Gastric Fistula?

swimmergirrl
on 2/14/10 1:38 pm - Branford, CT
What are the signs or symptoms of a gastric fistula? 

I am 10 years post op, RNY which as done Laparoscopically. Day one, post-surgery, a fistual was discovered.  I was placed on antibiotics and was observed for a few days  to see if it would resolve on its own, which it did.  A few endoscopies later revealed no opening at all in the pouch; it had healed completely.  An NG tube was placed along with TPN through the central line, I was sent home to wait for the next surgery.  Aproximately 6 to 8 weeks later,  an open revision was performed, recreating an opening to the pouch.  I went on to heal without any further problems.     I was successful in losing 164 pounds,  reducing my BMI from 51 to 24.  I was able to stay within a healthy weight/BMI for about 5 years without much work.  


5 years ago, I started gaining weight.  I started to work out, running 5 miles per day; if I did not run, I would gain.  I noticed I coiuld eat more than what I was used to eating.  I noticed that I started to overeat without having any nausea like I had in the past.   Around this time I developed a few occasions of gastritis but what really sticks in my mind, is the fact that when I vomitted during these times, stomach acid was present which had been absent in the past...(sorry, don't mean to be graphic).
 I do not know if it is normal for an RNY patient with 150 cm bypassed to experience this but it does make me wonder if somehow my insides have grown back together because of a gastric fistula had occured.  It wouild not surprise me with my past experience.  

Currently, I have a re-gain of 70 lbs. I am in need of some help, my insurance does not cover weight loss surgury and I am not sure of how it goes with a prior surgery needing to be revised.  I have been trying to tough it out on my own but I am have been losing the battle, yet again.  
I have moved to Florida and I am at a loss as to how to proceed down here, where to go and if there could be any help for me...  any information on where to turn and what anyone knows about the stomach "re-attaching" would be great.
gwease
on 2/16/10 8:56 am
dr gary wease here, from michigan.  you may well have developed a fistula.  alternatively you may simply have pouch or stomal dilation which allows you to eat more than previously.  this can be diagnosed with a combination of upper gi xray series and an upper scope.  i treat this often with StomaphyX and fibrin sealant i can be reached at surgfun1@aol.com
Murt
on 2/17/10 12:40 pm - Thornton, CO
RNY on 10/19/04 with
Two weeks ago from tomorrow I had my gastro/gastric fistula repaired.  While the recovery from the surgery has been a little slower than I had hoped, I am very happy with the out come so far.  My fistula was discovered within 2 months of my gastric bypass surgery in 2005 and ever since that day I struggled with never having a lasting full feeling.  I did manage to lose 80 pounds but over the last couple years I gained 60 of that back.  When I would drink I could feel the liquid entering the pouch then moving over to my old stomach.  Also when I ate I would eat until I thought was full only to be hungry once again minutes later. 

Last October I finally said enough is enough and went to my surgeon to start the ball rolling.  The insurance person who once working at this office coded my surgery request as gastric bypass revision.  The repair of a fistula is not gastric bypass revision and shouldn't be coded as such.  I wasted several months fighting with my insurance company because of this person error.  A new person was hired and after one simple phone call to my insurance company they told us gastro/gastric fistula repair didn't need a pre-authorization.  Within 2 weeks of finding this out I has my fistula repaired.  I checked on-line and my claim has already been paid to the hospital. 

I suggest you research available bariatric surgeons in your area and make an appointment with one you feel comfortable with and discuss your concerns.  Also discuss with them the proper procedure coding as this might save you time and headaches.

Good luck with your journey.

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swimmergirrl
on 2/18/10 6:49 am - Branford, CT
wow, that is good to know and it makes sense.  The one thing that has been holding me back, is the knowledge that my insurance does not cover anythign weight loss surgery related.  If the diagnosis is something as clear as gastro gastric fistula, then  it does not fall under  weight loss and perhaps I can get this procedure approved.  I now have some hope, now I have to find someone in Cocoa Fl, or surrounding area, who can evaluate me..Thanks so much for sharing that with me... 
Tate
on 2/18/10 12:34 pm
HI;
I am so happy to hear your story.  I am 7 yrs post RNY.  I have a diagnosed gastro-gastric fistula and had the band around my stoma removed because it had eroded into the pouch/intestine.  I am trying to find a surgeon to fix me up as I have gained about 70 out of the originalk 100 back.  It took me 4 years to ask for help again.  I am getting the run around from the surgeon I'm working with now.  It seems like he is afraid of me for some reason????  Did you have an open procedure to fix the fistula? I'm having a hard time finding a surgeon who seems competent to do my revision.
debbieblanchette
on 10/20/12 6:46 pm - GA
  I am having that very same thing done in a few weeks. I am having the band removed laporscopically and the repair as well. I work for Emory Healthcare in Atlanta and my doctor who is ding it is Dr Kevin Woods he is a gastroenterologist.
adbailey
on 11/26/13 11:02 am

I had my band removed by Dr. Kevin Wood in two parts.  One in June 2013 and the other in Sept 2013.  I just had the upper GI and Bowel test for fistual.  I had the Fobi Pouch in 2000 and never lost that much weight.  Dr,. Kevin Wood is the first Doctor who listen to me and helped me. 

 

pjwilsen
on 3/18/10 4:10 pm
Hi there, Murt: 

I hope this finds you feeling well. I am reading this a month after your original post.

I am wondering how you are progressing and if you lost any weight (provided you had some regain) after this fistula was repaired?

I'd love to hear form you if you have a moment.

Best wishes,
Pam
NorthernGem
on 1/30/14 4:54 pm - Sudbury, Canada

I hope you all are doing well its been awhile since the last post. All I can say is WOW I can totally relate, I have just found out that I have a Fistula and I have the same problems and sypmtons. Its been 26 years since my Vertical Gastric Bypass and I to never lost the weight. Im so happy that the Doctor is willing to fix it this summer. 

Referral July 2, 2012 * Ultrasound and Upper GI,  November 12, 2013 * Met Surgeon and Endoscopy January 29, 2014 * Orientation April 2, 2014 *  Physiotherapist, Social Worker  April 25, 2014 * Nurse Practitioner May 7, 2014 *  Nutritionist May 7, 2014*  Surgery Date Summer/Fall 2014*

Renfairewench
on 3/1/10 4:01 pm
Revision on 08/10/09 with
I too had an RNY ten years ago, however, my weight was much higher then too. I never got below 200 pounds before my weightloss stopped. I had a distal RNY with 150cm bypassed as well.  Between years four through year ten I had regained 92 pounds. No matter what I did to lose weight my efforts were frustrating and loss minimal. I did a lot of research and with the help of a friend found that I could revise from RNY to Dueodenal Switch (DS) During the consult with the surgeon who did my revision from he said (and I did learn through research) is that Band over Bypass, Stomaphyx, and the Rose procedures do allow for a small amount of weight loss. On average about 25-30 pounds, however, that the weight lost is usually quickly regained. I have not heard of many losing much more weight than that, but admit I have not really done too much research on it.

From the RNY I developed a nasty marginal ulcer which has kept me on PPI medication (Nexium) for nine and a half years.

An RNY to DS revision is not easy, but as far as I'm concerned has been worth the effort, despite several complications and a lengthy recovery that I did have following my revision. I'm 6 months post op and have lost nearly 100 pounds and for the first time in a lifetime feel like I might just make it to my goal weight.

Whatever you do decide to do be well educated and research both the good and the bad.

All the best,
Maddie
 

                   HW (pre RNY) 430 HW (pre DS) 302 / SW 288 /
                          Lowest weight 157 / CW 161
GW 150
                "I'm just one stomach flu away from my goal weight"