Overlarge-nonexistent Stoma

I'm nearly 5 yrs post open RNY proximal and had a swallow test with barium AND a small bowel series. The EGD the day before confirmed a very large stoma opening and the swallow test showed clearly that there is basically no difference between the small intestine and the pouch. (as an aside my pouch is still the original 1 oz size!) Has anyone else had surgery to correct this issue which is what they are talking about. There's other stuff going on but this is my prime issue I want to know from OTHERS WITH THE SAME ISSUE and their progress with resolving this issue. --bree

Hi bree, I am in the same situation as you.  There is no difference between the opening of my small intestine and pouch.  I can eat as much as I could pre-op (had surgery May 2005).  This went on for well over a year (I started complaining after month 7 that i could eat too much).  Finally, I have been approved for a revision which is scheduled for May 16.  The same surgeon is doing it.  He is going to make the opening between my intestine and pouch smaller and bypass more intestine.  I had an open RNY then and it will be an open revision this time too.  I am SO looking forward to it!  Don't give up!

Thank you for replying with your same situation!!..It seems like when I've tried to talk about this in chat or on here all people want to know is "have you regained?" Well there is more to it than that. I think it's a huge part of why all my blood work stays good. I'd been anemic last year for several months and finally changed docs to a new one that gives me the B-12 shots every 3 weeks if I want them.  I think this issue is a huge factor in why a lot of people regain and frankly I think that docs often will NOT listen to us if we start regaining ANY weight after maintaining for a long time. Yes, I am not working out at the level I used to, however I still do things to keep fit. The fitness level I was at just isn't something you just give up, it becomes part of your life.  I still can't eat like I did before surgery but I can periodically get more down than I should be able to at all. With the multiple EGD/Dialations it should have been apparent to my previous doc that it 'could' be a factor. But all SHE could say to me was "you look great, stop worrying" and there I sa****ching the scale go slowly UP and at that time I had changing NOTHING at all! Well we'll see what they decide is a solution for me and who they will send me on to.  My question of the day is this though: ---at what point of slow gaining after a 1 yr+ maintained weight do would docs decide they need to FIX This??? 25, 35, 45, 55, 65 75 100 lbs re gain?? which number is the magic number?

Yup, I had staple line disruption and stoma enlargment with my RNY.  So, I decided to go with the DS for my revision surgery, as there's literally nothing that can mechanically fail with the DS, unlike the RNY.  (not counting leaks of course)

I had several surgeons offer to fix the RNY for me but they just didn't get it.  I didn't want another surgery that could and most likely would fail.  Too old, too much scar tissue and too many times up and down the scales.  I'm almost 8 months out and about 20 lbs from goal. 

I finally got a call back from the GI's office after waiting 16 days and calling THEM first..urgg!  their office has offered to make sure that IF my GP doesn't send me on for a consult (which he will) to someone about this then they will. According to them everything in the small intestine and all that good stuff looked good,no torsion at this time (this has been an ongoing issue) but there is the issue of the overlarge stoma. My pouch is intake, and SMALL, the orginal 1 oz size.    There doesn't seem to be a concern which to me seems valid..if my food is going right into the small intestine all the time it would seem that in another 3-5 years at least I would start developing ulcerated places in the small intestine which is basically being my stomach since my 'stomach' isn't holding the food at all.     But what is frustrating to me is that they all want me to go back to the original doc who has moved wayyyy far away from here. What IS it with surgeon's reluctance to not touch anyone else's "work" anyway. It's not from a bad surgery, it's actually from the 12 dialations that left the stoma overlarge.       At any rate, revision wise we'll have to see who we can find here in Okla to do that. What I've found before while watching others go through the revision process is there are docs who do the gastric bypass but they won't or don't do the revision issues.      So today I'm pretty frustrated with this whole thing..! It's not solving the primary issue which is this:    --I eat, it hurts, I don't eat, my glucose drops wayyyyy down to the 50's, So I find that I often will wait until after 12 noon to eat, waiting until I absolutely can't wait anymore to eat and pray that "this time it won't hurt!"     Obviously this issue isn't going to be resolved soon :-(

Bree, I have the same problem.  I am waiting to have a lap band over it. That's what my surgeon is suggesting.  I have always been able to eat more than I should from day 1.   I did have a stricture as well and they did stretch it, so who knows what caused my problem.  Was on Reglan that promotes gastric emptying quickly which could also have caused problems. I also talked with Dr. Terry Simpson who only does lap bands now and he says that he see this happen in about 20% of RNY patients.  He used to do all the surgery types. Deanne 11/9/04

Just wanted to wish you all luck.  I had my lapband placed last July and I absolutely love it.  We have people on the lap band forum that have had the band placed over their RNY pouch and are doing great.  Best of luck to you. Dee

I was in exact same situation.  I regained after an RNY done i*****  In 1/06 I had the band place over my bypass and I have done marvelously.  I am at goal,  It was the best thing I could have done- completely resolves the enlarged stoma issue. I wish you the best of luck.

There are more and more of us in this boat floating down the RNY River lol. I had RNY 2002 was banded Oct 2006.  I was glad to get some hope again. My Dr said my pouch also was still small. But the stoma large and everything just went through. I have another Yahoo group it is Revisionbandster If anyone would like to join. When I started it I knew from my own experience that it would grow and it is. My question is for you Mish, Did you have  a hard time getting a good fill? I have had six fills and still having trouble even telling I had surgery. I am going back next week for another fill. I  am 3.5 cc in a 4 cc band. I think this will work but boy is it getting old waiting.

Hi--I had RNY in 7/99. Lost 130 # and began regaining after 2-2 1/2 yrs.  I am currently looking at the lap band to have it  done over the RNY, but the surgeons office I spoke with in my area says that the Lap after the RNY is not possible. ??  She said there is not enough tissue left to support the band.  Then she suggested I consider a revision.  I would totally do it if I could have it Lapproscopically but she says because of the first surgery being Open, there is too much risk.  Has any one had a revision and how much trouble is it to get approved?