Gastric Band Slippage Symptoms

Question

What are signs that your gastric band has slipped? I've been having reflux like symptoms, but don't know if that means anything or just not to eat Mexican!

Babak Moeinolmolki, MD, FACS · Answer

Hello,
Thank you for your question. I’m sorry to read about your difficulties.
Symptoms of gastric band slippage include:
1. Heartburn/reflux aka gastroesophageal reflux disease GERD)2. Pain with eating3. Vomiting after eating4. Nighttime cough5. Chest pain/pressure
Fortunately band slippage is rare, occurring in only 2-3% of patients. It is diagnosed by x-ray imaging. Sometimes removing fluid from the band will allow the stomach to adjust and the symptoms to resolve. If fluid adjustment does not resolve the symptoms, conversion to the sleeve gastrectomy or gastric bypass is usually recommended.
Best wishes,
Dr. Moein

Christopher S. Cobourn, MD · Answer

Slippage or pouch dilatation can occur if the Lap-Band moves down the stomach, or if the pouch above the band stretches up. Patients with these problems may notice heartburn or regurgitation of food at night when they lay down. Slippage of the band is unusual and occurs in approximately two or three percent of patients. It can cause acute symptoms of abdominal pain, or can cause failure to lose weight. The acute symptoms are pain, bloating, vomiting or difficulty in swallowing liquids and solids.

Shawn Garber, MD, FACS, FASMBS · Answer

The most common symptoms of a slipped Lap-Band is inability to tolerate solids foods as well as gastroesophageal reflux (GERD). Minor slips can resolve with removing fluid from the band but sometimes this requires a revisional procedure which can be performed laparoscopically.

Ricardo M. Bonnor, MD, FACS · Answer

It is important to know that a band can slip (slide) at any time but more commonly several months after the operation and following a period of weight loss. A minor slippage can usually be taken care of by removing fluid from the band, a slip that lasts for a long time or a major slippage that causes severe pain may require a re-operation. One of the firsts smptoms of a slippage is pain or severe reflux even with small portions.

	An upper GI study in which a patient drinks liquid and x rays are taken  to see the position of the band and how liquid travels in the esophagus and stomach is a quick but effective test to demonstrate a significant slippage. Over - eating is also another simple cause of reflux that can be treated with portion control.

Michael F. Sedrak, MD - Account Suspended · Answer

there are various symptoms that can suggest a band has slipped, while conversely some patients even have minimal or no symptoms ... best thing to do is to evaluate the band, such as with x-ray ('barium swallow') or endoscopy (EGD). but first step if there are any symptoms is to think about deflating the band.  
but from your description it sounds like its just a particular food item that causes symptoms? although its not fun to have to avoid certain things, if the band is evaluated and functioning properly, then perhaps just consider this as an element of food intolerance and things to avoid

Daniel J. Rosen, MD - Account Suspended · Answer

The two main signs of a LapBand slip include new onset of reflux and increased vomiting of solid food without a recent adjustment.  If you had a hiatal hernia that was present but was not diagnosed or treated, it likely will get worse after the Lap Band is placed.  That can also be a cause of worsening reflux.

Mark Pleatman, MD (retired) · Answer

Symptoms of band slippage (or prolapse) are difficulty tolerating solid or liquid foods at a previoiusly tolerated fill level, and heartburn or reflux.  Diagnosis is easily made with an upper GI series, also sometimes called a barium swallow.  Endoscopy is not necessary.  Though emptying the band will sometimes reduce the symptoms, reoperation will ultimately be required to solve the problem.  Options include repositioning the band, replacing the band, and removal of the band.  If the band is removed, however, all lost weight will be rapidly regained unless something else is done.

	I generally recommend that the band be removed, with simultaneous conversion to another procedure such as gastric bypass or sleeve gastrectomy.

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