4cm stoma?

I'm struggling with this stuff. My RNY never functioned properly, and I was good with the diet and didn't try to cheat a lot. But my RNY didn't work. I lost 20 pounds with the hospital stay and 19 more during the next 6 months. Then nothing. So a lot of surgery with a 39 pound loss.

Anyway, upper GI at one year said my stoma was enlarged. Original surgeon didn't want to help me anymore.

Intervening depression and being scared of doctors for 4 years as a result (I didn't go to the doctor at all). Never feeling full. Bathroom constantly. My life is a nightmare. And I'm still obese.

I'm now trying to get this fixed. Another upper GI showed a small hiatal hernia (whatever that is). EGD shows that the pouch is 4 cm long and, get this, the STOMA is also 4cm.

I would even trade this for my old anatomy. At least I would be full on occasion, like on Thanksgiving. I'm always hungry, never full, and always in the bathroom.

What the hell happened? How does this get fixed?

I have the exact same problem.  Most likely you'll be told your "pouch is too small" to do any sort of revision on...I've been told mine was too small for a lap-band-over-rny and too small for the tools used in the Rose (and I guess other endoscopic stoma-fixing procedures.)

My stoma is 3.5cm...except I have the opposite problem with the bathroom..lol.  It's like my food goes straight to the intestines and never really breaks down, but it sure does make sure to absorb those calories.  I can't eat much at one time, but 15 minutes later I'm starving.

I stay depressed thinking of all the procedures I've had as a result of the rny (the original "open" incision", gallbladder removal, hernia repair, adhesion removal, tummy tuck (I gave up at 195 lbs - thought that was my "maintained" weight and went ahead and had the tuck...then gained 25 lbs), breast reduction, 3 endoscopes, upper gi, catscans...etc.  Then there were the surgeons who said they could fix me, then last minute decided they couldn't.

I don't know what happened with mine, unless my surgeon didn't consider that it'd stretch over time when he made my stoma, and made it too big in the first place.  Or it could be from swallowing pills that were too big.  I never got food stuck or threw up when I first had my surgery, so it was probably too big too begin with.

lol sorry I got on a rant.  I'm curious what people will respond with... I've asked the same question on here before with very little luck, soo hopefully someone will chime in and help...lol.

I have the exact same problem.  You stories are mine.  I am seeking to get DS done.  I couldn't believe when I went to the doctor that I was only 10 pounds away from where I started  before I got my RNY.  I am hungry all the time too.  I walk.  I eat  complex carbs.  I eat protien.  I went through a long period of depression after the weight started coming back on and I didn't know where to turn.   I felt like a failure for so long only to realize that many people had the same problem.  I decided to get a DS because I was told this would permently fix the problem.  I don't have a problem with the diet or the exercise.  I just want to feel healthy again.  I am starting the vitamins now so when I do get the surgery I will be feel better as soon as possible.  Good luck to both of you and God Bless!

~~ I am starting the vitamins now so when I do get the surgery I will be feel better as soon as possible~~

Wait a minute... you have RNY and you haven't been taking your supplements?

Yea, I only lost a total of 39 pounds. I have kept off 10 pounds. So, all that surgery and misery for not much result.

4cm = 1.6 inch.
So your pouch is the same size as your stoma. It's bigger than a quarter, almost the size of a half-dollar. Your original surgeon didn't make it small enough it seems. Although, if you were eating the very small portions from day one, you would lose a large amount of weight just from less calories.
The stoma size would affect emptying of your pouch.
A good revision surgeon will help you decide how to revise your RNY.
Best of luck on the future.

I'm getting to this thread kind of late, but, better late than never.

Your stoma is massively dilated, and the intestine downstream from your pouch is acting like a giant resevoir for food that passes out of your pouch. There is no way to say how long it has been like this. Restoring a smaller stoma would be relatively low-risk, but may be of only limited benefit. Conversion to a Duodenal Switch would be more definitive.

John D Husted, MD

My story exactly.  My surgeon said he made a 2 oz pouch and 100 cm bypass.  He also uses a smaller stoma hole punch now.  I have never felt restriction.  i ate 3 oz of food in the hospital 2 days post op without a problem.  I agree about wishing my old anatomy was back because food dumps into my intestine raising my blood sugar and then crashing down frequently into the 50s and twice as low as the 20s.  My life is a nightmare and I am also obese.  10 lbs heavier than surgery.  I don't have a doctor.  I fell and crashed my head into a table and I wouldn't go to the ER cause I didn't want to get on a scale.  Finally after a week my husband pushed me in and I refused to get on the scale...I didn't know I could do that but I did.  I wish I knew how it could be fixed.  Failing a WLS is more shameful to me than being fat in the first place.  Daisy

Yes, I know. It's kindof what I knew in my gut (both senses intended) for a long time. I had a lot of nausea vomiting on the FIRST bite of food when I was advanced to solid foods (if you trace back my posts, you can see some of this).

That passed, but by month 4 I had only lost 30 pounds, 11 of which were lost in the hospital, and 9 more during the first three weeks of liquid and soft food. Over the next year, I lost a further 9 pounds for the total of 39. I have kept off 10-15 pounds at year 5.

By month 4, I also posted here about seizing and frequent BMs and asked for help (as I remember, I this had been going on for awhile before I posted...because I was embarassed).

At the time, the nutritionists kept telling me to eat more protein, and I did. I walked. The original doc was not concerned, and it was only that a new person (resident?) was on the service at the year check that I got an upper GI which showed my GI tract was a raceway.

Nothing is too late.....I've been this way for almost 5 years (5th year anniversary is in June).

Why would re-introducing restriction be of limited benefit?