Finally Seeing a Surgeon and dont know what say

My gastric bypass was in 2008 everything was with minimal issues until year 6- 7 when I started having stomach pains, cramps, belching, discomfort after eating, always hungry or some days not able to eat at all- I have seen doctors, & gastro one after another and been given all kinds of medicines, fiber, muscle relaxers to no help. Been diagnosed with IBS, they have checked my esophagus, already had colonoscopy (2016) endoscopy (2018) everything comes back normal.

Finally my doctor has approved me to see a specialist for weight loss surgeries and I am not sure how to get her attention and I don't know how to explain to her how frustrated and painful this has been.

not to mention I weight almost the same as the day of my surgery.

any suggestions please, I just don't want to blow my only chance to have something done, I feel that my frustration shows and they always blame my issues on anxiety or stress

Did you lose weight and then regain or never lost weight?

If there is nothing wrong with your RNY, and this surgeon should make sure from top to bottom, and you've also had all other aspects of your health checked, then you may have to consider that your food choices are causing your problems.

You might want to bring in a diary showing what you ate at each meal and what symptoms followed.

RNY gives you about a two year honeymoon where you body does not absorb calories and weight falls off effortlessly. After that passes, the body heals and starts to absorb calories again. Keeping weight off requires less calories every year.

By five years after surgery, roughly 50 percent of patients have regained 50% of the weight they lost after surgery. Some have regained all of it. Some people regain 100% of the lost weight. Some gain even more than that.

You should be consuming between eight and ten calories a day for each pound of weight that you want to maintain. That means to maintain 100 pounds you need between 800 and 1000 calories a day. To maintain 150 pounds should take between 1200 and 1500 calories a day.

There are tests to see if your pouch or stoma is stretched. Some surgeons will attempt to repair that. Some will convert to a distal RNY or a Duodenal Switch. If they determine that the original surgery failed, then insurance might pay for those revisions.

Bring in a list of your symptoms, and what other doctors have already done. You can hand that to the surgeon and say, "I don't know what's going on. Help." And a good doctor can take it from there.

Thank you for the replies, went to my appointment this morning, talk to the surgeon who said my reflux amount is really high, I take protonix and she suggested I take twice the amount, also suggested to see my original surgeon who's happened to be her friend and she will place a referral, she said that a revision might be necessary but she doesn't want to get into it until my original surgeon takes a look, I have had severe dumping since the beginning and it doesn't matter what I do it doesn't get better, some days even the foods that normally don't make me dump make me sick, I have rotated foods and nothing has worked, I also feel my intestines twisting and lots of pain and burning.

I will keep you all posted of what they find, it might be nothing because I am conscious that the days I don't eat are better than we I do, but the other days when I feel super hungry my food choices are not the best and I need to work hard on this part too. I am conscious that no amount of PPI's or probiotics will help with this.

• RNY surgery is supposed to correct GERD. Maybe you developed hernia and that is causing the GERD.
• If not hernia, the damage to the valve between Esophagus and the pouch could be damaged, and allowed the acid to back up the Esophagus.
• Overeating , eating too much can also cause the valve opening and allowing food and acid backing up onto your throat.
• Last but not least, acid is made when the stomach area is exposed to histamine. Histamine already presented in foods, or histamine our body makes as a response to food or allergies, intolerances to foods, drinks.

Long term post op RNY I started having serious acid burns in my esophagus, GERD like symptoms. EGD testing discovered that I already have Barrett Esophagus. At the same time I have no hernia and no defective valve. Most likely my GERD is caused by food allergies and intolerances, plus SIBO (small intestine bacterial overgrowth - Google that)

I got tested for food allergies and intolerances and removed a lot of foods from my diet: Dairy, Soy, Grains, high FODMAP foods (Google FODMAP ).

On top of that my doc prescribed special PPI that help controlling the excesive a I'd production. I have been on that for app 3 years. I am slowly tapering PPI down, because long term can be really dangerous.

IBS indicate that like me you developed SIBO. Gaining most if not all of your weight back, could cause significant pressure on the pouch and GERD. Losing some of the regain may help you manage your GERD better.

As for getting revision - you already have the surgery that is supposed to limit, eliminate the acid reflux. If they try to revise you -any other WLS (VSG, DS) are much worse for GERD. Distal RNY - could help the person lose more weight, but it is very unlikely to fix the GERD.

OMG, Thank you H.A.L.A B. for the detailed response, I will print and bring to the surgeons office as suggestions, you know my gastro prescribed me antibiotics for SIBO without testing she said it sounded like it was it, the pharmacy did not approve the medicine she submitted the request 3 times and no luck, it will cost me $1226 for the prescription.

I have like I said made so many changes on my eating habits that right now I am only drinking ensure for breakfast (high protein) another protein shake for lunch maybe a little food like rice or things like that without any sauces and not loosing any weight, I am gaining and I am bloated

will keep you all posted and see what they find, I know stress is making matters worse and I need to work on the mind part.

If insurance is not covering the medication, have you looked at Goodrx.com? There are often discount codes you can use to help bring the cost of meds down if it's not covered by insurance.

If the medication is not covered by your insurance, then the would never cover them. My gastro has to talk to the insurance company and convinced them I really need that. The cost of that specific antibiotic (Xifaxafan) is really very expensive.

They can use another antibiotics, but the other one can have a serious neurological side effects and most docs don't like to prescribe them.

The very first time I got prescribed that special SIBO antibiotic, I had to pay cash for it. I found that antibiotics in some other on line pharmacy, but it was still very expensive. Talk to your doctor, maybe he can fight for you with the insurance company, or maybe he can suggest a different one.