Expert: John Pilcher, MD - 6/19/2008

Question
I have had a band for about a year - about 30 lbs lost and 40 to go.  The slow weight loss more from my reluctance to get a second fill after my super painful first one.  

First question: Is there any danger with an upper endoscopy in moving or altering a gastric band? What will a upper E tell a doc that a Barium swallow cannot? My gastroenterologist (not my bariatric surgeon) wants to do an upper endoscopy on me because of my history of hiatal hernia, aspirational pnemonia and reflux which has gotten alot worse since my last fill.  My slight unfill last week has helped the reflux symptoms, but the GE still wants to take a look.   Unfortunately my bariatric surgeon spends less than a minute with me during fills/unfills (great surgeon, horrible communicator). He does routinely do Barium swallows w/fills and told me before he slightly unfilled me that my band was too tight, the liquid was sloshing back up into the esophagus, I have been eating too fast and that I had moderately stretched the stomach.     

Second question: Is it possible to stretch the 'pouch' by only drinking thicker liquids? or drinking with eating?

Thank you!  

Answer
Leigh,
An upper scope (EGD) can show if there's any persistent inflammation from reflux, or if there's delayed emptying of your pouch, and it's a more reliable indicator of persistent/recurrent hiatal hernia than Upper GI by X-ray.  There should not be any significant risk of damage/displacement of the band by upper scope.  On balance, it sounds like a good idea to me in your case.

I believe it is possible to stretch the pouch if one repeatedly overstuffs with solid food.  I don't think that thick liquids or liquids that wash through the solids should lead to a pouch stretching problem.

Best of luck to you,
Dr JP