Roux-en-Y surgery complications

Posted by bborth @bborth, Aug 5, 2019

Well, after dealing with bile reflux on and off for 5 years my GI has recommended this surgery for me. I will be having this done at the U of M after have been treated by Dr. Martin Freeman there for the past few years, and many ERCP procedures. The surgeon claims I am a good candidate for this being in good health otherwise and relatively young (56). A bit scared of course given the nature of this type of surgery, but staying as-is can’t be a long term plan for me. The surgeon agreed, and was concerned that the bile is now getting up in the esophagus/throat which can pose more serious issues down the road if not abated. I guess if anyone has advice on recovery, or hints on moving forward in life post roux en y surgery I would appreciate it.

I had the surgery twelve years ago at 65. It was done laparoscopically and although the first few days in the hospital were difficult recover was pretty eventless after that. Liquid diet for the first few weeks was a drag and adjusting to a new way of eating took some time. Overall it was for me a positive experience

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Let me know what adjustments to your diet you had to make, and if you regained the lost weight eventually. I assume this was not for weight loss? They cannot do mine laparscopically unfortunately, incision in the abdomin. Not looking forward to that.

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Hi @bborth,

Here’s some information you might wish to read, about Roux-en-Y: https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/about/pac-20385189

I’m tagging @claytamos @dandl48 @zifra @judipogo @lizzsocco35 @rmw719 and I’d also encourage you to view this Connect discussion in the Chronic Pain group:
Pain meds for Gastric bypass patients https://connect.mayoclinic.org/discussion/pain-meds-for-gastric-bypass-patients/

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Hello, I had a roux-en-y in March of this year. It was part of other procedures that I had to have done. I had the roux-en-y due to delayed gastric emptying. I was told by my surgeon that bile reflux can be a complication of the roux-en-y procedure. The surgeon I went to has 35 years experience and only does digestive surgery. I went to 3 other surgeons before I decided to go with the surgeon I went with. As it was explained to me a roux-en-y bypasses the sphincter which in my case was preventing food from going into the intestines as it should. They said it could also make it so bile could also come back up since the sphincter isn't there to stop it. I got lucky in my case my surgery was a success. After surgery, for about 6 months, no alcohol and I had to learn what foods I can tolerate. Simple sugar upsets my system. I drink lactose free milk. I'm still healing and getting used to the way my system works. But all in all I'm so much better off. I'm a firm believer in getting other opinions. Make sure you do your research, a roux-en-y is permanent. Good luck to you. I wish you the best.

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Thank you. When you say sphincter, sphincter of oddi then? This is the 3rd surgeon I have talked to in my journey. But he does seem to think that this will keep bile from getting into the stomach which is what my endoscopy and bravo tests revealed. Did you lose much weight by chance? And, were you able to gain this back at some point? Even if I am 50% better than now I will be happy.

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@bborth

Thank you. When you say sphincter, sphincter of oddi then? This is the 3rd surgeon I have talked to in my journey. But he does seem to think that this will keep bile from getting into the stomach which is what my endoscopy and bravo tests revealed. Did you lose much weight by chance? And, were you able to gain this back at some point? Even if I am 50% better than now I will be happy.

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The lower esophageal sphincter (LES). This regulates the food to leave the stomach to the intestine. I had a lot of other things wrong that caused me to have the roux-en-y. I had bad acid reflux that was causing stomach acid to go to my lungs. I had a botched nissen fundoplication surgery 2 years ago. I had another hiatal hernia (came back after repaired when I had the fundoplication), I had a very rare condition called chilaiditi syndrome. I was in the ER at least once a month for the past few years with extreme pain. My surgery was March 15th and 4 hours which resulted in me losing the bottom 80% of my stomach, had some of my intestine removed, hernia fixed, and the roux-en-y. I was 205 before surgery and I now weigh 170 lbs. I have stopped losing weight. Due to losing the majority of my stomach I have to eat small amounts throughout the day. I was told when you have just the roux-en-y you also have to do that while it heals. I no longer have reflux and my digestive system is now working as it should. I'm grateful that i found this surgeon and I am feeling better. If you feel comfortable with this surgeon and you've done your research then you should have it done. Let me know if you have any other questions and I wish you the best.

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@bborth

Well, I am 2 weeks past this surgery that was recommended to me for my bile reflux/regurgitation issue that I have had for some time now. The pain associated with this is unreal. Trying to sit up for the first time after having an 8 inch incision through the stomach muscles was excruciating. I was in the hospital for 4 nights and came home, improving each day. After 9 days of making progress each day I started having bad cramping on the right side where the liver sits. These starting coming in waves, and each one was very painful for about a minute. After enduring this for an hour, they went away but I started getting a fever. After a call to the nurse at the hospital where I had the surgery performed, they summoned me back in. I then stayed 3 more nights there as they figured out the infection (high white blood count as well). The cramps continued on and off as well. I am back home now but am still having cramps every so often that are really painful. Just curious if anyone out there can tell me what this is a result of, or what can cause it. I know this was major surgery, and this one takes time to heal (surgeon mentioned cramping as part of what I would be dealing with post op). But at the same time the pain level is sometimes so overpowering. Causing me some anxiety as well as I get nervous about having to back in again. Thoughts??

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@bborth I don't want you to think no one is listening.

I had Roux En Y surgery laparoscopically in 2014 at the Mayo in Jacksonville. I had complications… nothing to do with my surgery team. Just my body 😁 Because of these complications my answer may not fit you.

I had another surgery to repair everything in May of 2015. It was a lot of repair.. open with cut from middle front to up to my shoulder in back. A cracked rib, a cut rib and lots of muscle cut… and much more. Yes, still in pain from it. . I was told I would have a gassy stomach and not to bother with over the counter meds like gas x and tums… they would not do anything to help. I was so doped up on dilaudid and phenagran that I don't remember the why of the gas. Since I have esophagus problems.. it shortened during 2014 surgery and they lengthened it in 2015… I assumed it was to do with my swallowing problem (achalasia).

I was given a booklet about the surgery afterwards in 2014. It has the do and do nots and what complications could happen down the road. I cannot find it now. I have been looking for a couple of weeks. My aging brain forgets where I put it or perhaps my husband put it somewhere.

I hope you heal well.

ZeeGee

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@fourof5zs

@bborth I don't want you to think no one is listening.

I had Roux En Y surgery laparoscopically in 2014 at the Mayo in Jacksonville. I had complications… nothing to do with my surgery team. Just my body 😁 Because of these complications my answer may not fit you.

I had another surgery to repair everything in May of 2015. It was a lot of repair.. open with cut from middle front to up to my shoulder in back. A cracked rib, a cut rib and lots of muscle cut… and much more. Yes, still in pain from it. . I was told I would have a gassy stomach and not to bother with over the counter meds like gas x and tums… they would not do anything to help. I was so doped up on dilaudid and phenagran that I don't remember the why of the gas. Since I have esophagus problems.. it shortened during 2014 surgery and they lengthened it in 2015… I assumed it was to do with my swallowing problem (achalasia).

I was given a booklet about the surgery afterwards in 2014. It has the do and do nots and what complications could happen down the road. I cannot find it now. I have been looking for a couple of weeks. My aging brain forgets where I put it or perhaps my husband put it somewhere.

I hope you heal well.

ZeeGee

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With the gas….did you notice more cramping afterwards as compared to before?

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@bborth

With the gas….did you notice more cramping afterwards as compared to before?

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Not severe cramping… except when I eat something I shouldn't, but more cramping. I cannot eat raw fruits ( except ripe bananas) or veggies.. all have to be cooked to almost mush and meat has to be tender. When I eat broccoli or brussel sprouts I have more cramps. Also if onion and garlic are cooked into a soup, stew or veggie it will cause me stomach cramp. High fiber also causes stomach cramps.

Even though I was on feeding tube I could eat foods. I had to do blenderized first… pretty much soupy baby food. Then progress to more solid foods.

Easing into food should help keep cramps to a minimum. Did they give you guidelines to follow? If you are experiencing a lot of pain with the cramps you need to contact your surgeon. It could be a sign of blockage.

A couple of days after I got out of the hospital the last time 2015 I had to go back in. I was dry heaving… and on the feeding tube. I disconnected and went too Mayo ER… they stabilized me and I went back to our travel trailer (I had to stay in area after surgery and we stayed in an rv park) and a few hours later I was back again and they did a ct scan and it showed some edema.. swelling at some junction (my memory failing again). 5 days of steroids and a tube in my nose and still no relief. So they dilated my esophagus.. still no help.. then another dilation and I was okay and could finally go home and be out of area.

Hopefully you do not have a complication, but check with your surgeon to make sure.

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@bborth

Well, I am 2 weeks past this surgery that was recommended to me for my bile reflux/regurgitation issue that I have had for some time now. The pain associated with this is unreal. Trying to sit up for the first time after having an 8 inch incision through the stomach muscles was excruciating. I was in the hospital for 4 nights and came home, improving each day. After 9 days of making progress each day I started having bad cramping on the right side where the liver sits. These starting coming in waves, and each one was very painful for about a minute. After enduring this for an hour, they went away but I started getting a fever. After a call to the nurse at the hospital where I had the surgery performed, they summoned me back in. I then stayed 3 more nights there as they figured out the infection (high white blood count as well). The cramps continued on and off as well. I am back home now but am still having cramps every so often that are really painful. Just curious if anyone out there can tell me what this is a result of, or what can cause it. I know this was major surgery, and this one takes time to heal (surgeon mentioned cramping as part of what I would be dealing with post op). But at the same time the pain level is sometimes so overpowering. Causing me some anxiety as well as I get nervous about having to back in again. Thoughts??

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When this cramping flared up (which was then followed by a 101 fever) they did a CT scan and MRCP which did not show a blockage. I had an enema then as stool was backed up per the scan. So I was purged and had a lot flush out. The fever was their main concern, because anytime this happens post surgery they want to look at it to avoid sepsis. My cramps have lessened yesterday and today so far, and by that I mean no level 7-10 cramps. My instructions were low fiber/low fat foods, small portions eaten six times a day. I am having some anxiety now as this is almost a PTSD deal……where when a cramp starts I have to not think the worst, as in it will blow up into the major cramps I had before. This was as painful as anything I have ever experienced. My surgeon told me I would have cramps at our pre op meeting, something common for this surgery. They would dissipate over time according to him as the body gets used to the new configuration. I sure hope he is right. Fingers crossed.

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@bborth

Well, I am 2 weeks past this surgery that was recommended to me for my bile reflux/regurgitation issue that I have had for some time now. The pain associated with this is unreal. Trying to sit up for the first time after having an 8 inch incision through the stomach muscles was excruciating. I was in the hospital for 4 nights and came home, improving each day. After 9 days of making progress each day I started having bad cramping on the right side where the liver sits. These starting coming in waves, and each one was very painful for about a minute. After enduring this for an hour, they went away but I started getting a fever. After a call to the nurse at the hospital where I had the surgery performed, they summoned me back in. I then stayed 3 more nights there as they figured out the infection (high white blood count as well). The cramps continued on and off as well. I am back home now but am still having cramps every so often that are really painful. Just curious if anyone out there can tell me what this is a result of, or what can cause it. I know this was major surgery, and this one takes time to heal (surgeon mentioned cramping as part of what I would be dealing with post op). But at the same time the pain level is sometimes so overpowering. Causing me some anxiety as well as I get nervous about having to back in again. Thoughts??

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High fiber is hard to digest and so are meats. Stay away from fibrous veggies… like cabbage, greens, celery and seed and peel any veggies like summer squash. They usually start you out on liquid diet .. mine was thick liquid.. but I also had feeding tube. The surgeon suggested Carnation Instant breakfast.. high protein one.

In the 2014 surgery when I had the rny my esophagus shortened and pulled up a loop of intestines into my chest along with the pouch. I ran a fever… there was a leakage and they could not find it. It resolved as they pumped several antibiotics into me. I had two chest tubes, j tube, g tube, nasogastric tube, pic line. Seems like another tube, but cannot remember what. I don't remember a week or more of my 3 week stay. I needed more surgery to repair everything. The plan was to wait six month. That surgery was the last week of Sept in 2014. The first week of March 2015. I did not feel good. I was in a lot of pain. I went to our local ER.. 10 hours there and did not see a dr until about hour 8. The NP or PA not sure what he was did order a ct scan and blood work. Two more loops of intestines came into my chest.. pushed my left lung against my ribs. They stabilized me and the dr I saw was a surgeon. he said to go back to the Mayo as soon as possible. Don't let anyone here do surgery on you. I had no plans of that anyway. I called the Mayo, but my surgeon was out of country. It was only about a week wait to see him. At my appointment he said the surgery was going to have to be open and a thoracic surgeon had to be involved. Then it was a matter of them discussing how surgery was going to be and when. Surgery was 18 May 2015. It was very high risk. But if I did not have the surgery I would not live long. I still have pain from the surgery. I have a labrum tear in my shoulder because they had to get my arm out of the way to do what they needed to do. No one here will fix it. I may ask to be seen by someone at the Mayo. When I move a lot my chest hurts. .. diaphragm repair seems to be cause of that. My husband said something about they had to turn it (it had been shredded when the intestines pulled up) to attach the hernia to it. I don't really know. I only got a couple of page report on the surgery. My local GI doctor says the report is like a book.. they did a lot. Local GI dr won't do anything with my esophagus.. he just is not comfortable doing so because they changed me so much.

So that is more of my story. I pray you are blessed with no complications and heal well.
ZeeGee

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Well, I am 2 weeks past this surgery that was recommended to me for my bile reflux/regurgitation issue that I have had for some time now. The pain associated with this is unreal. Trying to sit up for the first time after having an 8 inch incision through the stomach muscles was excruciating. I was in the hospital for 4 nights and came home, improving each day. After 9 days of making progress each day I started having bad cramping on the right side where the liver sits. These starting coming in waves, and each one was very painful for about a minute. After enduring this for an hour, they went away but I started getting a fever. After a call to the nurse at the hospital where I had the surgery performed, they summoned me back in. I then stayed 3 more nights there as they figured out the infection (high white blood count as well). The cramps continued on and off as well. I am back home now but am still having cramps every so often that are really painful. Just curious if anyone out there can tell me what this is a result of, or what can cause it. I know this was major surgery, and this one takes time to heal (surgeon mentioned cramping as part of what I would be dealing with post op). But at the same time the pain level is sometimes so overpowering. Causing me some anxiety as well as I get nervous about having to back in again. Thoughts??

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@mdk

I have to revise to gastric bypass after having the sleeve 2 years ago. The problem is I have already lost all my weight. I am being revised because my sleeve is twisted. I have gastroparesis and am nauseous constantly. I feel sick every time I eat and always have stomach pain lately too. Will this revision stop all this nausea and pain? I want relief, but I am worried about malabsorption issues and looking sickly from losing more weight. Please help

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I've had multiple surgeries from complications of RNY bypass. I went from 180 to 155 in short period from liquids only diet
Once you get better or recover the weight should equalize. I'm back to 180 a year later.

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@mdk

I have to revise to gastric bypass after having the sleeve 2 years ago. The problem is I have already lost all my weight. I am being revised because my sleeve is twisted. I have gastroparesis and am nauseous constantly. I feel sick every time I eat and always have stomach pain lately too. Will this revision stop all this nausea and pain? I want relief, but I am worried about malabsorption issues and looking sickly from losing more weight. Please help

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I had a bypass in 2008 all I can tell you Have to take your vitamins every day for the rest of your life…..

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@bborth

I had Roux En Y surgery early Sept '19 for bile reflux. Not for weight loss, but to get the excess bile out of my stomach which was starting to go up the esophagus. Then I had an adverse reaction to the heavy antibiotics they put me on which again was a new issue I hadn't planned on. Anyway, I thought the surgery had done its job…..I started to gain weight back, enjoyed foods that before caused me issues, and generally felt good about what it appeared to have accomplished. About 5 days ago I noticed some symptoms coming back again……heavy bloating, nausea, no desire to eat, and just a general sick feeling. My GP had me do a stool test pronto, which now shows a bacterial imbalance. I will do a breath test for SIBO tomorrow, but as one can imagine, I am really scared about these symptoms coming back as I dealt with them for many months prior to my surgery. My GP says that a surgery like this can really alter how the gut works now that bile acid is no longer getting into the stomach. I wish my surgeon had told me this, but alas I was sent on my way. And of course antibiotics are first line methods to treat this which scares me given the reaction I had to cipro and flagyl post surgery. Curious if anyone has dealt with post roux en y and had issues come up. The mental part is setting in for me…..I can't imagine going through all the medical stuff again given what I did last year leading to the surgery.

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I've had roux n y in sept 2016. Approx a month later came the strictures. 7 balloon endoscopes and a temporary stent solved that problem
Then adhesions caused multiple obstructions and multiple surgeries to remove adhesions and multiple intestinal resections
The symptoms to watch for are bloating Nausa uncontrolled salivating followed by dry heaving If that happens, get to dr asap
As the next thing is total obstruction. Hope this helps you and good luck

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