Stricture Symptoms - How Do I Know if I Have a Stricture?

Strictures can occur once you are about 4 to 8 weeks out from surgery. A stricture is a narrowing of the new stomach outlet where it surgically attached to the small bowel. Symptoms include difficulty with eating solid foods, developing increased saliva or mucous, reflux symptoms, and in severe cases, difficulty with liquids. A stricture, with time, can resolve on its own, but often the waiting time to heal can make you feel miserable. Once you are out at least 4 weeks from surgery, balloon dilation with endoscopy can be performed to open up the narrowing. Several balloon dilations might be needed to fix the issue.

With gastric sleeve or bypass  there is a healing process (there is still  Inflammation in the stomach , and many patients have difficulty transitioning to solid foods.  It is too soon to think about a stricture.  If you are tolerating  protein shakes without difficulty, just be patient.  Stay on the consistency that you are tolerating or take a step back to a “complete” liquid diet  for a couple of weeks and when  you start again with solids, chew well, pause between every small bite and  stop when you  feel  full.  I'm sure it will be a different experience. Recovery is gradual  and different for everybody; it really takes 6 to 8 months for healing to be complete after any surgery. 

The literature reports stricture rates somewhere from 6 to 20 percent depending on who did the study and what technique was used. Usually strictures occur several weeks to months after surgery and these can be managed with endoscopic dilation. Difficulty eating solids or increased reflux may be related to a stricture or narrowing of the outlet of the small pouch.  An endoscopy or an upper gastrointestinal study can help with this diagnosis. Sometimes there are no anatomic reasons and simply controlling your portions is the reason for the symptoms.

Strictures occur in about 5% of patients after gastric bypass surgery at the connection between the stomach pouch and small intestines.  The sign of this is difficulty tolerating any solid foods.  This usually happens between 6 - 8 weeks after surgery.  The treatment is to perform an endoscopy and dilate the stricture with a balloon.  We usually perform this procedure right in the endoscopy suite in our office as an outpatient.