Jan - Feb 2011

What is a Stricture

By Kim Bertonica, RN

 

There are times we receive a call from a patient saying they have been doing fine with foods and fluids and then suddenly they have trouble getting foods down even though they are chewing the food well. Sometimes they are also having difficulty with fluids. Usually we will get this complaint during the healing process, about 2-3 months after bariatric surgery.                                                                  
 
When patients complain of having problems with foods and fluids at around 8 weeks post-op, one of the first things we consider is a stricture. Symptoms include vomiting and decreased tolerances to foods and even fluids. Patients typically do not have pain with a stricture.
 
A stricture is excessive scar tissue that can form where the stomach pouch is connected to the bowel. The tissue becomes fibrous, and the opening narrows. This occurs in about 2% of patients. Another area where strictures occur is where the small intestine passes under the colon. These strictures are rare and occasionally require surgical treatment.
 
Treatment is an upper endoscopy with balloon dilatation. This procedure involves inserting the endoscope through the mouth into the stomach, passing a balloon down the tube to the area of stricture, and inflating the balloon to dilate the scar tissue. Usually 1-2 dilations are needed. Surgery is rarely needed to revise the connection.  
 
Be sure to contact your bariatric program when you experience difficulty swallowing foods and/or liquids. It might be a sign that medical attention is needed.