What is a stricture and what are the signs of dehydration??

What is a stricture?  This question comes up weekly, if not daily on OH.  Below is a copy and paste from Wikipedia.  If you are a few weeks out post op from RNY and have problems keeping well chewed food (even water) down, you might have a stricture.  Very common and very treatable (about 10% of RNY patients get them).  Also do not freak out if you have to go back a second or third time to get treated for one.  The Gastroenterologist will go just below the pouch and air up the "balloon" .  It is an outpatient procedure and you will be sedated.  Brian 

As the anastomosis heals, it forms scar tissue, which naturally tends to shrink ("contract") over time, making the opening smaller. This is called a "stricture". Usually, the passage of food through an anastomosis will keep it stretched open, but if the inflammation and healing process outpaces the stretching process, scarring may make the opening so small that even liquids can no longer pass through it. The solution is a procedure called gastroendoscopy, and stretching of the connection by inflating a balloon inside it. Sometimes this manipulation may have to be performed more than once to achieve lasting correction.
 

Dehydration (hypohydration) is defined as excessive loss of body water.^[1] It is literally the removal of water (Ancient Greek: ὕδωρ, hýdōr) from an object. In physiological terms, it entails a relative deficiency of water molecules in relation to other dissolved solutes. Some definitions even require a rise in blood sodium concentration^[2], but in reality a loss of body water usually accompanies a loss of solutes as well.^[2]

[edit] Difference from hypovolemia

Hypovolemia is specifically a decrease in volume of blood plasma.^[3][4] Furthermore, hypovolemia defines water deficiency only in terms of volume rather than specifically water.

Nevertheless, the conditions usually appear simultaneously.

[edit] Medical causes of dehydration in humans

In humans, dehydration can be caused by a wide range of diseases and states that impair water homeostasis in the body. These include:

• External or stress-related causes
  • Prolonged physical activity with sweating without consuming adequate water, especially in a hot and/or dry environment
  • Prolonged exposure to dry air, e.g. in high-flying airplanes (5–12% relative humidity)
  • Blood loss or hypotension due to physical trauma
  • Diarrhea
  • Hyperthermia
  • Shock (hypovolemic)
  • Vomiting
  • Burns
  • Lacrimation
  • Use of methamphetamine, amphetamine, caffeine and other stimulants
  • Excessive consumption of alcoholic beverages

• Infectious diseases
  • Cholera
  • Gastroenteritis
  • Shigellosis
  • Yellow fever

• Malnutrition
  • Electrolyte disturbance
    • Hypernatremia (also caused by dehydration)
    • Hyponatremia, especially from restricted salt diets
  • Fasting
  • Recent rapid weight loss may reflect progressive depletion of fluid volume (the loss of 1 L of fluid results in a weight loss of 1 kg (2.2 lb)).^[5]
  • Patient refusal of nutrition and hydration
  • Inability to swallow (obstruction of the esophagus)

• Other causes of obligate water loss
  • Severe hyperglycemia, especially in Diabetes mellitus
    • Glycosuria
    • Uremia

[edit] Symptoms and prognosis

Symptoms may include headaches similar to what is experienced during a hangover, muscle cramps, a sudden episode of visual snow, decreased blood pressure (hypotension), and dizziness or fainting when standing up due to orthostatic hypotension. Untreated dehydration generally results in delirium, unconsciousness, swelling of the tongue and in extreme cases death.

Dehydration symptoms generally become noticeable after 2% of one's normal water volume has been lost. Initially, one experiences thirst and discomfort, possibly along with loss of appetite and dry skin. This can be followed by constipation. Athletes may suffer a loss of performance of up to 30%^[6], and experience flushing, low endurance, rapid heart rates, elevated body temperatures, and rapid onset of fatigue.

Symptoms of mild dehydration include thirst, decreased urine volume, abnormally dark urine, unexplained tiredness, irritability, lack of tears when crying, headache, dry mouth, dizziness when standing due to orthostatic hypotension, and in some cases can cause insomnia.

In moderate to severe dehydration, there may be no urine output at all. Other symptoms in these states include lethargy or extreme sleepiness, seizures, sunken fontanel (soft spot) in infants, fainting, and sunken eyes.

The symptoms become increasingly severe with greater water loss. One's heart and respiration rates begin to increase to compensate for decreased plasma volume and blood pressure, while body temperature may rise because of decreased sweating. Around 5% to 6% water loss, one may become groggy or sleepy, experience headaches or nausea, and may feel tingling in one's limbs (paresthesia). With 10% to 15% fluid loss, muscles may become spastic, skin may shrivel and wrinkle (decreased skin turgor), vision may dim, urination will be greatly reduced and may become painful, and delirium may begin. Losses greater than 15% are usually fatal.

In people over age 50, the body’s thirst sensation diminishes and continues diminishing with age. Many senior citizens suffer symptoms of dehydration. Dehydration along with hyperthermia results in seniors dying during extreme hot weather.

Dehydration is the excessive loss of water from the body. Diseases of the gastrointestinal tract can lead to dehydration in various ways. Often, dehydration becomes the major problem in an otherwise self-limited illness. Fluid loss may even be severe enough to become life-threatening.

Numerous studies have shown that for terminally ill patients who choose to die, deaths by dehydration are generally peaceful, and not associated with suffering, when supplemented with adequate pain medication.^{[7][8][9][10][11][12]}

[edit] Treatment

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The best treatment for minor dehydration is drinking water and stopping fluid loss. Sports drinks and other rehydration fluids are preferable to water; plain water restores only the volume of the blood plasma, inhibiting the thirst mechanism before solute levels can be replenished.^[13] To stop fluid loss from vomiting and diarrhea, avoid solid foods and drink only clear liquids. In some cases, eating of salted foods may have a positive impact on the person. However, eating salted foods should come with more intake of a clear liquid. It is wise to slowly drink liquids when dehydrated. ^[14]

In more severe cases, correction of a dehydrated state is accomplished by the replenishment of necessary water and electrolytes (rehydration, through oral rehydration therapy or intravenous therapy).