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Fistula - Leak from my small pouch to old stomach


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#1 CCaspurr

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Posted 07 November 2008 - 03:31 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.

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 - 05:20 PM.


#2 lealphachienne

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Posted 08 November 2008 - 08:57 AM

Only a surgeon can tell you how to fix it and with which procedure is best.
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#3 CCaspurr

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Posted 08 November 2008 - 09:00 AM

Thanks ! I meet with him Tuesday and in the mean time I'm so nervous.
I'm so hoping they can fix it without doing a total revision. Then there's the insurance to deal with.

#4 hotdrama

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Posted 26 November 2008 - 11:10 AM

Today, I went to the doctor and was told I too have fistula. They did the upper GI and Endoscope and have made the diagnosis. I was told by my doctor that a completely new bypass is needed. I have read articles on other corrections. The doctor stated that he has never seen my adnormal connection before.

--------------------------------------------------------------------------------

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.

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



#5 Phoenixfire

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Posted 26 November 2008 - 06:52 PM

As a fistula is a complication that faces us all, can I ask what the surgeon said? I'm so sorry you are facing this, but I'm glad you came here. We can learn a lot from others' experiences!

I haven't had a fistula but being a long-timer from surgery it's one of those things that could happen to anyone I figure.

What did the surgeon say? Hope you'll come back and continue to post both for support and to share your experience. Again, I'm sorry. It must be scary and disheartening. I can only imagine :eek:


Open Roux-en-Y on October, 2002 - 7 year anniversary is right around the corner
Height: 5'8"
Highest weight: 300 lbs. with a BMI of 45.6 :eek:
Current weight: 140-145 lbs. and a size 6/8 with a BMI of 21.7 :D
Total weight lost after Roux-en-Y gastric bypass: 160 lbs. POUNDS!

#6 hotdrama

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Posted 26 November 2008 - 08:32 PM

The doctor told me that they had never seen the condition that mine is. I have two opening to the stomach. An food enters throught the fistula and my stomach which is completely intact. The previous doctor has gone out of business (WishCenter) and moved to another state. I lost 100lb and have gained 45 of them back. My new doctor told me that I would have to have the gastric bypass redone completely to correct the adnormal connection.

As a fistula is a complication that faces us all, can I ask what the surgeon said? I'm so sorry you are facing this, but I'm glad you came here. We can learn a lot from others' experiences!

I haven't had a fistula but being a long-timer from surgery it's one of those things that could happen to anyone I figure.

What did the surgeon say? Hope you'll come back and continue to post both for support and to share your experience. Again, I'm sorry. It must be scary and disheartening. I can only imagine :eek:



#7 hotdrama

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Posted 26 November 2008 - 08:36 PM

I have the surgery in 2002. I was not ill. I went to talk to the doctor because I was gaining weight. He referring to the hospital's lifestyle (obesity) clinic. After returning to a low fat diet I still was not losing weight. The doctor suggested that we take a look at my bypass to see if it was still intact. That is when they found that the surgery was done incorrectly.

Today, I went to the doctor and was told I too have fistula. They did the upper GI and Endoscope and have made the diagnosis. I was told by my doctor that a completely new bypass is needed. I have read articles on other corrections. The doctor stated that he has never seen my adnormal connection before.



#8 MiladyB

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Posted 27 November 2008 - 07:08 AM

Fistulas are something that can happen to anyone after a RNY. The signs of one usually are weight gain, loss of that full feeling and throwing up bile when you throw up.

The most common cause of a fistula is from an ulcer in your new pouch. As the ulcer gets worse the wall of your pouch kind of begins to bulge. and weakens the wall of your new pouch. It forms a new channel over to your stapled off original stomach. So basicly when you eat the food goes into your new pouch and your original stomach.

I've taken care of several patients on the bariatric unit that have developed fistulas years after their initial surgery. The course of treatment that the surgeons on my bariatric unit use is a revision of the pouch. They go back in and close off that channel and revise the pouch.

There may be new techniques out there but this is the only course of treatment that I have seen.

Edited by MiladyB, 28 November 2008 - 11:05 AM.

~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
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#9 hotdrama

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Posted 27 November 2008 - 08:01 AM

What you are saying is correct. But I have something different. they said that I do not have a bypass and my stomach is intact and there is also another opening that my food empties into and I will need a complete new gastric bypass.

Fistulas are something that can happen to anyone after a RNY. The signs of one usually are weight gain, loss of that full feeling and throwing up bile when you throw up.

The most common cause of a fistula is from an ulcer in your new pouch. As the ulcer gets worse the wall of your pouch kind of begins to buldge. It forms a new channel over to your stapled off original stomach. So basicly when you eat the food goes into your new pouch and your original stomach.

I've taken care of several patients on the bariatric unit that have developed fistulas years after their initial surgery. The course of treatment that the surgeons on my bariatric unit use is a revision of the pouch. They go back in and close off that channel and revise the pouch.

There may be new techniques out there but this is the only course of treatment that I have seen.



#10 Phoenixfire

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Posted 27 November 2008 - 12:56 PM

The most common cause of a fistula is from an ulcer in your new pouch.


Your experience is very valued here! :D

Hot drama or Beth, Can you tell us what the causes are for ulcers in bypass patients? NSAIDS are a big cause right? What are others? Did your surgeon know Hotdrama?

I hope this isn't a thread hijack...I just think it's important for us all to know long-term potential complications. I worry about this. I have one complication I think: bone density compromise. I want to avoid others!


Open Roux-en-Y on October, 2002 - 7 year anniversary is right around the corner
Height: 5'8"
Highest weight: 300 lbs. with a BMI of 45.6 :eek:
Current weight: 140-145 lbs. and a size 6/8 with a BMI of 21.7 :D
Total weight lost after Roux-en-Y gastric bypass: 160 lbs. POUNDS!

#11 MiladyB

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Posted 27 November 2008 - 07:54 PM

Your experience is very valued here! :D

Hot drama or Beth, Can you tell us what the causes are for ulcers in bypass patients? NSAIDS are a big cause right? What are others? Did your surgeon know Hotdrama?

I hope this isn't a thread hijack...I just think it's important for us all to know long-term potential complications. I worry about this. I have one complication I think: bone density compromise. I want to avoid others!


Phoenix, anyone who had a RNY has an increased risk of developing an ulcer. Usually the doctors will find what they call marginal ulcers, which are ulcers at the margins of the connections. When someone has a fistula the doctor will usually find an ulcer at the connection where the small intestines is brought up into the new pouch. Which is the reason you usually can't just repair the fistula. The surgeon will usually also have to revise that connection and make a whole new connection. This sounds like what the doctor may be talking about with you, Hotdrama.

The two big things though that can increase that risk of an ulcer are the use of NSAIDs and smoking, Phoenix. Those are the biggest culprits.

Edited by MiladyB, 27 November 2008 - 07:58 PM.

~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

#12 hotdrama

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Posted 28 November 2008 - 04:26 AM

The doctor who did the first surgery is no longer practicing medicine in my state. The clinic in which i had it done has closed. Another doctor at a Northwestern Hospital here in Chicago. Wanted to take a look at my surgery since in had gained back 40lbs. My Surgery was put together wrong. That is what caused the Fistula. It is not always caused by ulcers. It can be that the suture line has a leak.:):)

Your experience is very valued here! :D

Hot drama or Beth, Can you tell us what the causes are for ulcers in bypass patients? NSAIDS are a big cause right? What are others? Did your surgeon know Hotdrama?

I hope this isn't a thread hijack...I just think it's important for us all to know long-term potential complications. I worry about this. I have one complication I think: bone density compromise. I want to avoid others!



#13 CCaspurr

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Posted 28 November 2008 - 10:39 AM

HotDrama,

That is the problem I had too. I had my surgery in 1997 and at 6 weeks I told my surgeon I thought I could eat to much and wasn't feeling full. He just said some people could hold more than others, etc. Needless to say a year later I had a fistula in the suture line between my pouch and stomach and he had stopped doing the surgery. I have gained 40 pounds this year but one my of doctor's had increased the dosagage of SEROQUEL I was on for sleep and I think that was a main reason I was gaining. It's a harsh drug and can cause diabetes and if you are diabetic can cause you blood sugar to sky rocket and it's killed a lot of people. There's actually a class action lawsuit against the Seroquel medication. I took myself off (gradually) of the Seroquel in September.

Anyway I finally have a good Surgeon now and we are going to try diet and exercise first before any revision of the fistula and pouch. He also said I may be elegable for the new ROSE procedure to make my pouch smaller but right now insurance will not cover it. I was 218 the end of september and today I'm 205. I've had a cold this week so I didn't go for Thanksgiving Dinner's and stayed home and they sent a plate home to me. So.. I didn't over indulge.. lol

Hope you will be ok.

P.

#14 hotdrama

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Posted 28 November 2008 - 04:00 PM

Thanks for the information. i am glad that someone understand what i am going through. I thought that i was some freak with her inside put together wrong.


Phoenix, anyone who had a RNY has an increased risk of developing an ulcer. Usually the doctors will find what they call marginal ulcers, which are ulcers at the margins of the connections. When someone has a fistula the doctor will usually find an ulcer at the connection where the small intestines is brought up into the new pouch. Which is the reason you usually can't just repair the fistula. The surgeon will usually also have to revise that connection and make a whole new connection. This sounds like what the doctor may be talking about with you, Hotdrama.

The two big things though that can increase that risk of an ulcer are the use of NSAIDs and smoking, Phoenix. Those are the biggest culprits.



#15 Godsblessedme

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Posted 28 November 2008 - 04:56 PM

wow i thought coffee caused ulcers too? I hope that you both get the corrected procedures, i'm sorry you had to experience this. It really is scary to know something can happen this far out of surgery
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#16 KathyV

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Posted 01 December 2008 - 09:21 AM

My Dr.'s number 1 nono is caffein. He said he sees more of these problems with coffee drinkers. So me being a heavy drinker gave it up about 9 months ago and ya know what? It only took about 2 weeks and I felt like I had more energy then with the coffee. I have heard so many horror stories on tt that it has kept me away from the stuff.
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#17 MiladyB

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Posted 01 December 2008 - 07:02 PM

wow i thought coffee caused ulcers too? I hope that you both get the corrected procedures, i'm sorry you had to experience this. It really is scary to know something can happen this far out of surgery


Alcohol and caffeine do stimulate acid secretion in your stomach, as does decaffeinated coffee. Caffeine also blocks production of prostaglandins, weakening your stomach's cytoprotection. Coffee, decaf and regular, and alcohol can aggravate an existing ulcer but probably won't cause one.

The reason docs suggest limiting caffeine after surgery is because it tends to increase hunger, is known to cause the 'munchies', inhibits calcium absorption and is a diuretic, which will make you more prone to dehydration.

Besides the use of NSAIDs and smoking, the H. pylori bacteria is one of the biggest culprits.
~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

#18 KathyV

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Posted 01 December 2008 - 07:15 PM

I am curious if people would fess up about drinking the coffee or smoking. The ones who have all the problems. I do realize that we can all have problems in time but what does statistics show? Just in this forum how many people who have had the problems drink coffee or smoke? Anyone willing to help with the statistics and let us know? Just curious. Kathy
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#19 hotdrama

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Posted 01 December 2008 - 11:53 PM

Kathy,

I don't have the stats but I do not drink coffee, alcohol or smoke cigarettes or otherwise. So that is not one of the reasone for my situation.

I am curious if people would fess up about drinking the coffee or smoking. The ones who have all the problems. I do realize that we can all have problems in time but what does statistics show? Just in this forum how many people who have had the problems drink coffee or smoke? Anyone willing to help with the statistics and let us know? Just curious. Kathy



#20 MiladyB

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Posted 02 December 2008 - 08:26 AM

Kathy,

I don't have the stats but I do not drink coffee, alcohol or smoke cigarettes or otherwise. So that is not one of the reasone for my situation.


Hotdrama, just curious, have they scoped you at all to check for ulcers? If they haven't scoped you I would think that may be something that is in order. During a scope they can check for the H. pylori bacteria. That is a bacteria that is frequently the cause of ulcers. Its treated with antibiotics. It won't get rid of the fistula but before doing a revision I would think they would want to try to figure out what caused that fistula in the first place and treat it if it was a bacteria.
~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