After Sleeve, have pain when I swallow food? Like it is stuck in throat or tube to stomic??

Question
I have pain when I swallow food like it is stuck in my throat. I start spitting up a thick mucus. The pain last around 0.5 - 2 hours depending. I always make sure that I chew up food until liquid in my mouth. I had this pain the day after surgery when swallowing water. I asked doctor that day he said he didn't know why I had that pain. I asked it again at 2 wk followup appointment, and he said it is common with the sleeve surgery. I'm have still to find anyone saying anything about this issue and the sleeve??? I was thinking that at the surgery that some how my tube to my stomic has gotton pinched by another organ before they closed me up or something? Any ideas on how to reduce this pain of having something stuck in my tube and spitting up thick mucus? I try taking small sips of water hoping that it will wash it down, but always have to endure the pain for an hour or so and hope it goes down. I eventually burp a little and slowly feel it go down and after two hours come back to normal. I'm generating a fear of eating.

Answer
Hi Jay:

Your doctor was right that it is quite common immediately after surgery.  Usually it is caused by the sleeve being swollen from the surgery--which, if you have a tight sleeve, can make swallowing a little painful.  The thing is, it should get better over time.  If it doesn't, you may need to have your sleeve dilated via endoscopy (tube down your throat).  I'm not sure how far post-op you are, but I would expect things to be getting better every week.  If you are at least 4-6 weeks post-op and still experiencing this, then you need to talk to your surgeon again.  You can ask for a fluoroscopy (basically like an x-ray where you swallow barium so that they can visualize your esophagus and your sleeve)... and if that does not give the answer, they may want to do an endoscopy.  Sometimes they will refer you to a gastroenterologist for the endoscopy.

The mucus is basically your body trying to lubricate things so that they will go down easier.  As your sleeve does dilate (widen a bit), that should improve as well.  Usually this is seen more often with a Lap-Band when the pouch is too tight.  The solution for Lap-Bands, is to remove some fill.  As a sleeve is not adjustable per se... but does stretch some over time... it's not as easy of a fix.  However, sometimes just the act of the endoscopy severs to dilate the sleeve and make things a lot easier.

The good news is that this means that you do have a very tight sleeve which should allow you to achieve the weight loss you desire.  However, it should not be at the expense of being anoerexic. :)

You could try going back on liquids (if you are off) for 2-3 days to see if things improve.  Then move to purees/mushees for a few days...and finally back to solid foods.  In general, it sounds like you're doing everything right... small bites, chewing to liquid, small sips rather than gulps of liquid.  

Please be very careful regarding dehydration.  If your urine is dark and cloudy, it means that you are becoming dehydrated.  Try and get 6-8 cups of liquids in a day.  If you have trouble with food, and protein shakes are a little easier, than use those--as you'll kill two birds with one stone.  But really, if you can't get anything down, focus on liquids first... as you are much more likely to become dehydrated than protein deficient in the early stages.

I don't know if your doctor has you on any sort of proton-pump inhibitor, like Prilosec, but sometimes that can help with over acid production in a new sleeve for the first few months.  If your surgeon does not, you could at least try one of the OTC acid-reducers available.

I hope some of this is of help to you.

Good luck and I hope this resolves quickly for you.

Karla

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