You're not " Stuck " your band is damaging your esophagus

If it wasn't referring to me then I have a doppleganger...

I was banded in March 2010, did my first upper GI in March 2011 and did a 2nd one at my 2 year mark March 2012. Was told I had esophagul dilation/achalasia but I had no actual symptoms that I recognized as such prior to that and I came on the board and posted about it a few months ago.

To be clear, I was referring to Maria F.'s post  "Some of you may remember a post by one of our bandsters here about 3 or 4 months ago. She is 2 yrs. out with her band. She had an upper GI on her 1 yr. aniversary and all was fine. She did the same on her 2nd and she has a band problem. I think it was a slip"

Sorry that it happened to you. I've been quoted 30 - 35% of us require a second surgery due to band complications, generally due to no reason we caused.

Best wishes and I hope you have no further issues.

So far, the only second surgery required after my band was skin removal. I was only too happy to have that done ;)

I don't know what the future will bring me but I'm fortunate enough to be insured. And for now, even if my band is only slightly filled, I'm doing fine.

Thundergrrrl ,

I'm so happy to hear that you are feeling better and that your surgeon went ahead and took some of the fluid out of your band. If I may make a suggestion...would you be comfortable with going back to your surgeon and asking him/her to completely unfill your band, and keep it completely emptied for at least 6 months or longer if you are able to ?

My OP was not directed at you, it's part of a post I randomly  re-post or bump from time to time. Here is the link to another " like " post and its bump date. I am sure I have since tweaked and re-posted it several more times, and not only here, but on other forums as well.

I have lots of helpful subjects bookmarked that I will re-post from time to time, and sometimes reading about a certain concern someone may be experiencing from time to time, will prompt me to re-post a prior post of mine or another posters, whose information I have found to be informative and I knew I would want to read/share it again sometime in the future.
www.obesityhelp.com/forums/lapband/4399622/Newbie-from-Chica go/#36376935
Post Date: 6/15/11 9:17 am
Last Edit: 1/18/12 7:32 am ( BUMP DATE )

Did you have the actual Esophageal Manometry test done ?

Esophageal manometry

Another test, esophageal manometry, can demonstrate specifically the abnormalities of muscle function that are characteristic of achalasia, that is, the failure of the muscle of the esophageal body to contract with swallowing and the failure of the lower esophageal sphincter to relax. For manometry, a thin tube that measures the pressure generated by the contracting esophageal muscle is passed through the nose, down the back of the throat and into the esophagus. In a patient with achalasia, no peristaltic waves are seen in the lower half of the esophagus after swallows, and the pressure within the contracted lower esophageal sphincter does not fall with the swallow. In patients with vigorous achalasia, a strong simultaneous contraction of the muscle may be seen in the lower esophageal body. An advantage of manometry is that it can diagnose achalasia early in its course at a time at which the video-esophagram may be normal.

• What is esophageal manometry?
• When is esophageal manometry used?
• How is esophageal manometry performed?
• How is esophageal manometry used to assist in the diagnosis of diseases and conditions?
• What limitations are there to the use of esophageal manometry?
• What are the side-effects of esophageal manometry?
• Are there alternatives to esophageal manometry?
• Find a local Gastroenterologist in your town

Thundergrrrl,

This is another example of an old post of mine that you or someone else reading this might find useful or bookmark worthy. I have TONS of bookmarks on several topics.
www.obesityhelp.com/forums/lapband/4506971/burning-in-esopha gus/#37307652

I know that your OP wasn't directed at me ;) Like I said, Maria's mention of someone who was asymptomatic and then discovered this issue at a routine 2 year GI study was what I meant. That was me.

Anyway, once we see the results of my next GI (on Monday) my dr. will determine if he needs to unfill me more/entirely or if my esophagus returned to normal then he'll probably want to leave me as I am and just keep an eye on it. I'm not opposed to a complete unfill but we'll see what he says. He's an extremely conservative doctor who doesn't see a lot of issues with bands because he refuses to fill people aggressively.

...and it's very painfull, and the longer this goes on...the more severe the pain will become, and the risks of permanent damage are very real.

If your band is functioning perfectly, then just bookmark this for future reference, hopefully you will never ever have to lay eyes on it again.
If your still going forward with having a LAGB implanted, then just bookmark this for future reference, hopefully you will never ever have to lay eyes on it again.
 

How does the normal esophagus function?

The esophagus has three functional parts. The uppermost part is the upper esophageal sphincter, a specialized ring of muscle that forms the upper end of the tubular esophagus and separates the esophagus from the throat. The upper sphincter remains closed most of the time to prevent food in the main part of the esophagus from backing up into the throat. The main part of the esophagus is referred to as the body of the esophagus, a long, muscular tube approximately 20 cm (8 in) in length. The third functional part of the esophagus is the lower esophageal sphincter, a ring of specialized esophageal muscle at the junction of the esophagus with the stomach. Like the upper sphincter, the lower sphincter remains closed most of the time to prevent food and acid from backing up into the body of the esophagus from the stomach.

 

What is achalasia?

Achalasia is a rare disease of the muscle of the esophagus (swallowing tube). The term achalasia means "failure to relax" and refers to the inability of the lower esophageal sphincter (a ring of muscle situated between the lower esophagus and the stomach) to open and let food pass into the stomach. As a result, patients with achalasia have difficulty in swallowing food.

http://www.medicinenet.com/achalasia/article.htm#tocb

What is dysphagia?

Dysphagia is the medical term for the symptom of difficulty swallowing, derived from the Latin and Greek words meaning difficulty eating.

http://www.medicinenet.com/swallowing/article.htm

What is esophageal spasm?

Esophageal spasms are irregular, uncoordinated, and sometimes powerful contractions of the esophagus, the tube that carries food from the mouth to the stomach. Normally, contractions of the esophagus are coordinated, moving the food through the esophagus and into the stomach.

There are two main types of esophageal spasm:

• Diffuse esophageal spasm. This type of spasm is an irregular, uncoordinated squeezing of the muscles of the esophagus. This can prevent food from reaching the stomach, leaving it stuck in the esophagus.
• THIS IS IMPORTANT TO UNDERSTAND because many banded people think that their food is stuck due to not chewing well or they think they ate too fast.
•  
• Nutcracker esophagus. This type of spasm squeezes the esophagus in a coordinated way, the same way food is moved down the esophagus normally. But the squeezing is very strong. These contractions move food through the esophagus but can cause severe pain.
• Again, this is often explained away by band surgeons and banded patients as eating to fast and/or not chewing well enough.

You can have both types of esophageal spasms.

Check out this link and then see if your surgeon or PCP can order you this test.There is a lot of really useful links here.

What is achalasia?

www.medicinenet.com/achalasia/article.htm#tocb

Esophageal manometry

Another test, esophageal manometry, can demonstrate specifically the abnormalities of muscle function that are characteristic of achalasia, that is, the failure of the muscle of the esophageal body to contract with swallowing and the failure of the lower esophageal sphincter to relax. For manometry, a thin tube that measures the pressure generated by the contracting esophageal muscle is passed through the nose, down the back of the throat and into the esophagus. In a patient with achalasia, no peristaltic waves are seen in the lower half of the esophagus after swallows, and the pressure within the contracted lower esophageal sphincter does not fall with the swallow. In patients with vigorous achalasia, a strong simultaneous contraction of the muscle may be seen in the lower esophageal body. An advantage of manometry is that it can diagnose achalasia early in its course at a time at which the video-esophagram may be normal.

Esophagus

After food is chewed into a bolus, it is swallowed and moved through the esophagus. Smooth muscles contract behind the bolus to prevent it from being squeezed back into the mouth. Then rhythmic, unidirectional waves of contractions will work to rapidly force the food into the stomach. This process works in one direction only and its sole purpose is to move food from the mouth into the stomach.^[2]

In the esophagus, two types of peristalsis occur.

A simplified image showing peristalsis

• First, there is a primary peristaltic wave which occurs when the bolus enters the esophagus during swallowing. The primary peristaltic wave forces the bolus down the esophagus and into the stomach in a wave lasting about 8–9 seconds. The wave travels down to the stomach even if the bolus of food descends at a greater rate than the wave itself, and will continue even if for some reason the bolus gets stuck further up the esophagus.
• In the event that the bolus gets stuck or moves slower than the primary peristaltic wave (as can happen when it is poorly lubricated), stretch receptors in the esophageal lining are stimulated and a local reflex response causes a secondary peristaltic wave around the bolus, forcing it further down the esophagus, and these secondary waves will continue indefinitely until the bolus enters the stomach.

Esophageal peristalsis is typically assessed by performing an esophageal motility study.

I'm glad you posted! I remember you thread so well, but I could not remember who it was! Hope your test goes well.

I just revised from band to sleeve on Tuesday. The scopes were showing that there was nothing wrong in there, so I expected the best. However, when they got in they found that the band had partially adhered to my spleen. I'm imagining if that went on with out me knowing it, no good could've come from it! Scary! 

I don't understand why so many of our diagnostic testing comes back normal. I had a CT Scan one day prior to an unplanned band removal. The report read, " The band is in the correct position and there are no signs of a slip " yet the surgeon came in early the next morning 8:00 AM ish, and told me I would be having my band removed later that afternoon because it had slipped.

I was wheeled into surgery 20 minutes later and woke up with a Surprise Sleeve... Weeks later I had learned that my band had eroded, but the surgeon never mentioned it to me, and in fact denied it, his PA denied it, the surgeons copy of my " OR Report " denied it, but the hospital records report had it in writing and it came with pictures too.

I had been complaining about bee stinging sensations, burning, swelling and tenderness around my port area for over a year, and they could never find anything wrong. In hindsight, I believe that is a sign of infection which may have or may not have been a symptom of the erosion.

 It's scary that we could have a complication and not have any symptoms.