Causes of a stricture - ThinnerTimes

LisaBoston · 11-22-2005, 03:16 PM

Hello all. Here in Canada, on one of our on-line groups we are having a real debate on a stricture. So I thought I would come here for help.

The doctor that I am seeing generally has his patients come back after 6 weeks post-op for a scope to dialate the opening to the pouch as a stricture has occured. Many patients here are having this done as they tend to have problems with narrowning.

From what I have read in books and here, a stricture is a narrowing of the connection and is caused by scar tissue. Its something that we can't do anything about.

My doctor has his patients on liquids for 8 weeks post-op. Starting with clear fluids and working up to puree foods by the 8 weeks and then slowly introducing foods after this.

Has anyone heard of any other reasons a stricture is caused? This group here feels that by having liquids for so long after surgery, you allow the narrowing to happen as dense foods are not passed through your system.

They also talk about not worrying about protein for the first 8 weeks as your system doesn't tolerate it well, nor need it.

I know we are supposed to follow our doctors orders..and I agree with this, but have to wonder why such different information???

This doctor only does RNY Open, not Lap (yet).

Any thoughts? Lisa

LarryB · 11-22-2005, 03:34 PM

Well. I was on a liquids for 6 weeks. I don't know that I agree with the no food causes the narrowing. Scarred tissue happens in a lot of things. I know from a couple other surgeries I have had there has been a great deal of scarred tissue appear and I can guarantee the one area is always used and scarred tissue still formed. As for the protein I couldn't disagree more. Protein is essential to healing well. I know that myself I have never had problems with handling protien.

eyesthatkissu · 11-22-2005, 03:38 PM

A stricture is caused by scar tissue. Period. Wether or not you have liquids or solids has little to do with it. There is no telling who will or who will not develop one. Statistically, there is no difference. Personally, 8 weeks of liquids is a little crazy. But every doctor is different. You should start protein as soon as you can tolerate it and the doctor advises you to do so. For us it's at 10 days post op. Maybe it doesn't matter, but I'm not willing to gamble with my muscles, or hair. You may have read my post about having difficulty finding a protein I liked. I can tell you that as soon as I did, I felt even better then I had before. And I was feeling pretty darn good. I'm not nearly as tired and I'm able to live completely like I was pre-op. So in a nutshell..... take your protein.

VanessaSFL · 11-22-2005, 04:02 PM

Scar tissue is what causes the stricture.
Some of us heal very well... too well at times.

Van

LisaBoston · 11-22-2005, 05:23 PM

I knew you would set the record straight. What do you do when you don't like broth....it makes me gag now. I can handle soups and even blenderized soups but straight broth...yuck.

Phoenixfire · 07-17-2007, 09:56 PM

Echo prior poster. I never heard of stricture until now, years after WLS. I did the cottage cheese and soft protein post WLS soon and had none. Seems that now stricture is so common and it puzzles me.

Dyann · 07-18-2007, 05:28 AM

Strictures do not happen because you do anything wrong. It is not exactly known why, but the thought is that the area where the stomach and the intestine join up is lacking in a little bit of blood flow to the area (ischemic due to dividing the blood supply to that part during the surgery) which makes the healing process different and you get a narrowing and scar rather then normal healing. That is why they are usually started 4-12 weeks after surgery (Unless you are Vanessa who was diagnosed after over a year!!). It is a techinical aspect of surgery as there are different width openings a surgeon can make. Smaller ones have a better weight loss, but a higher stricture rate. Larger ones have a lower stricture rate, but also less weight loss.

One thing is for sure, the earlier it is caught, and the less it has narrowed at the time of treatment, the easier it is to treat and possibly the fewer dilitations are required.

In terms of the protein....I think fluids are more important right after, but you can get protein malnourshment easily and you need it to heal.

If a doctor is only doing open procedures, they are not really up on the standard of care. Doing it open is acceptable under certain circumstances, but is not the best for the patient. Think of this...if you needed your gall bladder out would you have it open for no other reason other than the surgeon wasn't proficient at lap?? You would find another surgeon as lap is lower risk and evolved into the standard of care as it is evolving for GBP as well. The only reasons to do GBP open from the start are numerous previous abd. surgeries or the only surgeon you can use only knows the open way. It is always acceptable to convert from lap to open intra op.

There is my 2 cents

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fr1endly2 · 07-18-2007, 01:01 PM

Well im not sure i always did hear its scar tissue...
okay but what baffles me is im 2 years post
op and go to my surgeons support meetings.
HIS patients dont get strictures.
NOW when i questioned the "Y"...
he said its in his technique that folks
dont get these problems.
SO who knows!!!!!!!!!!!!
cant say i ever heard it had to do with being on liquids
long cause ill say being in the WLS world for 2 years now....people
get them that havent been on liquids for 8 weeks....!!!!