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THE
SYMPTOMS OF LONG TERM FAILURE OF A LAPAROSCOPIC ADJUSTABLE
BAND
Whatever the type of
complication of the lap-banding, here are the main symptoms that are consistant
with a long-term technical failure: - Vomiting : it is a concern if
it becomes frequent, and occurs with a modest food intake. If even drinking out
of the meals becomes difficult, an X-Ray should be performed as soon as possible
and the band should be deflated; in the same time one checks for the
positionning of the band, the gastric pouch above it and the size of the oesophagus.
An upper GI endoscopy is usually unnecessary, and represents a waste of time in
most cases. - Food
intolerance : it goes with vomiting and gastro-esophageal
reflux, i.e. heartburn, mostly when lying down (at night). This is caused
often by a too tight band, a slipped band, an esophageal dilatation, or sometimes a
physiological fatigue that eventually will lead to band removal. - Pain : it
can be heartburn, with food or saliva reflux; or more or less intense adbominal
deep pain. This can be explained by a pouch dilatation above the band
(herniation) and/or slippage of the band, particularly if combined with
vomiting. - Local symptoms : temporay pain caused by the access-port is common
and often related to physical activities or manual work. If the port is really
sore and if there is some oedema and redness, then one should see a physician
because an infection may have set in. - Unsual food compliance: if food intake
becomes way easier than usual, one suspects a leak at some place of the device
(port, catheter, or band itself). This can be assessed with an X-Ray. Sometimes
it is caused by the intragastric migration of the band, that becomes charred by
acid. Weight-regain is a logical consequence of a band leakage and this should
be fixed.
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