After a gastric bypass procedure for weight loss, some patients may have a narrowing of the new connection between the stomach and the lower intestine. This complication is called stomal stenosis.
Facts about stomal stenosis
It's not clear why stomal stenosis occurs after gastric bypass surgery. It may be because of a combination of factors. Some studies suggest that using staples, especially circular staples, poses a greater risk for stenosis than sewing up the stomach by hand after the surgery.
In other cases, scarring or insufficient blood flow to the area is thought to be the cause. This is a condition called ischemia. Repeated vomiting is sometimes a cause of stomal stenosis. Vomiting may also be a symptom of the complication and is difficult to diagnose.
Stomal stenosis typically occurs one to two months after gastric bypass surgery. It can occur later on, but in these instances, it's often accompanied by other problems such as ulcers, a ruptured suture, or a problem with the gastric band. Smoking and nonsteroidal anti-inflammatory drugs can also be risk factors for developing stomal stenosis, even long after the weight-loss surgery.
The symptoms of stomal stenosis can include:
If you have any of the above symptoms after a gastric bypass procedure, your doctor may need to conduct tests to find out if stomal stenosis is the cause. If so, more treatments or surgery may be necessary.
The simplest way to fix stomal stenosis is with a procedure called endoscopic dilation. Your doctor will put a special balloon into the new connection to your stomach in order to make it bigger.
In some cases, additional surgeries might be needed to fix any problems related to stomal stenosis. Proton pump inhibitor therapy might also be useful if you also have gastric reflux.
To help prevent stomal stenosis, follow your doctor's strict recommendations when it comes to diet and how you eat after a gastric bypass procedure. Like all weight-loss surgery patients, you will need lifelong monitoring by your doctor to check for nutritional deficiencies and other potential problems.