staple line ulcer

Luann S.
on 12/28/08 4:28 am - Randolph, MA
Hi there,  I haven't been here for quite some time.  Had RNY with Dr. Hess 9/14/04 and lost 80 lbs but have been gaining mostly due to bad habits.  However, my question is has anyone else had an ulcer along the staple line?  This has become a recurring problem for me.  The first time relatively minor and taken care of with a short course of OTC prilosec.  The second time landed me in the ED for 5 hours and some weeks now on Carafate and Protonix (which requires a prior authorization even for the generic) and from what reading I've done can interfere with absorption of vitamins and minerals.  I haven't been able to figure out who I should follow-up with, my PCP or my surgeon and the holidays have made it even more difficult to get an answer.  It is over a month now that I am on these medications and I don't know how long I need to stay on them.  I will try to see the surgeon (Dr. Hess-a wonderful guy) after the first of the year but I would like to know anyone else's experience.  I had ulcers before the surgery but they were due to being on steroids and NSAIDS at the same time and I thought they were unlikely to come back.  Unfortunately a very brief course of NSAIDS for knee pain brought this all back again and it just doesn't seem to be healing completely.
Otherwise, I have been very pleased that I had this surgery and the care I received.



    
jayner
on 12/28/08 7:05 am - Littleton, MA
hi Luann,

I had a marginal ulcer. It is called that because it is at the margin where the stomach is connected to the new branch of the intestine. I had sutures instead of staples. I took protonix twice daily and carafate - two teaspoons three times daily ( half an hour before meals). I had a hard time finding the liquid carafate - the pills did absolutely nothing for me. CVS could not get the liquid. I went to Walgreens for the liquid. It is cherry falvored and not bad at all. It forms a gel over the stomach lining and gives the ulcer a chance to heal. I had an endoscopy two months after the first one and the results showed that the ulcer was gone, but there was still some swelling in the area. Now, another month later, I am having some related problems and am going back to the carafate regimen.

My surgeon referred me to a gastroenterologist who is following the treatment. I have been working with the surgeon's office as this type of ulcer is definitely RNY related.

good luck,

Jayne
 
 
 
Luann S.
on 12/28/08 12:58 pm - Randolph, MA
Thanks Jayne

I did get the liquid Carafate and it did help so I guess I will continue with that until I see the surgeon and figure out what's next.  It's just kind of frustrating to have problems this far out.  I already have a gastroenterologist so I will have to find out if I need and endoscopy and who will do it.  Thanks, Luann
cdnov26
on 12/30/08 2:40 am - MA
Hi,

I have the same issue (diagnosed 12/17)  still waiting for a protonix approval...had my surgery 11-16-08.  Actually having some other issues right now as well and I am in the hospital.
 

    
Luann S.
on 12/31/08 5:44 am - Randolph, MA
Wow!  You are fairly recent with the surgery.  Hope things get straightened out.  I have no regrets whatsoever about having this surgery but just want to figure out if this is something that will stay resolved with medication or keep popping up!  Good luck with everything and get out of the hospital soon for a happy and healthy new year!
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