for me and I do not think you are being mean, I understand what you are saying. I actually was thinking of scheduling an appointment with the Professional Psychologist for eating disorders because I think that it may help me as well.  Our Support groups are once a month, and they are nice to keep informed, but in no way do we really discuss any problems that we are having individually, mainly a large group forum that we talk about how to deal with changes in your appearance, accepting how other people feel about you now...etc... and like I said, mostly people with the other types of surgeries, lap band is not as popular in my area as the sleeve is. I still like the support groups, but I found more help on these type of forums. Thanks again for your advice and response!

This is absolutely NOT common with a properly adjusted band! This can kill you by causing aspiration pneumonia. I've had my band for over 5 yrs and have never had this happen. Please call your surgeon immediately and get this checked out, it sounds like more than a tight band but in the very least get a partial unfill to relieve the symptoms you are having now. You may well need a total unfill to settle things down. You shouldn't have to sleep sitting up to keep acid down unless there is a problem. Best of luck to you and hope you get the issue resolved very soon!

I agree with HisLady call your doctor asap. You sound too tight.