All posts in Post Operative Problems

For all the adjustable gastric band patients, I want to give you some information that hopefully will give you some piece of mind. You need to know, at some point, your band will be too tight. This isn’t necessarily based on you doing something ‘wrong’ or not following our recommendations. Think about it, you have an unforgivong foreign body wrapped around your stomach, which is a dynamic digesting muscle. There’s bound to be some issues one time or another. Following our recommendations will go a long way in preventing something getting stuck, but it isn’t a guarantee.

That being said, if your band is too tight, it doesn’t mean you have a slip. The vast majority of cases involve inflammation or swelling around the band causing persistent obstructive symptoms. This can be from eating something that didn’t pass, or stress, or even menstrual cycle. The first thing to do is call your surgeon, me. I will recommend for you to go back to clear liquid diet, possibly add an antacid, and see me the soonest available time. In the office, I will take some fluid out of your band to relieve your symptoms. Importantly, an exception to this pathway is if you have persistent pain. In which case, you have to go to the ER. After the band is adjusted, you will feel better. And after a couple weeks, we can place some fluid back into the band to get to the right level of tightness.

Having the adjustable gastric band is a learning process. It’s a great tool to help in imroving your health, but bumps along the way are to be expected.

I have had plenty of Band patients express concern for a Band Erosion after they searched the Internet for answers to some of the quirky sensations they may be having. I want to clarify what a Band Erosion is. Basically, for some reason or variety of reasons, the silicone band around the top part of your stomach erodes into the wall of the stomach. We are not always sure what causes an erosion. It could be how the surgeon did the surgery, or the patient’s eating behavior, or their particular biology. For whatever reason, know that an erosion is RARE. Only 1-2% of patients will ever experience an erosion. If it happens, patients can present in a variety of ways. However, the hallmark is a lack of restriction despite successive Band adjustments (it could also be a leak in the system!). Sometimes people can have abdominal pain, fevers, or even Port-site infections. The doctor can diagnose an erosion with an Upper GI Swallow, but the best test is an EGD. If there is indeed an erosion, then an operation is in order for Band removal.

So remember: an erosion is rare, a significant loss of restriction is the hallmark, and an EGD is the way to diagnose it.

I have had plenty of Band patients express concern for a Band Erosion after they searched the Internet for answers to some of the quirky sensations they may be having. I want to clarify what a Band Erosion is. Basically, for some reason or variety of reasons, the silicone band around the top part of your stomach erodes into the wall of the stomach. We are not always sure what causes an erosion. It could be how the surgeon did the surgery, or the patient’s eating behavior, or their particular biology. For whatever reason, know that an erosion is RARE. Only 1-2% of patients will ever experience an erosion. If it happens, patients can present in a variety of ways. However, the hallmark is a lack of restriction despite successive Band adjustments (it could also be a leak in the system!). Sometimes people can have abdominal pain, fevers, or even Port-site infections. The doctor can diagnose an erosion with an Upper GI Swallow, but the best test is an EGD. If there is indeed an erosion, then an operation is in order for Band removal.

So remember: an erosion is rare, a significant loss of restriction is the hallmark, and an EGD is the way to diagnose it.