Experiencing a new, sharp, and localized pain two weeks after sleeve gastrectomy warrants careful attention, especially when the discomfort is described as excruciating and distinct from the usual post-surgical soreness. The location of your pain — in the right lower quadrant, lateral to the belly button and away from the incision sites — combined with the stabbing or pinching sensation that worsens with movement or changes in position, raises concern for a potential post-operative complication. At this stage in recovery, causes of such pain could range from musculoskeletal strain, particularly if you’ve recently increased activity, to more serious issues such as a hernia, localized infection, or even intra-abdominal complications such as a fluid collection or irritation of internal structures. While it is possible the discomfort stems from something benign like nerve irritation or muscle strain, the severity and persistence of your symptoms, especially when they interfere with basic movements like sitting or bending, make it essential to seek medical evaluation. You should not ignore this level of pain. Contact your bariatric surgical team as soon as possible for a physical examination and, if needed, diagnostic imaging. Early intervention can rule out or address complications promptly and help ensure your recovery continues safely.
Undergoing vertical sleeve gastrectomy (VSG) in 2011 and achieving a weight loss of 160 pounds is a significant accomplishment. Maintaining that loss for several years reflects a strong commitment to post-operative care and lifestyle changes. However, it is not uncommon for patients to experience weight regain following major life events such as pregnancy, particularly when dietary intake becomes restricted to easily tolerated foods like carbohydrates, which are often calorie-dense and less satiating. The fact that you currently feel little to no restriction may suggest anatomical changes in the sleeve over time, such as gradual dilation of the gastric pouch. While sleeves cannot technically be “retightened,” there are several potential next steps depending on your individual anatomy and goals. One option may be a surgical revision or conversion. A common route is converting the sleeve to a Roux-en-Y gastric bypass or a duodenal switch, both of which can offer additional metabolic and restrictive benefits. In some cases, a re-sleeve may be considered, although this depends on factors like current pouch size, surgical history, and overall health. Before any decisions are made, a full evaluation is necessary. This typically involves imaging studies such as an upper GI series or endoscopy to assess the sleeve anatomy, along with nutritional and psychological assessments. Consulting with a bariatric surgeon experienced in revision procedures is the most appropriate next step. They will be able to determine whether surgical intervention, medical weight management, or endoscopic options like sleeve revision with suturing techniques may be suitable in your case.
Given your height of 5’5” and current weight of approximately 245 pounds, your Body Mass Index (BMI) is around 40.7. This places you in the category of Class III obesity, which is commonly referred to as severe or morbid obesity. According to established medical guidelines, individuals with a BMI of 40 or higher are typically considered eligible for bariatric surgery, even in the absence of documented obesity-related health conditions. While comorbidities such as type 2 diabetes, hypertension, or sleep apnea can further support the indication for surgery, they are not strictly required when the BMI exceeds 40. Eligibility for surgery also involves a comprehensive evaluation by a bariatric specialist. This assessment includes your medical history, psychological readiness, prior weight loss efforts, and your understanding of the long-term commitment required after surgery, including dietary changes, regular follow-up, and lifestyle modifications. Based on your BMI alone, you would likely meet the criteria for bariatric surgery. However, a formal consultation with a multidisciplinary bariatric team would be essential to determine your overall suitability and to guide you through the process safely and effectively.
Given your surgical history, it’s understandable that you're concerned about the best path forward. You've had a Roux-en-Y gastric bypass in 2004, followed by the placement of a lap band in 2013 to address weight regain or pouch/stoma issues. Now, you're dealing with severe gas and stomach pain, an enlarged stoma seen on a barium swallow, and conflicting results from your EGD. Your concern about simply removing the lap band without resolving the underlying issue—specifically the enlarged stoma—is absolutely valid. The lap band might be contributing to your symptoms, especially if it's slipped or creating intermittent obstruction, but the gas, bloating, and stomach pain you're experiencing are also often linked to the enlarged stoma and reduced restriction from your original bypass. When the stoma becomes enlarged, food can pass too quickly into the intestines, leading to discomfort, increased gas, bloating, and reduced satiety—which can all interfere with weight maintenance and quality of life. Removing the lap band is likely the right first step, especially if it’s suspected to be malfunctioning, even if the EGD didn't show definitive slippage or erosion. It’s also important to remember that EGD findings don't always align perfectly with what patients are experiencing symptomatically or what might be seen intraoperatively. That said, removing the band alone may not resolve all of your issues. There are options to address the enlarged stoma directly. One possibility is a revision procedure, such as surgical pouch and stoma revision or conversion to a different bariatric procedure like a distal bypass or even sleeve-based revision, depending on your anatomy and overall health. Another less invasive option is an endoscopic procedure like Transoral Outlet Reduction (TORe), which can reduce the size of the stoma and restore restriction without additional surgery. Your next step should include a thorough discussion with a bariatric surgeon who has experience in revision cases. These are complex and highly individualized, so a careful review of your imaging, endoscopy, weight history, and symptoms is essential in determining the best treatment plan. Be sure to ask about all available options, including both surgical and endoscopic interventions, and the expected outcomes in terms of symptom relief and weight control.
Three years out from gastric sleeve surgery, persistent and severe pain like you're describing is not something to ignore. The sensation you mentioned—like being punched in the stomach, pain after just a few bites or sips, radiating to your back, accompanied by hot flashes—suggests there may be a serious underlying issue that needs to be thoroughly investigated. One possibility could be the development of strictures or narrowing in your stomach or sleeve, which can make it very difficult for food or even liquids to pass through, causing pain and discomfort almost immediately after eating. Another concern might be related to ulcers or irritation in the lining of the stomach, which can be aggravated by certain foods, medications, or even long-term acid reflux. There’s also the chance of a functional issue, like delayed gastric emptying (gastroparesis), or something anatomical such as a hernia or adhesion from previous surgery. The referred pain to your back and the presence of hot flashes may also point to complications involving your digestive system or possibly your gallbladder or pancreas. At your current weight and given your goal to lose more, this pain may also be affecting your ability to eat properly and continue your progress—so it’s crucial to get it addressed. I strongly urge you to schedule a visit with your bariatric team or a GI specialist as soon as possible. This isn’t something to wait on. You may need diagnostic imaging like an upper endoscopy, ultrasound, or contrast study to find out what’s going on. Until then, try to keep track of what triggers the pain, how long it lasts, and any additional symptoms—it will help your doctors better assess the situation. You’ve already made incredible progress in your journey by losing 70 pounds and committing to improving your health. You deserve to feel well and continue reaching your goals without being held back by pain or discomfort. Please don’t hesitate to get evaluated soon—your health is worth it.
