Question:
dose anybody know anything about Roux Stasis Syndrome

I have had none stop problems with my RNY for nine months now. Mostly nausea and I can't keep anything down, only liquids. I can not tolerate soft foods and even soup now. I have had endoscopys which show that the stoma size is normal and the doctors can't understand what is wrong. I work in a hospital and I have been explaining my problems to the GI doctors there and they said that it sounds like Roux Stasis Syndrome. They said that this is where the pouch just doesn't work to push the food along. The only place that they know of who has done any research on this is the Mayo clinic, but I am in Pittsburgh Pa. Does anyone know anything about this syndrome and if I have it, how do I get diagnosed and who can help me? Please, If anyone has any info Please e-mail me. My situation is very bad. I am unable to eat at all and I am wasting away. I don't know how much longer I can go on like this. Please email with any help!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!    — melissa J. (posted on July 11, 2001)

July 11, 2001
What an awful experience for anyone to have to endure. I cannot beleive the quality or lack thereof that you seem to have received from your initial surgeon. As for the reversal, have you tried to get an attorneys help to fight the insurance company? I would imagine you are also at risk for a disruption on the staple line from the constant vomitting. If you arent working, try and get Medicaid cause they usually pay or perhaps if you are still working, change jobs for better insurance. Maybe you can purchase a different policy although it might be considered a pre existing condition. It sounds like this is a very serious issue. No one can tell you what to do but if it was me, I would beg, borrow and steal to get my life back. Write to every reputable bariatric surgeon and ASBS and maybe one of the surgeons will go the reversal gratis based on the information you posted. You are your won best advocate. Keep the faith and good luck in your journey back to life. SO many people donate money to charities every day. I would glsdly put my 2 cents in to get your reversal. Do not give up!
   — Lisa L.

July 11, 2001
Hi Melissa, I've read your story. You've done everything within your power to help yourself. The insurance company would probably prefer you died, rather than pay. It is time to get a personal injury lawyer. They usually work on a contingency basis. Find a good one.
   — [Anonymous]

July 11, 2001
Hi Melissa. Since insurance refuses to reverse you they should cover the cost of sending you to the Mayo Clinic or anywhere else to get fixed. If theres a safe and effective solution that avoids reversal and the weight regain that might be the best solution. My payers are for you. I am seeing my surgeon tomorrow, I will ask him about this syndrome....
   — bob-haller

July 12, 2001
I was just reading the Alvarado center for surgical weight control site. They have some information "for doctors only" and although it doesn't say what the name of the problem is, it does discuss repetitive vomiting. If anyone wants to read more the address is: http://www.gastricbypass.com/Gastric%20Bypass-for%20Doctors%20Only.html I am so sorry you are feeling this way. I am so glad you decided to share your story with us. We need to see the bad side of surgery as well as the good. I will pray that some relief will come for you soon.
   — K T.

July 12, 2001
Melissa, I know it has been so very difficult for you, and I truly wish you the best of luck in obtaining a diagnosis and subesequent cure. I have heard of electrodes being implanted within the pouch to enhance the gastric emptying. For your reference, here is a portion of the article:<br><br>Alteration of the Roux Stasis Syndrome by an Isolated Roux Limb: Correlation of Slow Waves and Clinical Course Stephen Zonca, M.D., Paul Rizzo, M.D., F.A.C.S. From St. John Hospital and Medical Center, Detroit, and William Beaumont Research Institute, Royal Oak, Michigan The Roux-Y stasis syndrome after antrectomy and vagotomy has been well described. Delayed gastric emptying after vagotomy and antrectomy with Roux-Y anastomosis has been attributed to loss of the duodenal pacemaker and to the effects of retrograde slow-wave activity arising from distal small bowel pacemakers. Small bowel contractions are closely coupled with slow-wave activity. Transection and anastomosis of the small bowel distal to the jejuno-jejunostomy has been shown to electrically isolate the Roux limb from distal small bowel pacemakers. Using a canine model, a vagotomy and hemigastrectomy with Roux-Y were performed in five dogs using the standard operation (control); in four dogs (experimental), an additional and reanastomosis of the jejunum 25 cm distal to the Y anastomosis of the Roux limb was performed. All specimens had six electrodes implanted along the Roux limb at 5-cm intervals, used for weekly analysis of the jejunal slow-wave activity. The isolated loop cohort had reduced incidence of retrograde slow waves, reduced emesis, improved gastric emptying by upper gastrointestinal series, and reduced gastric pouch size at autopsy. Adding a distal transection and anastomosis, thus creating an isolated Roux-Y segment, may improve the course of the Roux stasis syndrome.<br><Br>I'm sure there are other physicians, most likely at research hospitals, who are familiar with this syndrome, so hopefully, you will not be limited to using only the Mayo Clinic. However, I'm sure you want the best care possible, so I hope you have many choices. Perhaps you can contacts the American Society of Bariatric Surgeons for help. Or, go to a comprehensive search engine like google and do a search on roux stasis syndrome. You should be able to find a good deal of information on both diagnosis, cure, and surgeons skilled in this type of procedure.<br><br>Again, Melissa, I'm so sorry for what you're going through. I've emailed you several times to let you know I've thought of you, and I understand that you couldn't respond. Please keep the faith - all the best,
   — [Deactivated Member]

July 13, 2001
I went to my local medical library and want to tell everyone what I found out about this syndrome. This is from the American Journal of Surgery. "The study led to the definition of a Roux-Y stasis syndrome, characterized by chronic abdominal pain, persistent nausea, and intermittent vomiting. The factors leading to the development of the syndrome, however, are unknown. ...Roux-Y stasis was more common among women. ...Mathias and colleagues called attention to the characteristic clinical syndrome of chronic abdominal pain, nausea, and vomiting made worse by eating which developed after the Roux-Y operation. ...The investigators proposed that the Roux-Y limb acted as a functional obstrution and caused the symptoms of abdominal pain, nausea, and vomiting, especially after eating. ...Although most patients escape this complication, a frequency of 30 percent after gastrojejunostomy, as found in the study, makes Roux-Y stasis a troublesome problem. Roux-Y stasis seems to be caused by a functional obstruction of the Roux-Y limb rather than by a mechanical obstruction. ...The limb itself contributes to the development of the syndrome is also supported by our experimental studies in dogs. ...Our study showed that conventional examinations, such as endoscopy and radiography, have low sensitivity and specificity for demonstration of the Roux-Y stasis syndrome." If anyone has read my profile, you know that this describes me to a tee. This is why all of the tests have showed nothing! Now that I have this information, what do I do? I need to be diagnosis with this and find who knows how to treat it. It's sad that I had to find this myself and suffer all this time, while my doctors sat on thier buts and called me crazy. Was anyone warned about this syndrome as a pre-op? I think if you weren't, you should be very mad at your surgen. This snydrome is a living nightmare and is being kept a big secret.
   — melissa J.

August 31, 2001
My first suggestion would be to go to a Gastroenterologist and get "gastric Emptying" study done. There are medications out there that promote peristalsis (the movement of nutrition along the alementary tract). Once this study is done then they will know if it is the Roex-Stasis or not. If it is not, then, yes, such things can be caused by anxiety and depression. Being in the health field, and having psychiatry as a specialty, I know how much ones mental outlook can effect the body. But before it is written off as stress, it is best to follow up with every physical possibility. Was your gall bladder removed with surgery? Did they check for a biliary obstruction?? Have they done blood work?? Checked for cortisol levels? Even excessive estrogen levels? If so, then don't be upset. Many fine people have adjustment problems that psychiatrists can help with medication and also with therapy. Good luck and I hope you will post your progress. Marie Kozak
   — Marie K.

May 23, 2003
I have a friend who had the same problems your describing. Come to find out, the doctor left metal stitches in her new stomach and whatever she ate (other than liquids) would get hung up on the wires and make her sick. She suffered terribly for more than a year until finally they did a scope down as far as they could and discovered the problem. Good luck
   — Brooke B.