Need Opinions Please!

I've been dealing with stomach issues for close to a year now. Long story short, I have severe nausea, heartburn, painful trapped gas, and vomiting whenever I try to eat solid foods. It doesn't matter what type of solid food, a few bites in, and the nausea hits. I will have uncontrollable vomiting, but no food will come back up--just mucous. I had an upper endoscopy done in April of this year and was told everything was fine. I'm seeing a new GI doctor and he is doing another scope this Friday with the thinking my pouch is too tight.

I just got a hold of some of my medical records and this is where I need some help/opinions because I'm very confused.

Per my surgeon's OP report, He made a 1 cm pouch. He said pouch, not stoma. Is this a normal size? Then I got my OP report from the last upper scope I had done, and this is what she notated.." There was not an impressive gastric remnant, but rather appeared to have jejunum attached very closely to tiny stomach remnant. There was a tiny clip noted at anastomosis which was unremarkable."

I'm trying to figure out if my pouch is too small and this is why I'm having these issues, or maybe there was a stricture that was missed when I had the last upper scope. If my surgeon meant he made a 1 cm pouch and wasn't referring to the size of the stoma, would this be considered a "micro pouch?"

I'm really frustrated at being sick all the time. I'm just trying to figure all of this out because my surgeon has not been very helpful. If anyone has any advice/opinions on this, I would greatly appreciate the feedback.

Thanks.

I don't have any medical advice for you, but I do know that if you want the medical community to pay attention to your predicament, there is nothing like rapid weight loss to grab their full attention.

While you're investigating the really horrible side effects, and pushing for a solution, I'd try limiting yourself to an OptiFast type product and tracking all your calories on something like MyFitnessPal to leverage this otherwise miserable period of recovery. You should start dropping weight fast, and this additional side effect may wake your providers up to the seriousness of the situation.

My brother in law had a horrible constriction in his throat, caused by years of untreated GERD. He was having symptoms like yours and I asked our family physician why no one seemed overly concerned about it. His answer was "It's hard to believe it's a real issue for him when he's fifty pounds overweight." Blunt, a little unprofessional, but possibly some insight into how providers view similar situations.

In my BIL case, he felt that the only things he could get down were soft foods like Mac and cheese, mashed potatoes and other starch heavy, calorie dense foods.

Good luck!!! And yeah, 1 CM sounds mighty tiny!

Thank you for taking the time to respond. You are probably right. It's very sad, but true. At one point, I was eating some slider type foods because they didn't cause as much discomfort, but now, anything solid causes me problems, especially at night. I'm still trying to obtain all my medical records. I hope to figure this out soon. I can't live like this anymore.

I think you need a second opinion. I suggest trying to book it now rather than waiting until you have all your records. You might have to wait along time to get in and your records will arrive in time. The scope report is prob 90% of what they need.

The other thing I would try to get: Did you have a barium leak test done right after surgery. That will also show the size and condition of your 'pouch' post surgery.

The day after surgery, I asked the lab techs to let me see the computer screen when they had a good picture on the screen and I remember seeing everything - the staples, the barium (white) filling my pouch and then the barium fading out as it went into my intestines. That will show your condition post-op. If you did not have one, a dr might order one now.

I would suggest a consult with my surgeon, but he is in NJ. WLS has been the majority of his practice for 15 years and one of the reasons I went with him was his willingness to stay with you with you long term. (There must be other drs in TN who specialize in this.)

I hope you feel better soon, You are right to pursue this. Things should have calmed down after a year.