Revision from Vertical Sleeve to RNY

[Double.Bariatric.Babe]

Good day everyone,

I am new here, but not new to bariatric surgery. I first had VSG surgery 8/2016. I went from 342 to 268 and I was quite happy to have my mobility back. Around 2018 I started developing an intense burning sensation in my stomach. This would occur in the morning while I was fasting. One day the pain was so severe I ended up calling my bariatric surgeon's office to see if I could get a recommendation for a good GI specialist in the area. Instead, my surgeon did an endoscopy and told me I had developed Bile Reflux. I hadn't a clue of what that was and figured it could be controlled with medicine, but that wasn't the case. The issue is that the sphincter muscle at that bottom of your stomach malfunctions and opens up when it should not, thus the bile will back up into the stomach instead of being routed to your intestinal track (like it should). Bile is actually very corrosive to your stomach lining, which is what caused the burning sensation in my stomach pouch and eventually caused the ulcers a year later. I was very stubborn and put off having the revision done until I couldn't handle the pain any longer.

Bile Reflux is something that can develop in a small amount of VSG patients a few years out from their surgery. Not to scare anyone, but if you are considering VSG surgery please look into this disorder. I was not warned about it and I had no idea this could happen to me. I had chosen the VSG procedure because I was told it was the safest option out everything they could do. Prior to surgery I had read that the worst that could happen is to develop GERD. That never was an issue before or after VSG surgery. I never got heartburn after eating food. GERD and Bile Reflux are actually very different where as GERD can be treated with medicine and a diet modification most times and BR cannot be treated without a revision surgery. The biggest thing I am dealing with right now is the regret of even having bariatric surgery all together. I had the revision RNY procedure done on 3/10/20 and I've had nothing but complications and set-backs. This particular surgery has been a hell of a lot harder to recover from than the VSG procedure. The only difference is that with this procedure I have a lot more energy. By day 5 post op I was able to walk a mile outside, by day 7 I was able to walk 3 miles. Today I keep it between 3-4 miles. Walking hurt like hell but sitting around hurt way more.

On April 3rd I ended having a dilation and internal staple removed because everything I was putting into my mouth caused so much pain when it tried to flow down. The opening was at 2 mm which is incredibly tiny. It's no wonder everything got stuck. Fortunately my bariatric surgeon was able to dilate me to 1 cm. Since then I have taken a step back and been placed back on the dreaded soft foods diet. Now the issues I deal with are constipation despite averaging 100 oz of water daily. I drink water from the moment I get up to the moment I lay down. I know what happens if you don't take your water consumption seriously. Today I have my first Telemedicine appointment set up with the Bariatric office and I am hoping they can help me find some relief. Currently I take 3 stool softeners a day, 3 Benefiber tablets in addition to all my vitamins. I just started incorporating Miralax a few weeks ago which doesn't seem to get anything flowing. Yesterday was probably the worst day for me. It was my birthday on Easter and I spent it curled up in a ball dealing with nausea and stomach cramping. TMI, hadn't gone to the bathroom in 5 days. I was never one to get constipated and it NEVER happened to me when I had the first bariatric surgery.

I'm so incredibly frustrated and want my digestive system flowing again. The sort of things I eat are all dairy based which is probably what is causing all the issues. Normally I didn't have issues with dairy, but then again I ate a combination diet. I loved veggies. I would make pureed soups and sprinkle bits of blue cheese on top. Now I'm terrified of going near anything with carbs since I had my first dumping syndrome towards thinned out pinto beans. Hoping relief comes soon. Thank you for providing a platform to discuss and vent. I've seen nothing but great conversations on this page.

 

[The BLJ]

Hi Babe - Welcome. Thank you for letting me know about Bile Reflux I just had my VSG 8 weeks ago. One question did you ever drink alcohol or smoke post op in the 2 years after surgery? Have you tried probiotics? They have helped a whole lot for the bathroom issue.

 

[Double.Bariatric.Babe]

Hi Babe - Welcome. Thank you for letting me know about Bile Reflux I just had my VSG 8 weeks ago. One question did you ever drink alcohol or smoke post op in the 2 years after surgery? Have you tried probiotics? They have helped a whole lot for the bathroom issue.

Hi BLJ -Post op VSG I didn't drink and I am not a smoker. I ate a variety of foods and did all I should have done and the BR developed regardless. I ended up seeking out a 2nd opinion a month before my surgery because I didn't want to do this again. The Gastroenterologist was not hopeful it could be cured on it's own due to the ulcers I had developed. He warned that it could eventually start affecting my esophagus. That is what ultimately made me go through with the revision. Currently I've been on probiotics since week two post op of the RNY revision. I started incorporating them with my vitamin regimen but it does not help much right now. Thank you for the suggestion.

 

[eladams2015]

Good day everyone,

I am new here, but not new to bariatric surgery. I first had VSG surgery 8/2016. I went from 342 to 268 and I was quite happy to have my mobility back. Around 2018 I started developing an intense burning sensation in my stomach. This would occur in the morning while I was fasting. One day the pain was so severe I ended up calling my bariatric surgeon's office to see if I could get a recommendation for a good GI specialist in the area. Instead, my surgeon did an endoscopy and told me I had developed Bile Reflux. I hadn't a clue of what that was and figured it could be controlled with medicine, but that wasn't the case. The issue is that the sphincter muscle at that bottom of your stomach malfunctions and opens up when it should not, thus the bile will back up into the stomach instead of being routed to your intestinal track (like it should). Bile is actually very corrosive to your stomach lining, which is what caused the burning sensation in my stomach pouch and eventually caused the ulcers a year later. I was very stubborn and put off having the revision done until I couldn't handle the pain any longer.

Bile Reflux is something that can develop in a small amount of VSG patients a few years out from their surgery. Not to scare anyone, but if you are considering VSG surgery please look into this disorder. I was not warned about it and I had no idea this could happen to me. I had chosen the VSG procedure because I was told it was the safest option out everything they could do. Prior to surgery I had read that the worst that could happen is to develop GERD. That never was an issue before or after VSG surgery. I never got heartburn after eating food. GERD and Bile Reflux are actually very different where as GERD can be treated with medicine and a diet modification most times and BR cannot be treated without a revision surgery. The biggest thing I am dealing with right now is the regret of even having bariatric surgery all together. I had the revision RNY procedure done on 3/10/20 and I've had nothing but complications and set-backs. This particular surgery has been a hell of a lot harder to recover from than the VSG procedure. The only difference is that with this procedure I have a lot more energy. By day 5 post op I was able to walk a mile outside, by day 7 I was able to walk 3 miles. Today I keep it between 3-4 miles. Walking hurt like hell but sitting around hurt way more.

On April 3rd I ended having a dilation and internal staple removed because everything I was putting into my mouth caused so much pain when it tried to flow down. The opening was at 2 mm which is incredibly tiny. It's no wonder everything got stuck. Fortunately my bariatric surgeon was able to dilate me to 1 cm. Since then I have taken a step back and been placed back on the dreaded soft foods diet. Now the issues I deal with are constipation despite averaging 100 oz of water daily. I drink water from the moment I get up to the moment I lay down. I know what happens if you don't take your water consumption seriously. Today I have my first Telemedicine appointment set up with the Bariatric office and I am hoping they can help me find some relief. Currently I take 3 stool softeners a day, 3 Benefiber tablets in addition to all my vitamins. I just started incorporating Miralax a few weeks ago which doesn't seem to get anything flowing. Yesterday was probably the worst day for me. It was my birthday on Easter and I spent it curled up in a ball dealing with nausea and stomach cramping. TMI, hadn't gone to the bathroom in 5 days. I was never one to get constipated and it NEVER happened to me when I had the first bariatric surgery.

I'm so incredibly frustrated and want my digestive system flowing again. The sort of things I eat are all dairy based which is probably what is causing all the issues. Normally I didn't have issues with dairy, but then again I ate a combination diet. I loved veggies. I would make pureed soups and sprinkle bits of blue cheese on top. Now I'm terrified of going near anything with carbs since I had my first dumping syndrome towards thinned out pinto beans. Hoping relief comes soon. Thank you for providing a platform to discuss and vent. I've seen nothing but great conversations on this page.

I had to revise from sleeve for this exact same reason - I wish that surgeons were more up front about the risks of reflux with VSG. I was already revising from a lapband because of consistent overfilling by a bad surgeon group; and I was going to a new group that was very very highly respected and recommended in the area we lived in at the time. I thought I had asked all the questions, but I didn't know what I didn't know, despite having done quite a bit of research. I would have loved to not do a 3rd surgery, but it was essential. I am very very happy with the bypass, and I would have likely gone directly to bypass had I known the risk of reflux, and what reflux can do to your body. I always tell people that are looking at sleeve to do more research and ask more questions before going that route.

 

[DawnaRose]

I'm glad I'm reading all this. I'm new to the site; just had a consult with the bariatric surgeon through the weight loss clinic. I have gerd stage 3 now. I've had it for over a year and have had 2 esophageal widenings. They wanted to put a ring in my stomach to stop any more damage, despite the medicine. I was opting at most for the sleeve surgery but he strongly cautioned that only the full bypass will help me. It was the first thing he said about the sleeve surgery and said the bypass would not only clear up the gerd but also the fatty liver I have.

I'm hoping the complications I'm reading about aren't outweighing the benefits.

 

[eladams2015]

I'm glad I'm reading all this. I'm new to the site; just had a consult with the bariatric surgeon through the weight loss clinic. I have gerd stage 3 now. I've had it for over a year and have had 2 esophageal widenings. They wanted to put a ring in my stomach to stop any more damage, despite the medicine. I was opting at most for the sleeve surgery but he strongly cautioned that only the full bypass will help me. It was the first thing he said about the sleeve surgery and said the bypass would not only clear up the gerd but also the fatty liver I have.

I'm hoping the complications I'm reading about aren't outweighing the benefits.
[/QUO

Dawna - sounds like you have a good surgeon that is giving you honest info. You don't want to go down the road of VSG if you already have such severe GERD.

 

[Double.Bariatric.Babe]

I had to revise from sleeve for this exact same reason - I wish that surgeons were more up front about the risks of reflux with VSG. I was already revising from a lapband because of consistent overfilling by a bad surgeon group; and I was going to a new group that was very very highly respected and recommended in the area we lived in at the time. I thought I had asked all the questions, but I didn't know what I didn't know, despite having done quite a bit of research. I would have loved to not do a 3rd surgery, but it was essential. I am very very happy with the bypass, and I would have likely gone directly to bypass had I known the risk of reflux, and what reflux can do to your body. I always tell people that are looking at sleeve to do more research and ask more questions before going that route.

That is an excellent way to put it, "I didn't know what I didn't know". I am so glad you got it sorted out despite having to go through this whole ordeal 3x. I've advised my friends to do the same thing. They've seen all I have gone through and the ones who were considering bariatric surgery are leaning toward the RNY side now. How are you doing now? Have all of your issues been resolved that were present after the other surgeries? I am hoping I can transition to a cleaner way of eating soon. I miss vegetables a lot and oatmeal.

 

[Double.Bariatric.Babe]

I'm glad I'm reading all this. I'm new to the site; just had a consult with the bariatric surgeon through the weight loss clinic. I have gerd stage 3 now. I've had it for over a year and have had 2 esophageal widenings. They wanted to put a ring in my stomach to stop any more damage, despite the medicine. I was opting at most for the sleeve surgery but he strongly cautioned that only the full bypass will help me. It was the first thing he said about the sleeve surgery and said the bypass would not only clear up the gerd but also the fatty liver I have.

I'm hoping the complications I'm reading about aren't outweighing the benefits.

I am so sorry to hear about all the issues you are having with GERD. That is such awful thing to put up with. My father has it and he's so fit. Ex marine, does his daily PT, drinks water, loves salads but he battles with his acid reflux issues. I'm glad you are doing your research and have a solid doctor that told you up front that VSG wouldn't cure that specific issue. My brother also had VSG surgery after I did and he developed GERD and is in process of getting a revision set up.

 

[3momchaos]

I had to revise from sleeve for this exact same reason - I wish that surgeons were more up front about the risks of reflux with VSG. I was already revising from a lapband because of consistent overfilling by a bad surgeon group; and I was going to a new group that was very very highly respected and recommended in the area we lived in at the time. I thought I had asked all the questions, but I didn't know what I didn't know, despite having done quite a bit of research. I would have loved to not do a 3rd surgery, but it was essential. I am very very happy with the bypass, and I would have likely gone directly to bypass had I known the risk of reflux, and what reflux can do to your body. I always tell people that are looking at sleeve to do more research and ask more questions before going that route.

I have been dealing with reflux issues for a while off and on but my mom and sister have GERD. That’s one of the reasons why I have decided to have bypass over sleeve. I don’t want to have to go back in for revision knowing what I know. I talk to the surgeon soon, so hopefully he’ll be accepting of my reasons for bypass.

 

[eladams2015]

That is an excellent way to put it, "I didn't know what I didn't know". I am so glad you got it sorted out despite having to go through this whole ordeal 3x. I've advised my friends to do the same thing. They've seen all I have gone through and the ones who were considering bariatric surgery are leaning toward the RNY side now. How are you doing now? Have all of your issues been resolved that were present after the other surgeries? I am hoping I can transition to a cleaner way of eating soon. I miss vegetables a lot and oatmeal.

I am doing GREAT now!! Not ANY episodes of GERD since the bypass (Aug 2019) - even when I eat super spicy foods! I have lost 163 pounds total - from a tight size 22/24 to a size 4 jeans almost being too big now. I was 308 pounds and now I am 145... I don't know that I have a specific weight goal right now for myself (I already met the surgeon's goal), just want to be and feel healthy.

 

[Bill S.]

Ever since I had the bypass I haven’t had Gerd either . Feels good to eat the things that used to make me sick

 

[3momchaos]

I am doing GREAT now!! Not ANY episodes of GERD since the bypass (Aug 2019) - even when I eat super spicy foods! I have lost 163 pounds total - from a tight size 22/24 to a size 4 jeans almost being too big now. I was 308 pounds and now I am 145... I don't know that I have a specific weight goal right now for myself (I already met the surgeon's goal), just want to be and feel healthy.

Just out of curiosity, how tall are you?

 

[eladams2015]

Just out of curiosity, how tall are you?

5'6"

 

[WWWindy]

You are all giving me so much hope! Thank you for sharing.

I've had GERD for many years. I take two kinds of PPI (proton pump inhibitor) twice a day, an acid suppressor once a day and an anti-spasmodic four times a day. I've gone through the H.Pylori treatment and have had my esophagus and upper stomach sphincter injected with Botox twice. My esophagus has been dilated three times and I've had any number of tests and procedures. My hospital knows me by site now. lol.... I have finally found a really competent GI and bariatric surgeon. They've had me jump through lots of hoops in order to qualify for RNY but I'm finally there. Whew!

Your sharing has given me hope that my condition, although under complete control now, will really be a thing of the past once I have RNY. Thank you, thank you, thank you.

I will miss the Peppermint Patties. When I would start spitting up stomach acid/bile, those were the only things that would settle my stomach. hahaha