Strictures are a problem unique to the Bypass and Sleeve patients. Basically, it is a narrowing preventing food to pass normally through your digestive system. With the Bypass, strictures occur at the gastro-jejunal anastomosis (the top connection where the small bowel is attached to the gastric pouch). Sleeve patients can have a stricture anywhere along the length of the stapled stomach. A stricture will almost always occur within the first three months after surgery. Generally, a patient will complain of not being able to advance their diet beyond liquids. They may have frequent vomiting episodes, or even night time regurgitation/reflux.
A stricture can be identified by an Upper GI Swallow, but the most appropriate test is an EGD (v). An EGD is where the doctor gives you an IV sedation, and they pass a long flexible scope with a camera on the end, down the esophagus to evaluate the narrowing. If there is indeed a stricture, the doctor can usually dilate it with a balloon. Strictures commonly are fixed withEGD dilations, but sometimes a surgery is required for persistent symptoms. One of the new options for treatment include placement of a temporary stent via the endoscope.
What causes a stricture? We can’t always say with certainty why one individual ends up with a stricture. But factors that can create this problem include how the surgery was done and how the patient responds to healing/scarring. Strictures are rare, anywhere from 1 to 8% in the literature. A reasonable stricture rate for a surgeon should be 1-3%.More