Question:
What type of revision is performed for a stomach that empty's too fast?

I had RNY 10 months ago and have only lost 40 lbs!!! At 2 months out up until my appointment this week I told the surgeon that the volume of food I can consume at one sitting is too great! He never really HEARD me he just kind of smurked and would tell me I am not exercising enough or I must be grazing. BUT I never gave up trying to get him to understand the volume of my meals are too high. I can eat 4 baked chicken wings & a salad at one sitting one time. A recent meal included to ground beef patties and a salad. Hey that sounds like a preop meal to me. After healing i never went through a phase where i could only eat a few tablespoons of food. 2 months out I could eat a whole lean cuisne meal...I could have probably eaten more but I would stop. The doctor told me this week that it sounds like the connection between stomach & intestine is too large ( an upper GI exam shows my stomach size coninues to be 5-10% the size of a normal stomach) Because I can eat so much and am hungry... VERY hungry soon after it appears that the food is emptying out of my stomach too rapidly i knew this two months out! Anyway the surgeon suggest that for the next month that i self limit meals to no more than 1/2 cup each mealand skip meals if I am not hungry (does not happen) he hopes to jump start my loss. (You know what if I had that type of self control I would have avoided going under the knife!!) I left the office thinking this made sense now i know this IS NOT A SOLUTION because my tool is not working! The surgeon said maybe he can tighten the opening by putting a clamp around the opening to close it a little. Any suggestions on type of repair needed, where I can find answers? has this happened to you? Don't get me wrong I have a good surgeon; we have to make sure we have really communicated out points to our physicians!    — Dee H. (posted on September 8, 2002)

September 8, 2002
I notice you haven't received any answers yet, and unfortuatnely, I don't have much information for you either. I can tell you that I've heard that "stretched stoma" revisions are difficult. Some surgeons say that there is nothing that can be done. (I really don't think that is true, however.) I saw from your profile that you're in Baltimore. You may wish to speak with Dr. Hazem Elariny in Arlington, VA. He was my surgeon, and he's extremely skilled. He performs all types of WLS, and I know he's done a variety of successful revisions. I feel sure that he would at least take your problem seriously and provide you with some reliable information & advice. Best of luck!
   — Tally

October 26, 2002
Boy, do you sound just like me. I had my surgery january 4, 2002 and have lost 50 pounds to date. I finally had an upper gi and they discovered a hiatal hernia. The surgeon says this is creating more room for food to go. He is going to repair the hiatal hernia and resize my pouch a bit. It is supposed to be an outpatient procedure. I am hoping this will be the solution I have been waiting for. I do hope your surgeon begins to listen to you and keeps searching for why you are not losing. Please keep us posted. Landa
   — landal

October 26, 2002
Boy, do you sound just like me. I had my surgery january 4, 2002 and have lost 50 pounds to date. I finally had an upper gi and they discovered a hiatal hernia. The surgeon says this is creating more room for food to go. He is going to repair the hiatal hernia and resize my pouch a bit. It is supposed to be an outpatient procedure. I am hoping this will be the solution I have been waiting for. I do hope your surgeon begins to listen to you and keeps searching for why you are not losing. Please keep us posted. Landa
   — landal

October 26, 2002
Boy, do you sound just like me. I had my surgery january 4, 2002 and have lost 50 pounds to date. I finally had an upper gi and they discovered a hiatal hernia. The surgeon says this is creating more room for food to go. He is going to repair the hiatal hernia and resize my pouch a bit. It is supposed to be an outpatient procedure. I am hoping this will be the solution I have been waiting for. I do hope your surgeon begins to listen to you and keeps searching for why you are not losing. Please keep us posted. Landa
   — landal

June 16, 2003
Hi I don't have an answer to your question either. I had rny proximal in Oct 99. I lost from 315 to 199 and now my weight is creeping back up. I think I weight 242 now. I have been consulting with a surgeon because I want to get my surgery revised to distal. I had an Upper GI recently and have an appointment to see the surgeon tomorrow to discuss the results. I looked at the report and it said I have a hiatal hernia and that the barium flowed freely from the stomach. So I will see what that means to Dr. Lin and will go from there. I am very frustrated and like so many others I feel like I am starting from scratch.
   — kaydeeb16