Help, 6 yrs out, now upper abdomon bloating and pain
So my roux-n-y went great and I had great results. Went from size 24 to 8 and lost 120 lbs. Last year at year 5 my iron was low and I got 3 iron infusions and I haven't felt right since. I gained 10 lbs in like 5 weeks and bloated up like a balloon, smelly gas and became lactose intolerant. We to 3 different docs and GI doc and they think its SIBO - small intestine bacterial overgrowth which I've been on 3 courses of Xifaxin but still feeling so bloated especially on my right side above my belly button, it sticks out further than my left side. Now I'm getting pains on my right side. Sometimes shooting pains, sometimes just tenderness like a bruise. And now for the last couple weeks i have burning in my stomach in the morning especially when lying on my stomach. I've never had acid reflux, heartburn or ulcers so I don't know what they feel like. I feel like something isn't right inside, how do you know if you have internal hernia, or scar tissue issues or a kink? Made appt with original surgeon on Dec 19th. Would a MRI, cat scan or xray or scope show any of these issues? I need to know what's wrong. I'm not in a lot of pain, it's just annoying and getting worse and so sick of the bloating! I did have one hernia repair about 3 years ago
I am an RN in Northern Michigan. I have worked as a traveler and am familiar with Munson and your surgeon in particular. When you go in to see him DEMAND that he address your issues! If it were me I would request
1) A stool culture to identify if the problem is indeed related to an overgrowth and if so, of what, so that it can be adequately treated.
2) An upper GI with small bowel follow through. They should be able to see the whole area and assess if there is a structural issue.
3) A scope to assess for ulcers. And a prescription for a proton pump inhibitor to see if it helps.
4) Demand his assurances that he will follow through to find the problem and not blow you off after this visit. Surgeons often want to perform surgery but do not want to follow through after. Dr. Nizzi is a nice guy but I would still press the issue. He will make sure you get dealt with if he knows you are the squeaky wheel!
I hope you feel better and get some answers soon! Good Luck!
Marianne :)
1) A stool culture to identify if the problem is indeed related to an overgrowth and if so, of what, so that it can be adequately treated.
2) An upper GI with small bowel follow through. They should be able to see the whole area and assess if there is a structural issue.
3) A scope to assess for ulcers. And a prescription for a proton pump inhibitor to see if it helps.
4) Demand his assurances that he will follow through to find the problem and not blow you off after this visit. Surgeons often want to perform surgery but do not want to follow through after. Dr. Nizzi is a nice guy but I would still press the issue. He will make sure you get dealt with if he knows you are the squeaky wheel!
I hope you feel better and get some answers soon! Good Luck!
Marianne :)
I just saw your reply, thanks so much. I actually did go see Dr Nizzi and just said I know my body and something isn't right. So next Tuesday Jan 24th I am getting a EGJ (scope) to look for ulcers and I was wondering if they could swab for bacteria then too?? Also all your natural health doctors talk about yeast overgrowth?? Then in Feb I'm scheduled for laproscopy to go in through my original incisions to look for anything else, scar tissue, hernia, obstructions, I guess?? Any other suggestions?
Hi,
I have SIBO confirmed by a breath test. Xifaxin will only work if it has direct contact with the bacteria. Guess what? It doesn't dawn on some docs that if part of your small bowel is bypassed or if you have a blind loop, Xifaxin will not have any direct contact with the bacteria and it will not help. Give any docs you see a drawing of your WLS and ask them about systemic treatment of SIBO. Yes, this is a side effect of WLS... If you have a scope, ask for a double baloon enteroscopy. This is a looooong scope that may be able to negotiate distorted RNY anatomy.
I have SIBO confirmed by a breath test. Xifaxin will only work if it has direct contact with the bacteria. Guess what? It doesn't dawn on some docs that if part of your small bowel is bypassed or if you have a blind loop, Xifaxin will not have any direct contact with the bacteria and it will not help. Give any docs you see a drawing of your WLS and ask them about systemic treatment of SIBO. Yes, this is a side effect of WLS... If you have a scope, ask for a double baloon enteroscopy. This is a looooong scope that may be able to negotiate distorted RNY anatomy.
Hi,
Yeah... Sounds like more surgery is putting the cart before the horse. I think you have more to check out. Doesn't seem they have ruled everything else out as in "differential diagnoses."
If during any testing, they can't view the entire digestive tract, things may be missed. So, you ask them what would be the best way to look at the entire DT.The DBE I mentioned is a good way. This must be done by an endoscopist with a good amount of experience. I had two performed by an internationally renowned Dr in L.A., Ca.
I was told the bacteria couldn't be swabbed due to other contamination caused by stuff in the bowel. Systemic Tx of SIBO is performed using antibiotics absorbed into the blood v.s. Xifaxin which only works when it mechanically comes in direct contact with bacteria and it's not absorbed systemically into the blood. Since Xifaxin can't get into the blind loop, it can't kill anything there. Good luck.
Yeah... Sounds like more surgery is putting the cart before the horse. I think you have more to check out. Doesn't seem they have ruled everything else out as in "differential diagnoses."
If during any testing, they can't view the entire digestive tract, things may be missed. So, you ask them what would be the best way to look at the entire DT.The DBE I mentioned is a good way. This must be done by an endoscopist with a good amount of experience. I had two performed by an internationally renowned Dr in L.A., Ca.
I was told the bacteria couldn't be swabbed due to other contamination caused by stuff in the bowel. Systemic Tx of SIBO is performed using antibiotics absorbed into the blood v.s. Xifaxin which only works when it mechanically comes in direct contact with bacteria and it's not absorbed systemically into the blood. Since Xifaxin can't get into the blind loop, it can't kill anything there. Good luck.
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