Anyone had VSG for Gastroparesis

Hi, my name is Lauren and I'm new to this forum. I'm in the process of getting this surgery approved because I have severe gastroparesis. Is there anyone on this site that's had the surgery for that? If not, that's okay because I'm just thankful to have found you guys so that I can learn more about it. Question, do you have to watch your sugar/artificial sweetner intake? I can't seem to find much information about the diet you're supposed to follow after this surgery. Every website just talks about the diet after a gastric bypass. Thanks for any help you might have. Lauren from MO

Welcome Lauren! I am not sure how a VSG would benefit gastroparesis...maybe less quantity to digest?   As far as the diet goes you have to ease into food intake by liquids them "mushies" that are easily digested.  The point is to not stress the newly formed pouch.  After a short period of time you can introduce new foods, according to your doctor's guidelines. The amount of intake is quite small, thus weight loss.  Also, I should mention an ever present counting of protein & fiber grams while trying to not get too carried away with carbs.  After awhile it is second nature. Good luck! 

 

 

I would think that a stage two - DS, or gastric bypass would be more effective for gastroparesis.  Seems the 'dumping' would be more beneficial. 

DSers don't dump :)  RNYers do... but not all... only about 75%, and it often goes away after a year or two.

Thanks for your reply. I actually have a lot of problems w/ dumping right now and it has caused me to get pretty sick in the past so I think that's partly why my surgeons don't want to do the RNY. They also want to do the sleeve because they said it was a safer surgery for me. Actually everyone that I know who has gastroparesis has had the RNY so that's why I'm totally lost right now and have turned to getting help and info from all of you. Thanks so much for your thoughts! Have you heard anything else about why you think those surgeries would be better? Thanks. Blessings, Lauren from MO

Hi Lauren,

I suppose you could sort of say I did, or at least that it was a part of it all. After 24 years with type 2, I had started developing some complications of diabetes, including gastroparesis, which makes losing weight even more difficult. All of this was discovered in conjunction with diagnosis of very early, very mild retinopathy, which finally got me to wake up and smell the coffee and go on a crusade to get my diabetes under control. A year of very strict diet and carb control got my BG under control, but brought me no more than a 10 pound weight loss.

So, I made the decision to get WLS and specifically the VSG. The good news for people like us is that in at least one (small) study so far, VSG patients are showing faster stomach emptying post-op (I have a copy of the study my surgeon sent me, if you are interested). I don't have any proof that the condition has improved in me other than that I do not feel distension and discomfort after eating unless I eat more than I should (which is not often), and when that happens, the sensations subside pretty quickly, which indicates to me that the stomach is doing its thing.

Some VSG patients do experience certain "dumping" symptoms if they eat a lot of sugar or sugar/fat, which I suspect is due to the faster stomach emptying referred to above, but the phenomenon seems to be fairly uncommon. Since most of us have the surgery primarily to lose weight, we are supposed to avoid sugar, like all other WLS patients.

There are dietary guidelines for the VSG posted on the faq site, vsgfaq.com. I have been avoiding sugar/carbs for a long time due to the diabetes, and intend to continue that, and have drastically cut down the use of artificial sweeteners (stopped drinking soda and using "light" or "sugar-free" products, etc.) - basically, I have an occasional cup of tea with artificial sweetener in it. I have had no problems eating the occasional sweetened yogurt or whatever (sweetened with sugar/fruit, not artificial).

 

 

Ros-mari, Wow, I was so happy to read your letter and the research you sent me! Thank you so much. It gave me even more peace that I'd made the right decision about having the surgery. Thank you so much for sharing your story w/ me. I really appreciate it. Blessings, Lauren from MO

The abstract follows (I have a six-page report):

Sleeve Gastrectomy – A Restrictive Procedure?

John Melissas, MD1; Sofia Koukouraki, MD2; John Askoxylakis, MD1;

Maria Stathaki, MD2; Markos Daskalakis, MD1; Kostas Perisinakis, PhD3; Nikos Karkavitsas, MD2

1Bariatric Unit and Department of Surgical Oncology, 2Departments of Nuclear Medicine and 3Medical Physics, Heraklion University Hospital, Faculty of Medicine, University of Crete, Greece

Background: Diet and surgically-induced weight loss have been shown to lead to alterations in motor and sensory function of the stomach.We investigated the clinical otcome and gastric emptying of solid foods in morbidly obese (MO) patients following sleeve gastrectomy (SG).

Methods: We studied 23 MO patients [(7 males, 16 females), mean age 38.9 ± 11.0 years (range 20-64 years), mean weight 135.1 ± 19.0 kg (range 97-167 kg), mean BMI 47.2 ± 4.8 kg/m2 (range 39.6-56.0 kg/m2)] who each underwent a sleeve gastrectomy (SG) for weight reduction. At the monthly follow-up visits, variations in weight and BMI changes, postoperative meal size and frequency, and presence of gastrointestinal symptoms were recorded. 11 patients underwent scintigraphic measurement of the gastric emptying of a solid meal pre- and 6 months postoperatively.Results: A significant reduction in patients’ weight was evidenced at 6 and 12 months postoperatively [98.6 ± 11.8 kg and 87.0 ± 10.7 kg respectively (P=0.001)]. BMI decreased to 35.2 ± 4.3 kg/m2 at 6 months and to 31.1 ± 4.5 kg/m2 at 12 months, respectively (P=0.001). Although meal size was drastically reduced, meal frequency increased postoperatively in 12 patients (52.2%). Only 5 patients (21.8 %) reported occasional vomiting after meals following SG.The gastric emptying half-time (T1/2) accelerated (47.6 ± 23.2 vs 94.3 ± 15.4, P<0.01) and the T-lag phase duration decreased (9.5 ± 2 min vs 19.2 ± 2 min, P<0.05) postoperatively.

The percentage of the meal emptied from the stomach 90 min after consumption increased significantly after SG (75.4 ± 14.9% vs 49.2 ± 8.7%,P<0.01).

Conclusions: This study indicates that  following SG, the stomach empties its contents rapidly into the small intestine and symptoms of vomiting after eating (characteristic of restrictive procedures) are either absent or very mild. Therefore, the term ‘restrictive’ is possibly ill-advised for this new bariatric operation. It  remains for other mechanisms of energy intake reduction, such as intestinal distension and satiety signals through gut hormones to be investigated, to comprehensively explain precisely how this ‘food limiting’ procedure results in weight loss.

Are you diabetic by any chance?  I have just read a study that was about that VERY PROBLEM.  The article can be found HERE:  http://jp.physoc.org/cgi/content/full/533/3/801  and was about gastric distension CAUSED by gastroparesis.  Basically the researchers came to the conclusion that much of the stomach distension they were finding was due to diabetes and was caused by the high blood sugar causing a neurotransmitter called NPY to be released into the hypothalamus (a region of the brain that links the nervous system to the pituitary gland). This in turn inhibits or restricts the activity of the vago-vagal reflex nerve fibers through the neurotransmitter receptors in the hypothalamus. The reduced activity in the Vagal nerve due to High Blood Sugar Levels decreases the release of Nitric Oxide from the myenteric plexus. High Blood Sugar levels associated with Diabetes may have severe effects on the stomach’s ability to empty. These effects are in part caused by the neurotransmitter called NPY which acts as a transmission agent and a causal agent on the central nervous system. The harmful effects of High Blood Sugar on the intestinal system’s ability to move food bring to light the importance of strictly controlling the Blood Sugar Levels of all diabetics according to the authors of the article. Once the blood sugar levels are controlled, the gastroparesis should also come under control if this is the cause of your problem.  Of course, I am NOT a medical professional.  I didn't even spend the night at an expensive hotel.  I just HAPPENED to have read an article that touched on this subject.    If you want a more in depth description of this article in layman's terms, check out my profile page.  It will be in my blog. I hope this helps, Hugh

Just a note, gastroparesis as a complication of long-term diabetes does not usually get better, but the progression can be slowed down or halted (as with other complications affecting autonomous functions, retinopathy, etc.) Once these things have begun happening in diabetics, it is extremely difficult, in most cases impossible, to reverse them.