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Narrowing of the stomach (pyloric stenosis apparently) and stomach stretching

on 4/12/11 7:00 am - Bloomington, IL
So I've been posting the last few months about pain, nausea, vomiting, and such.  They did finally do the CT scan- it was clear.  So the surgeon decided that I didn't need surgery to look for a hernia- not even exploratory surgery.  He decided NOW I needed to have an endoscopy done of my stomach to look for ulcers.  When I had the GI scope done (where they make you drink barium and follow it down through your digestive tract with the xray machines and such) they did note "narrowing of the stomach".  The surgeon said he didn't think that would cause any of my symptoms and dismissed it.  I had my endoscopy yesterday and it was clear but he said he stretched out my stomach where it was narrowing and that I would need to go in several more times to have it done again because it would not stay stretched.

Anyone dealt with this?  I have to admit it was easier to eat and digesting food did not hurt yesterday after the procedure.  The bloating, gas, and crazy diarrhea have also lessened/subsided.  That's some pretty quick results.  I haven't been able to find a whole lot of information on stomach narrowing (which also seems to be called pyloric stenosis) in adults.  Seems to be a common condition in infants but rare occurrence in adults.  So I really have no information to go on as far as how effective this whole stomach stretching is.  Not to mention how it will affect my DS.  I am relieved to have some, well, relief from the pain but I didn't even get asked if I wanted my stomach stretched and have literally no information on what the pros and cons are.  And he wants to do this several more times so I am concerned.

Any thoughts, information, or suggestions would be appreciated. -My Mom blog were I talk about my journey through weight loss & weight loss surgery, my kids, cupcakes, Star Wars & pretty much everything!         
on 4/12/11 7:13 am - bay area, CA
It sounds like you had (have?) a stricture somewhere in your sleeve stomach, which is totally different from pyloric stenosis. This is a relatively common problem after RNY and much less common with the DS, but it does occur.
     Fortunately, it can almost always be treated with dilations, though usually more than one is needed, as they already warned you.

on 4/12/11 7:22 am - Bloomington, IL
A stricture has not been mentioned in any of the lab results or paperwork but I suppose its possible.  The narrowing is apparently in direct relation to the area of the pyloric valve.  Of course I was half out of it with the anesthesia and am mostly going by what my friend said the doctor said and the notes from the hospital at this point!  The surgeons office should be calling today with a follow up appointment date.. maybe.  I don't really have a whole lot of faith in their office after the past 4 months of bull**** to be honest.  Thanks- I will check out the information on strictures! -My Mom blog were I talk about my journey through weight loss & weight loss surgery, my kids, cupcakes, Star Wars & pretty much everything!         
on 4/12/11 7:49 am - bay area, CA

A stricture won't show up on lab results. It's possible that it's near the pyloric valve and that this is causing the confusion, along with some good drugs that you got for the procedure. Hopefully your surgeon will clarify things for you. If still in doubt, keep on pushing and asking questions til he makes things clear. That's part of his job. And make sure you get your info directly from him, and not from the office staff. Again, his job.


Chad M.
on 4/12/11 12:23 pm - Indianapolis, IN
Honestly, I had a similar experience. Coming out of anesthesia from my first scope, I remembered being told about stenosis, and my pylorus, and I remember googling later and finding pyloric stenosis and that it is typically something seen in infants. Turns out it wasn't at all what I had. Talk to your surgeon in a clear state of mind and find out exactly what's going on! That helped me a lot.
Chad M.
on 4/12/11 7:15 am, edited 4/12/11 7:16 am - Indianapolis, IN
It's an unusual, but not unheard of complication for DS'ers. It's more common for other surgery types. Dilation as you received is the treatment of choice and, as I understand it, is usually effective. Multiple treatments are sometimes necessary.

In my case dilation wasn't possible. It was just too narrow, due to scar tissue constricting it, and I had to have a second surgery.

You should talk to your doctor more about your concerns and what the possible risks are, but it sounds like the right way to go to me.
on 4/12/11 7:25 am - Bloomington, IL
Thanks!  I just haven't ever heard of the stomach narrowing like that!  How have you been since you had the second surgery?  Better I hope! -My Mom blog were I talk about my journey through weight loss & weight loss surgery, my kids, cupcakes, Star Wars & pretty much everything!         
Chad M.
on 4/12/11 7:46 am - Indianapolis, IN
Been great ever since then! I had a lot of swelling right after so it took a few weeks to really get better, but the nausea stopped, the vomiting stopped, and I got my life back. Good luck to you!
on 4/12/11 8:05 am, edited 4/12/11 8:07 am - Macon, GA

This sounds like a stricture to me also.  Most on here have heard my story, but here goes.  I went 10 weeks right after surgery where food, vites and most fluids would not stay down.  I ended up with malnutrition issues from this and on TPN for 11 days in the hospital.  When an EGD was done, there was a stricture.  My Dr stretched it and immediately I was able to eat and keep food and it has not stopped since, well I still have what I call "bad food days" where I don't want anything or it just doesn't sit well and may come back, but I think that is par for the course with the DS.

I hope your stretching procedure was enough and now you will be on your way.

Highest 330,    Surgery 297,     Goal 140.     Current 130
First Dr visit - 330 -
BMI 58.4,    Surgery - 297  BMI 52.6
01/24/2011 - 196 BMI 34.7 (ONEderland YEAH!!!),                 ...GeorgiaPink
08/10/2011 Reached GOAL Baby! 140 BMI 24.0                           is my Angel.
- 139 BMI 23.8 One Year Anniversary 
Ms. Cal Culator
on 4/12/11 9:30 am - Tuvalu

My BIL's pyloric valve is lined with scar tissue from ulcers.  Every now and then, he irritates it and it bleeds and then--when it finally clots (because he's on blood thinners, too) the healing process makes the passageway even smaller and sometimes he has to go in and have it all stretched out. 

If he does not have this done, the whole thing closes up and food sits in his stomach and rots...and goes nowhere until they pump it all out.THAT has to smell good.

Anyway, he has the dilation done a couple of times a year I guess and it helps.
on 4/12/11 12:05 pm - Omaha, NE
DS on 05/31/11 with
 I work in the GI dept. and there are different reasons that the pyloris can be narrowed or have stenosis. May or may not be related to surgery. But either way, the way to treat it is to have it dilated or "stretched" as needed. Some people are a couple times of year, others only need to have it done every few years. Initially, though, it usually done more often because they want to make sure to get it opened and don't want to do it too much and cause more damage, and to see long the results remain. 
It is really just about 5 minutes added onto a normal 2 or 3 minute upper endoscopy (or EGD). Sometimes it can take longer if it is narrowed down to nearly closed. 
Basically a small tiny catheter is place through the scope and once the tip is place in the pyloris a small balloon is inflated and stretches the pyloris. The balloon stays inflated for only one minute at a time and can be reinflated a few times. They don't want to fully stretch it at time usually. Depending on why it's stenosed, they don't to cause any rips in the tissue. There are different size's of balloons that gradually get bigger and bigger and each balloon can be filled to 3 different sizes (we are talking measurements in cm's here, not big size difference).
There really isn't anyway to see these clearly without doing an upper GI scope (or Upper endoscopy or EGD -- all are the same thing).
If you have questions about this (or other GI procedures), just ask or pm me!
I'm glad they got you diagnosed!
HW/SW/CW/GW:   294/288/170.2/150  ht: 5'2" (06/03/2012)
Ms. Cal Culator
on 4/12/11 2:03 pm - Tuvalu

Yes...this is NOT a pleasant experience, however...I think I'd rather have my pyloris dilated than my urethra...again.
Jolly Rancher
on 4/12/11 2:54 pm
DS on 05/28/09 with
Sounds like a stricture to me. I had one, and was dilated a good 4-5 times, once even awake. I still deal with food issues, I could probably use another scope. I wouldn't worry about the stretching of your stomach. The reason for multiple scopes, as I understand it, is so they don't push too far the first time, and rip your stomach tissue. That would be WAY worse than having mulitple scopes!!! 

on 4/13/11 5:55 am - Oak Ridge, TN
I had a stricture at 2 months out and had a balloon dilation to have it stretched back out. I've been fine ever since. I haven't had a need for a 2nd stretching at all. I do keep an eye on things though.  I had nausea, vomitted etc for a prolonged period of time also. After the dilation, I was perfectly fine. :)

 ~Kelly ~   
SW 364/CW 164/GW 150