difference between Endoscopy & Upper GI

What is the difference between the Endoscopy & Upper GI? Why does surgeon want them for revision? Also, What does each diagnost? The difference? If your not sure don't answer this post. Thanks everyone

The endoscopy is much more invasive, but much more revealing.  I had the upper GI done so they could see basic anatomy - like whether the pouch stretched.  When you drink the barium, they can see the flow of the system.  If your stoma is enlarged, the fluid will exit the pouch quickly.  An endoscopy shows inside the digestive system.  It can get an accurate measure of the size of the pouch and stoma.  From the GI, they couldn't measure the diameter of the stoma.  I kept a copy of the report from the MD/radiologist.  The last sentences read: "The gastric pouch is grossly normal sized.  The gastrojejunal anastomis appears to be of greater caliber than usually seen in a post gastric bypass patient.  Endoscopic interrogation may be confirmatory." So, the GI gave a good picture, but an edoscopy would be more accurate.  The surgeon needs the information to see if the bypass is still intact and whether there has been stretching.  Hope that helps. ~Shelley

Thanks so much for the help. I go for an endoscopy on tuesday. I hope that they find something wrong ...isn't that terrible to want to find a problem..It's just from what I've been told here at OH that there has to be a problem for a revision (staple line, pouch streched, stoma enlargement) coverage. Have you ever heard of other reasons insurance covers Revision?  Thanks again, God Bless  Leslie

Good luck.  I know what you mean about wanting to find something wrong.  Unfortunately, it doesn't always help the problem.  In my case, there is clearly something wrong, but it sounds like something insurance won't care about.  If I were throwing up or had something stuck or staples torn, that's reason for them to approve a revision.  If we stretch the pouch or stoma, it sounds like our problem to pay for.   I've noticed some of the people who have posted about revisions are getting a DS after having a RNY.  My surgeon said those are for people who can't follow the diet and avoid carbs.  The DS bypasses more intestine and causes malabsorbtions, so you eat more but absorb less.  My surgeon seems opposed to those as a general rule.  He's rather see us learn to eat better.  We all know it's more complicated than that. Let me know how it goes...sounds like we're in similar situations... Shelley

Your surgeon is way off his rocker. He doesn't do the DS so that is why he is trying to discourage you to have it. You definitely have to check with a surgeon who does the DS. And it is not for people wo can't follow the diet and avoid carbs. It is for people who want a more normal stomach, who enjoy eating, yes, but they are normal with none of the pitfalls of RnY like no pyloric valve, dumping, barfing up, can't take NSAIDS. You must check the DS forum and you just can't believe some surgeons. And the poop smell/problem is definitely not as bad as some nsayers say. You have just been misinformed Shelley.

HI Karen, You are right, I likely misquoted my surgeon about the carbs part.  He does do DS's, but he does not recommend it for me.  Because I was able to lose weight with the original RNY without any problems, it's still the best choice for me.  I think we all know we like to eat and I know that my food choices have contributed to my weight gain.  The failure of my stoma and 2 pregnancies 7 years post op were factors, but in the end it's about eating.  I need help feeling full again.  I'm 36 and I want to learn to eat healthier - especially now with 2 little girls who are likely to face weight issues in their futures.  It's not that I don't know what foods to eat, I just need to learn to enjoy the healthy stuff and not be tempted by all the cheap, easy, tasty bad stuff that fills the store shelves.  It does sound like DS is right for you and maybe later I'll find I just can't keep the calorie intake down.  I haven't had much dumping or any other problems and I have a small pouch so now I just need the lifestyle change.  Good luck and keep us posted. Shelley

Can he name any people he has done the DS on? I've never heard of him. That doesn't mean he has never done any, but you'd think I'd have seen someone mention him after all these years if he did 'em. Good luck in your journey. It can't be easy. ETA: Wowza. He's easy on the eyes! Jeanie

He talked about it when we went over my options, but I didn't ask for names.  His specialty is endoscopy and he is also tough on people making lifestyle changes.  On his site, DS is an option: http://www.thinnerfuture.com/malabsorptive-procedures.html I don't understand why there is so much defensiveness about RNY vs DS.  They are very different procedures with different needs and risks down the road.  I also need a hysterectomy because of a prolapse uterus and heavy bleeding.  My OB/Gyn recommends only taking the uterus, not the ovaries.  For me, at 36, that's the right thing to do.  If I were 50 and/or had cysts, I'd want the full hysterectomy.  Different needs have different solutions.

"My surgeon said those are for people who can't follow the diet and avoid carbs." This is funny, because DS'ers do live lower carb -- it's the fat that we're eating a lot of (because we malabsorb 82%).  Yeah, in all honesty, many of us indulge in something sweet, but it's not like we're dining on twinkies and hoho's all day.  If you're really interested in the DS, see a surgeon who does both for some straight answers. 

Leslie, I think I told you before, but if not, I was told that if diabetes has returned with the weight gain, if you still have sleep apnea, or any other comorbids, insurance should pay for a revision (If RnY failed or didn't do what it was supposed to i guess).