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Fistula - Drainage from my small pouch to old stomach


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#1 CCaspurr

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Posted 07 November 2008 - 02:17 PM

Hi,
I had the gastric bypass in 1997 and initially lost 88 lbs. Then I started throwing up blood and didn't have a full sensation. They did an upper GI which showed a small leak from my pouch to my stapled away stomach. I couldn't find a surgeon to repair it because they didn't take our insurance. The one surgeon that could have done it wouldn't because I had eaten a minature reese cup (yep)...

Anyway I was told by my G.I. Doctor that it had healed itself. I've never been below 170 and my weight goes up and down like a yo yo. I've gained more weight this year so my new doctor did an upper GI today and I still have a fistula. I haven't spoken with him yet and don't see him until next tuesday. I know he had told me I could not have the whole GB surgery done over because of all the scar tissue I have.

Anyway has anyone had a problem with a fistula and if so do you know if there is a way they can stitch it up without doing surgery ?? I've read a couple of articles about them going through the esophagus to repair small fistula's.

Any help would be appreciated.
Thanks,
Paula

Edited by CCaspurr, 07 November 2008 - 05:19 PM.


#2 Squishy

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Posted 09 November 2008 - 07:48 AM

Hi!
Looks like you have had a lot of views but no responses. I suspect that this is because you have finally found something that nobody else here has experienced. (that's pretty rare) Although I can't offer answers to your questions either,`I just wanted to wish you well.

Since you will now be the official "expert" on the pouch fistulas, please be sure to keep us posted.

Take care of yourself!
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#3 Sue0609

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Posted 20 November 2008 - 08:07 PM

You might want to Google "gastric bypass fistula". There are some articles and info on it, even a video showing one. It's apparently rare. Are there any Bariatric Centers of Excellence covered by your insurance? Good luck.
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#4 dolphin12969

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Posted 15 December 2008 - 09:18 AM

Hi,
I had the gastric bypass in 1997 and initially lost 88 lbs. Then I started throwing up blood and didn't have a full sensation. They did an upper GI which showed a small leak from my pouch to my stapled away stomach. I couldn't find a surgeon to repair it because they didn't take our insurance. The one surgeon that could have done it wouldn't because I had eaten a minature reese cup (yep)...

Anyway I was told by my G.I. Doctor that it had healed itself. I've never been below 170 and my weight goes up and down like a yo yo. I've gained more weight this year so my new doctor did an upper GI today and I still have a fistula. I haven't spoken with him yet and don't see him until next tuesday. I know he had told me I could not have the whole GB surgery done over because of all the scar tissue I have.

Anyway has anyone had a problem with a fistula and if so do you know if there is a way they can stitch it up without doing surgery ?? I've read a couple of articles about them going through the esophagus to repair small fistula's.

Any help would be appreciated.
Thanks,
Paula


I had my fistula repaired a week ago & they did have to do it surgically. I was so stuck together though that they ended up removing most of the old stomach & they had to trim down the pouch to remove the damaged tissue. I had a great deal of scar tissue as well & my surgeon said that he basically redid the GB by the time he was done in there. If your Dr. is mentioning the amount of scar tissue you have, it doesn't seem likely to have it fixed through the esophagus. I do hope that's an option for you.

RNY Bypass: March 2007
Gallbladder removal: February 2008
Fistula repair & removal of most of the old stomach: December 2008

Multiple complications

J (feeding) tube surgically placed: January 2013
Always a work in process :cool:


I will not let my past mistakes define who I am!


#5 hotdrama

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Posted 19 December 2008 - 07:49 AM

i have not seen any of your post since the surgery. I am having the same kind of surgery. I too have a fistula. Could you please share your experiences with me after the corrective surgery. That way I don't have to be so fearful as to what to expect. I had WLS surgery 8/02 and lost a 100lbs. I did not know what was wrong with me until the doctor did a upper GI. I then learned that I have a fistula. I am waiting on the insurance company to approve the surgery. Let's hope the for the best in Jan 09.


Hi,
I had the gastric bypass in 1997 and initially lost 88 lbs. Then I started throwing up blood and didn't have a full sensation. They did an upper GI which showed a small leak from my pouch to my stapled away stomach. I couldn't find a surgeon to repair it because they didn't take our insurance. The one surgeon that could have done it wouldn't because I had eaten a minature reese cup (yep)...

Anyway I was told by my G.I. Doctor that it had healed itself. I've never been below 170 and my weight goes up and down like a yo yo. I've gained more weight this year so my new doctor did an upper GI today and I still have a fistula. I haven't spoken with him yet and don't see him until next tuesday. I know he had told me I could not have the whole GB surgery done over because of all the scar tissue I have.

Anyway has anyone had a problem with a fistula and if so do you know if there is a way they can stitch it up without doing surgery ?? I've read a couple of articles about them going through the esophagus to repair small fistula's.

Any help would be appreciated.
Thanks,
Paula



#6 hotdrama

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Posted 20 December 2008 - 05:13 AM

Hey,

Are you ok? I have been watching for your post. talk to me I'm listening.


I had my fistula repaired a week ago & they did have to do it surgically. I was so stuck together though that they ended up removing most of the old stomach & they had to trim down the pouch to remove the damaged tissue. I had a great deal of scar tissue as well & my surgeon said that he basically redid the GB by the time he was done in there. If your Dr. is mentioning the amount of scar tissue you have, it doesn't seem likely to have it fixed through the esophagus. I do hope that's an option for you.



#7 dolphin12969

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  • Surgery Type:Gastric Bypass

Posted 20 December 2008 - 06:24 PM

My staples are all out & I am healing. I forgot what a slow process it is. Feeling pretty good one day & hurting like hell the next. It's weird starting all over.

RNY Bypass: March 2007
Gallbladder removal: February 2008
Fistula repair & removal of most of the old stomach: December 2008

Multiple complications

J (feeding) tube surgically placed: January 2013
Always a work in process :cool:


I will not let my past mistakes define who I am!


#8 hotdrama

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Posted 20 December 2008 - 06:57 PM

do you mean that it is just like the first time? Is better now that you know what to expect?

My staples are all out & I am healing. I forgot what a slow process it is. Feeling pretty good one day & hurting like hell the next. It's weird starting all over.



#9 dolphin12969

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  • Surgery Date:March 2007
  • Surgery Type:Gastric Bypass

Posted 20 December 2008 - 07:02 PM

Even knowing what to expect, it's hard starting over. They fast tracked my diet progression so that I don't lose too much more. I'm already upgraded to lean protien & I was just in surgery on Dec 8th. I'm struggling though. A lot of pain with eating so I'm back on mushy protiens today (only so much you can do with an egg). I guess I really forgot the emotional part of this. What a roller coaster!

RNY Bypass: March 2007
Gallbladder removal: February 2008
Fistula repair & removal of most of the old stomach: December 2008

Multiple complications

J (feeding) tube surgically placed: January 2013
Always a work in process :cool:


I will not let my past mistakes define who I am!


#10 hotdrama

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Posted 20 December 2008 - 07:26 PM

I gained most of my weight that I lost back. The doctor said that it would be like having a whole new WLS.


Even knowing what to expect, it's hard starting over. They fast tracked my diet progression so that I don't lose too much more. I'm already upgraded to lean protien & I was just in surgery on Dec 8th. I'm struggling though. A lot of pain with eating so I'm back on mushy protiens today (only so much you can do with an egg). I guess I really forgot the emotional part of this. What a roller coaster!



#11 dolphin12969

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  • Surgery Type:Gastric Bypass

Posted 20 December 2008 - 07:40 PM

Yeah, my Dr. said that he basically re-did the bypass while he was pulling everything apart for the fistula repair. Hadn't re-gained any weight in spite of the fistula. I had relaxed my eating though. I mean I was still watching everything & making sure I got all my protien, but I could eat more than 1/2 an egg. Now it's weird going backwards.

RNY Bypass: March 2007
Gallbladder removal: February 2008
Fistula repair & removal of most of the old stomach: December 2008

Multiple complications

J (feeding) tube surgically placed: January 2013
Always a work in process :cool:


I will not let my past mistakes define who I am!


#12 TexasSportzFan

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Posted 03 January 2009 - 08:40 PM

Hello, new here but wanted to share my "fistulas" story. I'm 5 1/2 years out from my GBP. I lost a total of 120 lbs however, at about 15 months out I started gaining weight - went to the Dr and found I had 2 fistulas. I had them repaired by the surgeon inserting mesh between the pouch and the remnant stomach. Lost the gained weight. I never had any pain but the weight gain was a clue something might be wrong.

Fast forward to 5 plus years and I started having a 'burning' sensation similar to what ulcer patients say they have. After an endoscopy they found another 2 fistula's.

One of the Dr's where I go described a fistula as:

"A gastro-gastric fistula is simply a communication between the
new "pouch" and the "old" stomach.

"When we separate the pouch from the stomach we staple and then cut
the two parts of the stomach so they are "separate". We do not remove
the old stomach but rather "separate" it from the pouch. That being
said the distance of separation is only a few centimeters (ie. less
than an inch).

"In MY OPINION a fistula can occur: 1) Most commonly when an ulcer
develops in the pouch and works its way into the old stomach, 2) if
the stomach was not completely divided (much less common!), 3) if an
obstuction of the pouch occurs and the pressure gradient pushes the
contents of the pouch into the old stomach 4) if a leak occurs from
the pouch and works its way to the old stomach.

This time I am told that the reason for the burning sensation is that the acid from the remnant stomach is coming up into the pouch through the fistula's and is going out the small intesting that is attached to the pouch...and the intestine does NOT like it!

My options here, 1) to leave it as is and 'deal with the pain' or 2) have the fistula's closed again. This time they will remove part of the remnant stomach leaving at least a 2 inch gap between the pouch and remnant stomach. This gap should not allow another fistula to occur. My only concerns here are that my pouch will 'try again' to heal itself. Without the remnant stomach being right next to it I'm worried my 'peas and carrots' will be floating in my body cavity!! Decisions, decisions!

I know that my pouch still works and doesn't allow me to eat excessive amounts of food. My reasoning for weight gain this time - I went back to old habits.

Anyway, I just wanted to share my experience with fistula's.

Take care!

#13 dolphin12969

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Posted 09 January 2009 - 03:31 PM

CCaspurr & hotdrama - haven't heard anything from either of you. Have you heard any more about getting your fistula's repaired? Are you doing ok?

TexasSportzFan - How are you doing? Have you gotten any info on getting your fistula repaired?

RNY Bypass: March 2007
Gallbladder removal: February 2008
Fistula repair & removal of most of the old stomach: December 2008

Multiple complications

J (feeding) tube surgically placed: January 2013
Always a work in process :cool:


I will not let my past mistakes define who I am!


#14 hotdrama

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Posted 09 January 2009 - 03:37 PM

You bet,

I had to see the head doctor and the bar-nurse. I saw the head doctor yesterday and the nurse today. I was told that I was a great candidate for the surgery and my paperwork was going to be sent to the insurance company.

How are you? anything different than the first that you see.

CCaspurr & hotdrama - haven't heard anything from either of you. Have you heard any more about getting your fistula's repaired? Are you doing ok?

TexasSportzFan - How are you doing? Have you gotten any info on getting your fistula repaired?



#15 dolphin12969

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Posted 09 January 2009 - 03:44 PM

You bet,

I had to see the head doctor and the bar-nurse. I saw the head doctor yesterday and the nurse today. I was told that I was a great candidate for the surgery and my paperwork was going to be sent to the insurance company.

How are you? anything different than the first that you see.


I'm doing much better. I went back to work 1/2 days this week, still pretty tired & a bit sore, but doing ok. Hope the insurance doesnt slow you down, it's better to just get it done.

RNY Bypass: March 2007
Gallbladder removal: February 2008
Fistula repair & removal of most of the old stomach: December 2008

Multiple complications

J (feeding) tube surgically placed: January 2013
Always a work in process :cool:


I will not let my past mistakes define who I am!


#16 jeepdogs

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Posted 03 February 2009 - 06:38 PM

I am thinking I may have a fistula. I had my Roux-en-Y in August 2005. I had my gallbladder removed in November 2008. Ever since the gallbladder removal I have been experiencing what now seems like a fistula based on what I read above. My family doctor hasn't been able to figure it out and I will have an Upper GI in a couple weeks. I will call the GI tomorrow to mention the fistula to him as I didn't know what it was until tonight. I am also going to have him measure my pouch, etc to see if I might be a candidate for StomaphyX although I have only gained 20-30 pounds back since basically February 2006 when I plateaued.

The pain I am experiencing occurs at any time but there is no consistency to it. It only last a couple minutes at the most and goes away if I walk around. It usually wakes me up out of bed but it will also happen when I am sitting at my desk at work. It starts out sort of like the feeling you get when you are hungry but then it spreads across my abdomen (basically following the incisions from both surgeries). To me it is worse than the pain I experienced with the gallstones as well as the numerous kidney stones I have had. Does that sound like a fistula?

#17 MiladyB

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Posted 03 February 2009 - 07:23 PM

Fistulas in and of themselves usually aren't painful. The pain comes from the ulcers that can cause the fistula to form. An upper GI won't tell you if you have an ulcer but it would show a fistula. It sounds like a scope might not be a bad idea.

Another thought is what I recently experienced. I had my gallbladder out in June '08. In Aug. '08 I started getting intermittent pain. It was very much like my gallbladder pain. An ultrasound showed that my common bile duct was enlarged. The concern was that I still had gallstones and sludge in my bile system. That occasionally occurs after your gallbladder has been removed. For me they didn't find any gallstones or sludge but I had a stricture in my bile system that was causing bile to back up. If you haven't had your liver enzymes checked I would suggest that you do. See if they are elevated at all. Also an abdominal ultrasound would show if your bile duct is enlarged at all.

I hope you find some answers.

Edited by MiladyB, 03 February 2009 - 07:27 PM.

~Beth~

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PS Revisions: 04/29/08-Dr Ronald Ford
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Sclerotherapy: 06/09/2011-Dr Randal Baker

#18 jeepdogs

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Posted 03 February 2009 - 08:00 PM

Since the gallbladder removal I have had x-rays, CT scan and blood work and everything is normal so the Upper GI was next on the list.

#19 MiladyB

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Posted 03 February 2009 - 08:17 PM

Since the gallbladder removal I have had x-rays, CT scan and blood work and everything is normal so the Upper GI was next on the list.



Have you had an abdominal ultrasound? The pain I was having was intermittent. Sometimes it lasted minutes, other times hours. It progressively started lasting longer. It was a sharp, tight pain in my upper abdomen, just under my sternum. It wasn't related to eating and at times woke me from a sound sleep.

Ulcers and internal hernias could also cause pain. An upper GI may catch an internal hernia but you would need a scope to find an ulcer.

Hope you get some answers to your pain.
~Beth~

Lap RNY: 1/30/06-Dr Randal Baker
TT/BL: 09/21/07-Dr Ronald Ford
PS Revisions: 04/29/08-Dr Ronald Ford
Gallbladder: 05/14/08-Dr Randal Baker
Emergency surgery (Intussusception): 02/29/09-Dr James Foote
Exploratory Lap: 03/16/2011-Dr Randal Baker
Sclerotherapy: 06/09/2011-Dr Randal Baker

#20 jeepdogs

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Posted 04 February 2009 - 02:50 AM

The only ultrasound that I had was the one that found the gallstones. The upper GI is on the 16th so we'll see what they come up with. I was having the pain almost once or twice a day and right now, I have only had it once in the past two weeks or so.