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Tuesday, September 13, 2005

Gastrogastric Fistual Following WLS:
Community Member Shares Story

We have a reader who could use some warm thoughts from our LivingAfterWLS community. Margo 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 studie (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!"


Anonymous said...

Margo, I am very sorry to hear about your rough start, but very glad that your problem was diagnosed promptly. It must be discouraging to think you are on the road to improved health, and then to encounter a detour. But, that's all it is--you'll soon be heading back in the direction of weight loss and feeling much better. If I had some extra patience, I would send it your way. I do have extra good wishes and good cheer, though, and they are on the way to you!
Sara (post-op 6.5 weeks)

reggy said...
This comment has been removed by a blog administrator.
Anonymous said...


So sorry to here you have complications. I hope you are getting the best treatment and hope you are doing well soon. My mom had WLS and I helped her with lots of bumps. Be sure to tell your loved ones what you need mentally and phyisically, it is hard for us non-WLS to understand what you need.

Lots of love to you,
Rose Green

Anonymous said...


I too am sorry to hear of your complications. It is not an easy road without complications with them must be extra hard.
I will put you in my prayers and hope you have a speedy recovery.
Bless you and your family.
Post-op (8 weeks)

Diane; AL said...

Thank you for taking the time to share with us. It is a testament to your courage and dedication. With everything you are experiencing you are still committed. I applaud you.
When we all make this final decision to change our lives, we go into it with the knowledge of what to expect. Some do not fully realize just what is entailed. As Kaye and many others will keep telling us, it's not the easy way out.
Good luck on your journey. Get back to us as time will allow to update us on your progress.