I have a non-healing anastomotic ulcer three and one half years after proximal RNY. With that exception I have been very lucky with no complications. I do have an extrodinarily large pouch that I have been complaining about since about 3 months out.
This ulcer has caused enough pain that I have been to the ER twice in the past three months. It has not bled that we are aware of. I have had three EGDs and have tried 3 different medications. My surgeon keeps a close eye on me and he practices at a center of excellence. He is starting to talk about exploring a surgical fix.
He is discussing two options.
Option number one is a selective vagotomy done with video assisted thoroscopy. It is done by a cardiothoracic surgeon who I actually work with. It has the shortest hospital stay and the shortest time off work.
Option number two is a revision of my RNY. He said that basically he would resect the pouch making it smaller and redo the anastomosis. There is some indication that marginal and anastomotic ulcers are more common with the larger pouches. This option might correct the huge pouch and hunger issues as well as the ulcer. It requires longer off of work and hospitalization. The surgeon says that about 50% of the time he ends up having to open instead of lap due to adhesions.
What can anyone tell me about the advantages and disadvantages of these two options? What potential complications and side effects can either of them give me? I want to go into this as educated as possible. I have tried reading medical journals but want to hear from survivors and people in the trenches.

 I too had surgery this past Wednesday for a Petersens hernia, where they found a small bowel obstruction due to adhesions!! I also wish more people had talkwe dabout thsipossible complication! I would get these horrible stomach cramps/spasms and had no clue!!! glad I decided to check it out!!
Thanks for sharing,

 Your story sounds like mine. Same thing I just had it done last Wednesday. I too am having  a hard time eating solid foods. I have been eating Jello w protein, pudding w protien, protein shakes, etc. I go to drink a redimix shake and can only do 1/4 at a time. I think its our instentines being resituated and we have to get it all working again. I am going to see the Dr on saturday and will ask what he recommends. I have one port that is KILLINg me when i get up- on my right side next to my bely button. I had RNY 3 yrs ago.I can hear the food and liquid move in my stomach- it is weird.

I have a question - do you still have your gallbladder or was it removed?  I ask this for a few reasons and possible reasons.  You describe terrible pain and nausea which are symptoms of gallbadder disease which would be obvious for someone with a gallbladder.  It is possible to get gallstones after you have your gallbladder out and sometimes you had tiny ones in the ducts when you had the gallbladder out but they were tiny so they didnt' mean anything.  If gallstones get lodged in the ducts, they cause alot of pain and nausea - can cause pancreatitis.

The other thing I read about recently is people that have had there gallbladder out - most times the liver takes over the function within a few weeks and you can digest fats and no problems.  But in some and especially those that have gastric bypass, digesting fats are really dificult and you can get an accumulation of bile in your stomach and/intestines with no where to go and it can cause pain/nausea or severe diarhea called bile salts diarhea. - I see you dont have diarhea but I am sure there are other similar possibilities. 

I have also heard of people getting Sphincter of Oddi Dysfuction which can cause a lot of pain, nausea.  Normally the SOD would be diagnosed with an ERCP but we can't have this so you would need an MRCP - an MRI version.

I know this is all pretty far fetched but thought I would put it out there for you.

I wish you the best/

I am sorry you are going through all this and I hope you get some answers.  I have one stupid question - is it possible that the G tube is clogged?  I had a G tube for a while and it wasn't working - at one point it got clogged and at another point, it actually fell out.  When it got clogged and nothing would go through, I ended up in the ER and they put some gingerale in the tube and the bubbles broke the clog after about 5 minutes and they told me to have it in the house all the time in case it happened again.  Just a thought.

as far as the pill test - be careful - I asked my gastro doctor and he said he wont do it on me because he said when we swallow it  = there is a possibilty that it will not go  through our small intestines fully, it may go to the bypassed part and get stuck and then surgery would be needed.  He also said it is a large pill and there is a possibility that it could get stuck at any of the connections also requiring surgery, so he felt it was way too dangerous for us.

I am interested in that special CT you mentioned and I am going to do some research on it.  I have had alot of complications and my digestive tract hasnt' been the same since having my illiostomy reversed.

as far as the fentanyl patch - why are you afraid of it?  If you need it there is no danger to use it long term, that is what it is used for - it says right on the package,not for acute pain, only for chronic pain. I have been on it for about or more years and can't live without it.  Since my abdominal surgeries, I wear the fentanyl patch and use either percocet or dilaudid for breakthrough pain.  I am finally doing better the past few weeks but I used to take the dilaudid every 3 -4 hours with the patch.  there are pain meds out there that can help us - dilaudid is a tiny little pill - the size of a dot.  Even when I couldn't swallow pills, that one I could it is so tiny.
I wish you the best and hope they can fix you