Revision - Ulcers

I had GBS about 6-7 years ago. When I had the surgery, approximately 2 weeks after, I began to throw up blood. It was found that an ulcer had developed around the site where the surgery or stapling was done. Since then I have been on carafate, protonix, prilosec. I've had to have 2 blood transfusions and my ulcer continues to bleed from time to time. I catch it soon enough to where they can get the bleeding to stop but it always seems to happen again. My gastroenterologist said that he thinks a revision needs to be done but that is not his expertise. I take iron pills and I have a vitamin D deficiency. Im constantly in pain from my stomach. So I am trying to figure out what would be the best revision. I saw something where they can redo my pouch or make it smaller. So is it possible to just cut out the ulcer and reconnect it to my pouch? Then I saw something where someone had to get a revision for the same reasons as i and her doctor said or advised her that where the pouch or stomach connects to the esophagus i guess should be directly connected to her intestines.  Sounds scary. Any advice?

(Tara)

I really depends on exactly where your ulcer is located. Marginal ulcers, or ulcers at the stoma (where the intestine connects to the pouch) are generally caused by the fact that intestinal contents can move backward into the pouch. Since stomach contents and intestinal contents have different pH levels, this is constant irritant. If this is the sort of ulcer you have, I'd recommend getting revised to either a Sleeve or a DS---you'd no longer have a pouch and stoma, but would once again have a fully-functional stomach, complete with th pyloric sphincter.

Sounds like you really need to see a bariatric surgeon that does all 4 of the major surgeries and see what they say. I thought most ulcers were caused by Hpylori bacteria and were pretty easily fixed with antibioics so not sure about recurring ones. Either way you really need an expert to help you amke this decision. Good luck to you!

You story is similar to mines.  except I just developed my ulcers (i have 3) within the last 7 months.  My surgeon is going to perform a revision to remove the ulcers (they are in the same location as yours...right where the instines meet the pouch) and reroute the intesine to the stomach and make my stomach even smaller (cut in half).

he said that I will still have to take two medicines (can't remember the name) for a year after the revision to keep the ulcers from coming back.

I had the RNY and he is going to peform another RNY.