Gastric Bypass Complication Gastrogastric Fistula

While the success rate of gastric bypass surgery is very good, complications from the weight loss surgery do occur. One of the rare complications is a gastrogastric fistula or leak in the newly reduced stomach pouch.

Recently a LivingAfterWLS reader named Margo suffered such a complication. She had surgery on July 11th. On August 18th she suffered a setback when a gastrogastric fistula was identified in the surgical area of her stomach. The fistula was identified with an upper gastrointestinal contrast study (UGI).

A fistula is an abnormal connection between an organ, vessel or intestine that results from trauma or surgery. In gastric bypass the separation of the gastric pouch from the main stomach decreases the incidence of fistula formation and stomal ulcer but does not eliminate it. Leakage of ingested food through the fistula may allow the small pouch to empty faster, leading to increased volume of meals and increased appetite. Patients stop losing weight or begin regaining weight. Surgical intervention may be necessary to correct the fistula.

In Margo's case the leakage was causing vague symptoms such as nausea a couple of hours after eating. She said after two times of trying to vomit producing nothing but bile she knew her pouch was working. Margo added, "Luckily, after that I kept myself from retching, or I might have made it worse. I felt increasing but very vague pain in my stomach, but not necessarily in the area I knew my pouch resided. I went back to liquids only, and that did not help, either. This lead to the Upper GI."

Fortunately she was early enough post-op on a limited liquid and soft food diet that she did not experience peritonitis, inflammation of the abdominal organs due to bacteria from the intestinal gastric contents.

After the fistula was identified Margo was put on IV feeding and her weight loss has stopped. She said, "I am hanging in, but just barely. Still glad I had WLS, though, and glad I discovered LivingAfterWLS."

Nearly a month after identifying the fistula Margo is still on the IV feed but is able to add a few things to her diet. "I have had a second Upper GI and the fistula has improved a bit. My doctor now has me drinking liquids: when I get up to 48 oz of liquid, and 400 calories (of protein drink) for "several days" I can abandon the IV feeding and go back to square one. I'll spend 2 weeks on a liquid diet, and then begin to add soft foods. I'll have at least one or two more UGI's."

Margo says it hasn't been easy to keep a positive spirit. "I want to add my positive spirit does not come naturally-I have been deeply depressed, but at least now I have something to aim for, and that has helped quite a bit."

Take a minute to send some warm vibes her way, and leave her a comment here. I'm sure she'd love to know how much we are pulling for her. She said, "I appreciate your prayers and interest a lot, and am determined to muddle through this setback-and any others thrown my way-because I want to continue to lose weight so I can live!"

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