ulcer in remnant stomach??

I'm 5 1/2 years out post-op my original RNY. I've had 2 diagnosed ulcers since surgery. My first ulcer I was scoped, they found it and treated it with nexium and carafate and it went away after 6-8 weeks. My second ulcer I had for 6 months, they scoped and medicated me, and nothing fixed it. I had to have an RNY-revision to surgically remove the ulcer in the anastimosis. I now have the same symptoms as the first 2 ulcers, except they couldn't find anything from the scope. They said everything looks perfect. I've been on Prilosec or  Protonix for 12 weeks with no effect. They've done an EGD and CT with contrast and the doctor says I'm fine. He can't figure out why I'm hurting. I think that it's a problem in the remnant stomach which I believe there are no tests out there that can detect problems with it specifically? He wants to do an upper GI with small bowel series, but it's likely he won't see anything again, because the barium won't touch the remnant stomach.  It seems like he doesn't want to go in surgically again. I've had blood tests done and they appear normal also. Any suggestions or opinions?

I am 8 years post lap rny and have not heard of this one.    I assume you are not taking any nsaids orally or by patch (thins the  lining of the stomach and intestines).  I had a different problem that was only found and corrected by exploratory surgery (internal hernia and bowel obstructions ) that did not show on 4 catsacns with contrast,  mri, ultra sounds or xrays. I hop in your case they do not have to go in to see the problems.

Hugs 

I am a non-smoker, never EVER take NSAIDS due to previous ulcers and am a non-drinker. Thanks for the info.

It is very difficult to diagnose remnant stomach issues as it is totally blind.  The only way to see it is to actually surgically open it and this is done VERY rarely as I have been told.  I had a problem about 6 months post op with terrible cramping in my remnant area.  We did several things and after months with a feeding tube and a PICC line (b/c the remnant wouldn't accept liquid food without severe cramps) my surgeon opened up the Y so nothing would back up into the remnant and things were much better.  I like my surgeon and his team and all the specialists who had tried to help, but when the problem lies in the remnant it is very difficult.  I am still having pain on occasion and am at the same point as you...all the diagnostics show nothing, but I know how I feel.  It is very frustrating.  My surgeon has asked for me to get a second opinion so someone else would possibly see things in a new light.  I have to figure this out prior to the end of July b/c I am doing plastics and don't want to do stomach plastics and then have more exploratory surgery.

I wish you the best of luck. Hopefully a new surgeon will realize why you're hurting.

I made a comment a few weeks...?...a couple of months?...ago and was told tht is IS now some way they can figure out what's going on in the remnant stomach without opening you all the way up.  I don't remember what it was...just that someone was saying that it was possible.

In your situation, I'd go to the main board, and just post something like, "I was told that there may now be some kind of exploratory option short of full open surgery to figure out what is going on in the remnant stomach.  Anybody else hear of it?"  And I wouldn't get into a debate with a few of us DSers who might...you know what?  I'll go ask.

I'll tell you what I learn as soon as I learn something.

Sue

I found out what it is. It's called a double balloon enteroscopy.

Turns out it's not an ulcer. Dr thinks it's adhesions or a partially obstructed bowel. I had a Upper GI series with small bowel follow through yesterday and should have the results Monday. I'm getting closer to an answer.

Well, I'd better unsound the alarm!  lol

But it's nice to know there is a procedure.

In my case they went in lap and took a look (after bowel obstructions) and found an internal hernia that did not show  on any test, multiple scans ultra sounds, xrays, etc.  Good luck!

Hi, I am 6 years out this past October.  I ended up having a marginal ulcer, one of the worst pains ever!  But, before they figured out that was the cause of the pain they thought it was scar tissue.  I had surgery for the scar tissue and seemed great for a week or two, then the same pain started back up.  So, apparently the symptoms are similar perhaps you cold ask your dr. about the scar tissue thing.  I actually did have to have the scar tissue fixed so it wasn't an unnecissary surgery, but it was not the cause of all of my pain.

Hope this helps!