Stretched Esophagus

I hope someone can help me cause I'm a little bit freaked out!  I've had my band for 5.5 years and have had no problems, other than the usual stuff.  I went to my doc about two months ago because I was having a lot of indigestion and she told me at that time I was in what she called "the exceptional group" of banders because I had taken off all my weight and kept it off for so long.  She prescribed some nasty medicine for my irritated esophagus and instructed me to take pepcid every monring.  I did that and it got much better.  Well, about two or three weeks later, I could suddenly eat more than I had ever been able to and I could tolerate things that previously had been a problem without feeling the need to spit it up.  And of course I started gaining weight.  So I went back to her about a week ago and she put me under the flouroscope and had me drink the lovely white sludge.  She said it showed that my "little stomach" as I call it, had stretched!  So now I'm wondering how my little stomach went from "wow, that's too much and I'm gonna spit it back" to "wow, that's too much so I'll just expand to accept it".?  It seems like it happened overnight.  So I'm hoping someone here has had this problem and overcome it.  What really scares me is that maybe the band has a "shelf life" so to speak, and my fairy tale band experience is over. 

My doctor advised me to eat no more than a cup of food at a time and basically, start over like things were in the beginning.  And if that fails, she'll have to empty my band for a while.  I don't want to have to do that!  The thought of gaining back my 100 pounds scares me to death!  If anyone has beaten this problem, please share your experience with me.

Thank you.

PS. I LOVE MY BAND!

I am sorry you are having these problems. Don't be scared too much of a total unfill. You can still follow your food plan but hunger may cause you to need snacks (protein of course), or more fiber, etc. Even with all that it is possible to gain but by being really careful you can keep it in bounds. Usually a total unfill lasts for about 6 weeks or so. I suspect that if all that doesn't resolve the problem you may need to revise. I hope not for your sake, but it happens.

Sue

Thanks Sue!  I hope it works too because I have no desire to revise to another procedure.  I did lots of research before getting my band, and besides not wanting to have my anatomy altered, I know that it's possible to stretch out your stomach regardless of which procedure is done.  I'll just have to try and muster up the will power that I never had before my band!  Zumba, here I come!

Ok Miss Sue was sweet about it now I'm here to rain on your parade. Just a few facts that I have learned over the last several years. The band does indeed have a shelf life, it is from 5-10 years, this is from the manufacturers. If you are able to eat more because of your small stomach being stretched that is a slip and you should be either partially or totally unfilled to hopefully allow it to go back into position. Once you have a slip you are more inclined to continue to have them. If you are lucky and patient with a total unfill you "may" be able to keep the band a while longer, but in all reality this is usually the beginning of the end of banded life. For your sake I truly hope this will work out but in all reality you should start reading up on other surgeries just "in case" you need to revise or figure out how to live with out the band and still maintain your weight loss. I'm really not trying to be mean, it's just that I have been on this forum everyday for over 6 years and I see this same story play out more and more often. Myself I've had to have my band totally empty for over 2 yr now because of the heart burn and pain. If the heart burn continues please get at least a partial unfill because the more acid the more damage it can do. I wish you the best but please prepare for the worst so you aren't blind sided IF things don't turn around.

The title of your thread is Stretched Esophagus, but you're saying that it's your "small stomach" that has stretched. A dilated (stretched) esophagus is a different problem from a dilated stomach. The 2 problems seem similar but (in my experience) they have different implications for the future of your band.

The esophagus is designed to move food up or down, not to store it, and certainly not to store it long enough to cause dilation. The implication here is a problem with esophageal motility, meaning that for some reason, your esophagus is no longer able to push food into your stomach. In a bandster, that can happen because the band is too tight. I know you hate the very idea of it, but a complete unfill can relieve the dilation, though it can't necessarily cure the motility problem. The longer you leave the dilation untreated, the harder it will be to resolve.

Dilation of the upper stomach pouch can also be caused by a band that's too tight. I know that it's perplexing to for your body to suddenly decide that your band is too tight, but the human body is a living thing, not a machine. It's affected by hydration, medications, illness, etc. etc. The treatment of stomach dilation is the same as for esophageal dilation - a complete unfill and rest period. The prognosis here is likely to be better than with esophageal dilation because unlike the esophagus, the stomach is designed to expand, contract and churn to break down food enough to move it into the intestines.

In my opinion, you really need to get a complete unfill and let everything rest for a few weeks. You may regain weight, but if you don't take action now, you could end up losing your band.

Good luck!

Sorry Carla!  Get a complete unfill or close. YOU ARE IN TROUBLE AND IMMEDIATE ACTION NEEDS TO BE TAKEN OR YOUR CONDITION WILL GET WORSE.

P.S. No one wants to revise.  We wanted  the band to work forever.

Good Luck with that.

Hi, 

I hate to contradict Hislady, but as I understand it, a slip is when your band actually "slips" out of position.  I have had a stretched upper pouch yet my band is in perfect position.  I agree with what Jean said, it can happen if your band is too tight of suddenly becomes too tight for whatever reason.  My surgeon INSISTS on a total unfill so you can give your pouch a rest.  I'm honestly shocked that your Dr. didn't unfill you just to give everything time to relax and your pouch to hopefully go back to it's normal shape.  (mine did).  If your pouch continues to be stretched out of shape not only will your level of restriction will change but the reflux will worsen because the opening from your pouch to the esophagus can be affected.

Be cautious and don't be afraid of the unfill.  Usually 4-6 weeks will do it and it's worth it if it means saving your band.

Best~

Lisa O.

The first time I had trouble with the Esophagus at a year out the did a totally unfill for 6 weeks.  The second time they did a totally unfill for 2 months.  As stated above the sooner the unfill the better.  Think, if you blow a balloon up once and unfill right away it looks about the same.  If you blow it up and keep it blown up after a while it is bigger, thinner and winkled.

Not exactly the same but you get the idea.  Yes, each time I was unfilled I gained 30 pounds.  The first in 6 weeks the 2nd in 2 months.  This last time it took 4 months and the holidays to gain it.  So I did learn to do better over time.

I'm sorry you're having problems.  If you have esophageal AND pouch dilation, you should probably empty your band and give everything a rest for a few weeks.  If you choose to keep your band filled, I (though I'm no doctor) would recommend eating half a cup at meals and supplement with high nutrient snacks to make up the difference to take the pressure off the pouch and esophagus.  

I had a very mild pouch dilation last June, with slow esophageal motility and had a complete unfill.  Even without fill, I'm too tight much of the time due to spasms.  I still have motility issues and take medications for it.

i hope you're able to resolve this without losing your band.

Carla,

You mentioned:

Well, about two or three weeks later, I could suddenly eat more than I had ever been able to and I could tolerate things that previously had been a problem without feeling the need to spit it up.

This is the problem that happens to about 50 percent of lap banders, you were just plain too tight for too long. This has been happening to ALL lap banders OVER AND OVER AND OVER AGAIN. This is why the complication rate is SO HIGH with the band.

As Dr C used to say, it's very hard to convince a obese person that they will do better with a looser band, and I agree many folks will have to learn the hard way. I know sometimes it's very hard to get to the green zone, and often times we settle for an inch over into the red zone, and many of us want the band to completely stop us from eating, it's not design to stop us from eating to the point of vomiting. It's designed to help us stop with a soft stop, if you';ve been depending on the band to stop you with PBing, that will surely cause complications.

You fell into the trap that so many of us have experienced, many vets used to warn newbies about this same trap for many years, and told them if they were plan on GOING TIGHT, only do it for a short time and if possible don't eat any solids until you get your weight off, and that's still not a guarantee that you won't either suffer from esophageal dilation or pouch dilation, two separate complications, but both require removal if damage is too severe.

If you have not already gotten your band emptied, you SHOULD, IF YOU LOVE YOUR BAND, a (PARTIAL UNFILL WILL NOT HELP),  if want to KEEP IT,  it may be too late already depending on how long you were too tight, if you've lived with a too tight band for 4 years, you may have too much damage to your esophagus to keep your band.

Remember the band is a guide to help us, as many vets use to tell others, you cannot keep a too tight fill level for long periods of time and get away with it, it will catch up with you sooner or later, it does not matter if you feel good for a few years, sooner or later that tight pressure against your esophagus will do lots of damage. And apparently, you started to experience damage which can range from horrible reflux and indigestion/burning or vomiting and band damage can get wicked and very painful.

We were trained IF we were going to go tight, lose the weight quickly, and keep the food only limited to liquids/soft foods and then remove saline to prevent damage, also you have to be closely monitored by your surgeon if you are planning on going "tight" , it's a slippery slope, some can get away with it, if they don't vomit and only pureed their food, but unfortunately many suffer complications.

Also remember often times, when the band has been so tight, scar tissue is formed especially if the pouch has stretched from being too tight or the band has slipped a bit,  and when the surgeon unfill the band and you get refilled, you may never get back to your sweet spot, it will take a whole lot of tweaking, but you may luck out and escape permanent damage.

Dr. Simpson explains pouch dilation and band slips in detail on his website this may help you.

http://drsimpson.net/fills/lap-band-problems/Lap-band-slip-w hat-is/Lap-band-slip-what-is.html

Good luck