Expert: John Pilcher, MD - 3/21/2011

Question
Hi, Dr. Pilcher -
I had a Vertical Banded Gastroplasty (VBG - http://www.answers.com/topic/vertical-banded-gastroplasty) and cholecystectomy in December, 2006 at age 23. Since then, I have met (and maintained!) my goal weight, and have even reached my ultimate goal of starting a family.
When I was pregnant with my first son (March - December, 2008), I found it was harder and harder to keep food down. Since his birth in 12/2008, and throughout this pregnancy (August - present, due 6/2011), I am throwing up about 95% of what I eat.

My 1st cousin was diagnosed with gastroparesis a couple of months ago, and his symptoms sound a lot like mine; inability to keep food down, food hardening in his stomach and refusing to process, nausea, etc. For me, it feels like all the food just sits on my band, and it starts to actually turn sour and cause the most foul nausea and horrible smelling burps.

Is it possible that I, too, have gastroparesis? How would I find out?
Thank you!!!

Answer
Krystal,
It sounds like you are suffering from a complication that is all-too-common after a VBG.  This problem is not exactly the same as gastroparesis, but is related and would show up with very similar symptoms.  What seems to happen is that the non-adjustable gastric band causes the upper stomach and the esophagus to work too hard, so that over a period of years they "wear out" and fail to push food downstream as they are expected to do.  Over a period of years, the patient becomes less and less able to keep down solid food. They shift toward softer food and then liquid calories, but eventually even liquid calories fail to stay down reliably.

The best way to find out if this is happening to you is to visit with an experienced bariatric surgeon in your area.  I recommend for this purpose that you not consult with the surgeon who did the VBG.  You can find Center of Excellence Bariatric surgeons on the web at:
http://www.surgicalreview.org/locate.aspx

Depending on the findings with this surgeon, it may turn out that you could benefit from surgical revision.

Best of luck!
Dr JP