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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22744
Experience:  Over 20 yrs of Family Practice
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I am a 34 yr old mother of 4. Had a gastric bypass in 2001,

Customer Question

I am a 34 yr old mother of 4. Had a gastric bypass in 2001, maintained 80 lb weight loss even thru last 2 pregnancies. I am on 400 mg of wellbutrin and an antabuse maintainance dose of 250 mg. I haven't always followed the no NSAIDS for bypass patients rule. When my stomach started bothering me about a month ago my Dr put me on 150 mgs of zantac. It did help the severe middle abdomen pain, but I still have the chest pain that came at the same time, I have completely lost my appetite and I feel full very quickly. Last week I started noticing that my pants were really tight, pants I could pull off without unbuttoning the week before were leaving marks on my skin. I jumped on the scale to see how much I had somehow gained, and was shocked to see that I had lost 12 lbs in about 2 weeks. It's stayed the same for the last 8 days: no appetite, random nausea, feeling full right away whenever I do eat, crazy bloated stomach, and down 12-13 lbs on the scale. It makes NO sense. Any ideas? Thank you!
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Chip replied 2 years ago.
How are your bowel movements and specifically why the Zantac?
Customer: replied 2 years ago.
Unpredictable. No constipation, some diarrhea, mostly just very irregular. My Dr assumed the pain was an ulcer because of gastric bypass and continued use of NSAIDS. Zantac did reduce the Sharp mid abdomen pain I was having, but didn't touch the rest of the symptoms, like the chest pain, loss of appetite, nausea and feeling full right away. Then last week, after about 2 weeks of this, I couldn't button my pants and found out I had unintentionally lost so many lbs so quickly and freaked out.
Expert:  Dr. Chip replied 2 years ago.
I assume the weight loss could be explained by your not eating very much? Did the abdominal pain radiate to your back?
Customer: replied 2 years ago.
No. That's what I figured, but why did I blow up? And why are the other symptoms persisting?
Expert:  Dr. Chip replied 2 years ago.
Belching? Gas? Cramping or rumbling?
Customer: replied 2 years ago.
No, not really. It growls when I leave it empty too long. It hurts when I eat too much or too fast. Very little cramping, burps or gas. So weird...
Expert:  Dr. Chip replied 2 years ago.
OK. While I can't say exactly what the problem is I have three thoughts. Gastric paresis--poor emptying of the stomach--is one. Depending on your type of bypass, peptic ulcer may not be possible but outlet obstruction at the stomach/small intestine anastomosis could. Finally there's irritable bowel syndrome. You need a gastroenterology referral for upper endoscopy and possibly colonoscopy to see what's going on. I also can't be sure H. pylori--the "ulcer bug"--isn't also a factor so that needs to be screened for.
Customer: replied 2 years ago.
I had the Rou-N-Y (sp?) bypass, the old original one. You're saying I can't get peptic ulcers? I always thought that was why I wasn't supposed to take NSAIDS. So the zantac is useless? I felt like it helped some. Is it common for IBS to come on so suddenly? I thought that was a chronic thing. I had the bag test several years ago, would it be worth a repeat? Could you explain the paresis and the blockage a little more, like causes and common symptoms?
Expert:  Dr. Chip replied 2 years ago.
Not that you couldn't get peptic ulcers but it would take an intact stomach/duodenum connection to cause a peptic ulcer to obstruct. You could get either stenosis or ulceration of the roux en Y anastomosis of the stomach to the jejunum. The reason for not taking NSAIDs is to prevent gastritis and ulceration of the anastomosis. IBS doesn't usually come on so suddenly but it still can. Gastroparesis is a loss of stomach paristalsis so food stays in the stomach longer than normal and that can cause a too full too soon feeling.
Customer: replied 2 years ago.
I don't know if this is related or not, but it can't hurt to mention it, right? For the last year my periods are suddenly crazy heavy, ob doesn't know why. And for the past several months I've been having this weird urgent sensation. One minute I'm fine, the next I'm rushing to the bathroom, praying I make it. And sometimes if I can't head straight to the bathroom, it goes away. Like one minute I'm fine, the next I'm squeezing my legs together and bouncing like crazy, them the next no urge to per at all. It's not a uti, I know when I have one of those right away. Could there be any connection between my upper and lower symptoms?
Expert:  Dr. Chip replied 2 years ago.
Have you had your thyroid function and cortisol levels checked?
Customer: replied 2 years ago.
Thyroid is normal, not sure about cortisol...
Customer: replied 2 years ago.
Relist: Incomplete answer.
Expert:  Dr. Chip replied 2 years ago.
Sorry but you posted you last response after I had logged off. The the irregular periods and the bladder symptoms wouldn't be related.

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