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Stomach ulcers before gastric bypass surgery.

barbyannn
on 8/13/11 6:35 pm - Andover, OH
 I had an endoscopy this past Thursday and much to my surprise I have two gastric ulcers. I will be going on medication to heal them. Will this delay my gastric bypass. I am looking toward the middle of September for sugery.
Barbyann 
MsBatt
on 8/13/11 8:03 pm
They are definitely going to want you to be ulcer-free before surgery---and frankly, if you have ulcers BEFORE, I'd think the gastric bypass/RNY a bad surgical choice. Have you considered the Sleeve or the DS?

The gastric bypass will leave you with a tiny pouch and a huge 'remnant' stomach that can still develop ulcers, but which can't be 'scoped. Neither the Sleeve nor the DS would leave a remnant stomach---just a smaller, but still fully-functional stomach. You REALLY need to give this some thought. We have a poster right now who's looking at a reversal of her gastric bypass due to intractable ulcers---and she's only four months post-op!

Given your BMI, I strongly urge you to look most closely at the DS. It has the very BEST long-term, maintained weight loss, and it's the best at resolving or preventing co-morbs like diabetes and high cholesterol.
rbb825
on 8/13/11 10:34 pm - Suffern, NY
We can be scoped after RNY in both the pouch and the remnant stomach - it is called a double balloon endoscopy. It isn't as common as the regular endoscopy but it is done when the remnant or parts of the small intestines need to be seen.

 

rbb825
on 8/13/11 10:41 pm, edited 8/13/11 10:42 pm - Suffern, NY
Yes, this will delay your surgery and if the surgeon doesn't delay it - you need to delay it.  You want your stomach in the best possible shape it can be in prior to surgery.  You also need to be able to have another endoscopy after your 8 weeks of treatment to make sure that they are healed.  Did your surgeon do a biopsy during the endoscopy to check for HPylori?  Some ulcers are caused by a bacteria and need to be treated by not only a PPI but also antibiotics and it comes in a pack called the Prevpac.  This is taken 4 times per day for 14 days and then you go on the PPI for an additional 8 weeks until the ulcer is healed.  You would then have another endoscopy to make sure the ulcer healed and they can again test to make sure the hpylori is gone.  Once you are ulcer free, then you can have the surgery and yes, gastric bypass after ulcers is fine.  I had ulcers preop and haven't had one since.  You just have to take precautions - stay on PPI's for atleast 1 year post op to reduce your acid levels and being you have 2 ulcers preop, it might be a good idea to stay on them indefinitely - that is what I am doing.  My surgeon and gastro doctor have me on them for life.

Make sure you never take anything with aspirin or NSAIDS - Ibuprofen, aleve or any arthritis medications again.  These are the number one causes of gastric ulcers.

 

MsBatt
on 8/14/11 9:21 am
I had ulcers preop and haven't had one since.


Really? I'm surprised---you'd had everything else known to man.
rbb825
on 8/14/11 10:48 pm - Suffern, NY
Sarcastic much.  Not every RNY gets ulcers and yes, I did have them preop and severe reflux.  Had surgery to correct acid reflux back in 1998.  No reflux or ulcers since.  When I had my RNY, they had to reverse my reflux surgery and I am still ulcer and reflux free.   I just take protonix daily as a precaution to prevent any recurrance.

And yes, unfortunately I am one of the unlucky few that has had tons of complications.  Be happy you aren't one of them.  It isn't fun being in and out the hospital with multiple surgeries.  I will be going in again next month to have more kidney stones blasted.

 

(deactivated member)
on 8/14/11 10:32 am
If you have stomach ulcers now, did your surgeon explain to you that the majority of your stomach will be sitting there, able to produce ulcers,but unable to be scoped or evaluated without another surgery to open you up?  That part of the stomach bypassed cannot be evaluated via endoscopy.

If I were you the only surgery I'd opt for knowing this information would be the DS or VSG.

Please don't continue with your gastric bypass plans.  Once you have ulcers developing more tends to be a reoccurring problem (at least what I have seen and know from my nursing practice).

rbb825
on 8/14/11 10:51 pm - Suffern, NY
I wish people would stop spreading around this lie - you can be scoped after a gastric bypass - both your pouch and your remnant.  It is fairly new and is called a double balloon endoscopy.  It can even seen part of your bypassed small intestines.

I had ulcers preop and have never had one since.  You just have to take PPI;s postop for atleast a year and if you are high risk like she is, you take them for life and she should have no problems with future ulcers.

 

(deactivated member)
on 8/15/11 4:38 am
On August 14, 2011 at 10:51 PM Pacific Time, rbb825 wrote:
I wish people would stop spreading around this lie - you can be scoped after a gastric bypass - both your pouch and your remnant.  It is fairly new and is called a double balloon endoscopy.  It can even seen part of your bypassed small intestines.

I had ulcers preop and have never had one since.  You just have to take PPI;s postop for atleast a year and if you are high risk like she is, you take them for life and she should have no problems with future ulcers.
"It is fairly new "

Yes, I work in healthcare-fairly new and rarely done.  I wouldn't want to be the one having possible ulcerations and trying to find a doctor or facility that does this 'new' procedure.
rbb825
on 8/15/11 9:26 pm - Suffern, NY
I guess living in the NY metro area, I am  lucky that it is available.  IF I needed it, I certainly would go for it rather than suffering and not knowing what was going on with me.  It has been around for a couple of years and it certainly has been done enough times that I would trust someone to do it on me if necessary. It isn't major surgery - it is still just a scope.