Stricture question

on 9/11/17 10:53 am, edited 9/11/17 11:24 am
RNY on 07/27/17

so I had a stricture at 3.5 weeks out. I got it dilated, all was good. It's been slightly more challenging to eat food in the last two weeks (I'm 6.5 weeks out now) but liquids still go down fine as long as my swallows aren't too huge.

When I saw my gastroenterologist last Thursday, he said that my stricture was "really tight" and he was only able to dilate it to 9mm. He said they usually tighten up again by a mm or two, so he assumes I'm at 7-8mm now. He said he would ideally like me at 10-12mm, and would like to dilate me again in the next two weeks.

I was reading some studies that suggested that weight regain correlates with the increased size of the stoma. So my question is: should I be dilated again? Should I just be happy I have a tight stoma and adapt accordingly? Anyone have experience with this?

on 9/11/17 11:13 am
RNY on 05/09/17

Personal opinion? YES! Get that sucker dilated again!

When it's unhealthy small like yours is, it gets easily agitated and will continue to ulcerate and create scar tissue. Meaning it will continue to get tighter! When it gets tighter and tighter you won't be able to get your protein in, you won't be able to get your vitimins down, you won't be able to take in fluids. It will be heeeell. Seriously. I ignored my stricture till I landed in the ER because I was unable to even keep down water without throwing it up immediately. I was then in the hospital for a total of three weeks because I had gotten so malnourished and dehydrated. The most miserable I had ever felt in my entire life. I was genuinely depressed- to the point that my surgeon made me meet with a counselor. Yup.

Please, please consider trusting your surgeon and getting it stretched further. It will shrink up again a little after you get it stretched anyway.

As for increased hunger and a stretched stoma. Maybe? I am able to eat more than before. But as a wls'er we shouldn't be eating so much by feeling. You need to measure and weigh your food. Stop eating when you're out of that food or when you feel satisfied (not full), whichever comes first. If you do this, your stoma size shouldn't matter as much.

I know this is a long post, but I'm really passionate about it. When I had my strictures I was miserable. I cried and cried and really regretted this surgery (thankful for it again). Even now I still have a lot of anxiety that my stricture is coming back. I would hate for you to ignore the problem like I did and then experience the same agony and depression. Best of luck!

on 9/11/17 11:54 am
RNY on 07/27/17

Thank you for taking the time for such a long answer! I really do appreciate it. I guess I'm just so scared of this not working that I wasn't really thinking through all the consequences of not having the procedure done.

I've called for the appointment. Just waiting for them to call me back.

on 9/11/17 12:36 pm
RNY on 05/09/17

I understand. There is a dark appeal to having a structure initially. I lost a ridiculous amount of weight very quickly because of mine. But it wasn't healthy, and honestly I probably lost a fair amount of muscle with it . But it's just not a sustainable way to lose weight and really will hurt you long run.

on 9/11/17 1:24 pm
RNY on 07/27/17

Oh, forgot to say--there's no WAY I could eat over my allotted amount! My surgeon makes her pouches small to start with. I can get in maybe an ounce of dense protein at lunch, then maybe a couple of bites when I get home from work. I'm focusing on liquid protein because I can eat maybe 10-ish grams over the day (we're only supposed to eat once or twice a day). Otherwise I'm just too full. It takes literally hours for my stomach to empty again.

Grim Traveller
on 9/11/17 12:24 pm
RNY on 08/21/12

I can't say if you need another dilation or not. But, most people seem to need 2 or even three treatments before it's the size it should be. It sounds like your surgeon is on top of this.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

on 9/11/17 9:53 pm

Yes, you should get it done. I know it's a headache but you will be happier in the end. You will be able to eat and drink more (good stuff). You will have less of a chance of getting dehydrated...It will prevent you from losing too much muscle mass. Also try not to get depressed if you have to go back for a third one. I know there will be a lot of "what have I gotten myself into" type of feeling...I know you feel it now. But later when the stricture is fully taken care of, you'll be glad it is over and done with. I had to go home with a catheter...Talk about fun!! Talk about second guessing myself. But it was taken out...About 10 days later and I had my freedom back. So hang in there...Brian