One stricutre....Nine dilations....time for a revision???

Hi everyone, It's been 18 months since my gastric bypass and I'm down 205 pounds...yeaaaaa! However...I am having a problem. One year ago (actually, 13 months ago...August 2005), I was diagnosed as having a stricture. The opening leading from my stomach keep shrinking. Last September, it was totally closed...even water would not stay down and I became dehydrated which resulted in a five day hospitalization to for IV fluids and to have my first of nine dilations. Each dilation seems to be harder to recover from than the previous dilation. (yes, I realize this could be psychological...haven't rulled that out) A little education: a dilation is when, during an enoscopy, they send a ballon down to the site of the stricture and stretch it. Literally, they force the opening to expand and the hope is that it will remain the size they stretch it to. These procedures are outpatient and considered minor. I am home and sleeping it off within three or four hours. The last two dilations have been much harder on me that the previous seven. During this past year, I have developed ulcers which, as those of you who have ulcers can testify to....they are far from pleasent. Since my last dilation (last week) my stomach has felt like it's on fire. I was told that I have the ulcers for two reasons...it's the way I healed from the gastric bypass and from all the vomiting. Since my last dilation (which was last week) I have been on medication (carafate) which has to be taken either one hour before a meal or two-three hours after a meal. To keep my stomach from hurting, I have to eat six small meals a day. It seems my whole day is spent checking the clock to see if it's time for a pill or a meal. I have to stay on this medication for two months. I'm also on Protonix (I've been on this since I was first diagnosed with the stircture, taking it is no big deal). In the past year, I found that I need to stick with soft foods because they stay down better. The firmer the food, the greater the likelhhood of the food not staying down. I do not tolerate many vegetables at all, no meats, no pasta, no bread. This really limits what I can eat. I focus primarily on soups, beans, protien drinks, cottage cheese, yogurt...things that those who are only a few months post op are able to eat. Before the stricture really goe bad, I was eating firmer foods and doing fine. I have been told that I might be one of those who will have to have dilations the rest of my life...not something I really look forward to! Has anyone else had this problem? I had my 18 month check up yesterday and asked my doctor about maybe correcting the sticture surgically. He said that a revision is major surgery and requires a longer hospital stay than the gastric bypass required. From what I read on another web site, it sounds like the revision is a more serious surgery than a gastric bypass is. What would you do? Would you seek a second opinon? My surgeon said he thinks that I need to continue with the dilations and hope that is solves the problem. I have also been told that I might be one of those who will have to have dilations the rest of my life...not something I really look forward to! I would appreciate your input....especially if anyone out there has had this problem. I am especially interested in hearing from someone who has had a revision. I apologize for such a long post...I wanted to be very clear on what is going on and couldn't figure out how to make it shoter. Thank you! Karen

Karen, I have no personal knowledge on your situation and I'm sorry to hear you are having difficulties. I do have a friend from another support group that had surgery February 2005 that has had lots of problems with strictures and vomiting. She has been dialated many times. I'm going to contact her and have her read your post, maybe you two can relate to each other since your complications are similar. Dana

Thank you!

Karen: I had a bout with a stricture months 2-5 and had 6 dilations, used the carafate, and understand your concern. My surgeon purposely makes the stoma smaller and that can complicate things if the scar tussue builds on the interior. I'd suggest seeing another surgeon who has a longer positive track record. I wonder whether dilations are somewhat "art" and science (ie: how they are done). I worried toward the latter procedures that I might require a revision. I'm very thankful that things appear to have resolved. Good luck and here's a Kentuckian inviting you to Lexington. Dave